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Protecting Your Pelvic Floor

How Much Do You Know About This Part of Your Anatomy?

By Jacqueline Rupp

) have repeatedly concluded that liberal use offers no benefit and increases risk for harm."

6. False. "Cesareans appear to make no difference whatsoever regarding later-life pelvic floor problems," says Dr. Sakala. "However, this major surgical procedure is associated with worse outcomes in many other respects, and it's important to include this information in the discussion." With C-sections, there is an increased risk for infection, accidental surgical cuts, blood clots, rehospitalization and more intense and prolonged pain. In addition, there are long-term risks such as scarring and adhesions, chronic pelvic pain and bowel blockage.

7. d. Continuous electronic monitoring is used with an epidural because there is a greater likelihood of problems occurring to the baby once the epidural is performed. The monitoring indirectly increases the risk of pelvic floor damage because it increases the chances for interventions such as vacuum extractions and episiotomies. The monitor also does not allow for position change during labor and delivery.

"Assisted delivery is almost always accompanied by an episiotomy," says Dr. Sakala. But for most vaginal deliveries, neither is medically necessary. It is best to find out the reasons why an intervention is being suggested. If the reason is not an emergency, giving labor more time to progress can help to avoid the use of these procedures. Epidurals often make it harder for women to experience their baby descending and harder to push effectively. They can make it harder to get into safer and more effective pushing positions."

8. False. "Even many of the situations that are believed to be good reasons for cutting an episiotomy have been debunked with research," says Dr. Sakala. Being a first-time mother, large babies or a danger of tearing are no longer acceptable reasons to choose an episiotomy. "Some practitioners have very low rates (0 to 2 percent). Our national 'Listening to Mothers' survey found that 35 percent of women with a vaginal birth had had an episiotomy. Fortunately, there is a trend of declining use of this intervention." Some problems that have been linked with episiotomy include anal muscle injury, which can lead to leaking gas, a sense of urgency about elimination or even bowel incontinence.

Want to see more?

• Birth Positions: How the Right Position Can Prevent an Episiotomy
• Powerful Pushing: New Method Promises Safer, More Efficient Delivery
• Pregnancy Nutrition From A to Z: A Comprehensive List of Nutrition Issues for Moms-to-be
• The Grand Tour: A Quick Trip Through the Labor and Delivery Room
• Pelvic Power: The Benefits of Kegel Exercises for Pregnancy and the Rest of Your Life
• Talk about it!