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Debate Article: Childbirth, modes of delivery and pelvic floor dysfunction

Monday 19 Aug 2019 {{NI.ViewCount}} Views {{NI.ViewCount}} Views

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The impact of the mode of birth on the mother and fetus has been a popular topic for a long‐standing debate. Several morbidities have been associated with one mode of delivery or another. When this debate focuses specifically on the effects of vaginal birth or cesarean delivery on pelvic floor function and dysfunction, current research‐based evidence fails to provide clear answers as many contributing and confounding factors, and other limitations inherent to the evidence itself blur the links between causes and outcomes.

Taking a step back, we realise that this area is only one aspect of a number of considerations to be taken when choosing the mode of delivery as an elective choice or in the context of an emergency, where factors, such as suspected fetal distress, obstructed labour or other acute events may eventually dictate the decision on timing and mode of delivery. In addition, the umbrella term “vaginal birth” covers a series of different modes of delivery (forceps, vacuum, spontaneous, vaginal breech, and waterbirth) with different risk profiles with regard to pelvic floor sequelae.

This commentary aims to contribute to the ongoing debate, with viewpoints that may add insights into the decision making processes on a day to day clinical practice, and hopefully add aspects to the wider perspective.

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The aim of the ICS debate series will be to highlight different points of view on contentious topics, steer ideas and directions for future scientific developments and strategically encourage integration between different educational products.

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