The vaginal birth is primarily physiological process Interventions and therefore special clarification are required. It is the medical task of diagnosing risks and, if necessary, suggesting interventions. These must take into account the health well-being of mother and child and weigh up the advantages and disadvantages of an intervention for the health of both. Every intervention requires the informed consent of the women.
In their meta-analysis, Kean and co-authors analyzed the long-term effects of caesarean section with almost 30 million births. From this it can be seen that there was actually less damage to the pelvic floor and less incontinence in the caesarean section, although negative consequences for maternal and child health occurred to far greater extent. Caesarean section was therefore not recommended by the authors to avoid damage to the pelvic floor.
The scientific discussion about the cause of possible pelvic floor damage is not over. Many studies indicate that pregnancy and the presence of risk factors such as obesity, large child, diabetes mellitus, smoking and corresponding personal and family history have stronger influence on the development of later incontinence or pelvic floor damage than the mode of delivery.
If one or more risk factors are present, an internet calculator such as Ur-Choice can be helpful for ing the risk of pelvic floor damage be. From this it can be seen in most cases that the mode of delivery has no significant influence on the development of incontinence.
Vaginal-operative labor termination is of course also an indication that results in risk to maternal or child health. When deciding whether to perform an abdominal surgical procedure (Caesarean section) or vaginally using suction cup or forceps, it depends on the time of the necessary indication.
In summary, all women should be informed about the risk of vaginal birth with regard to possible risk to the pelvic floor does not correspond to the state of science and would only contribute to further uncertainty among women.
Prof. Dr. med. Michael Abou-Dakn , 12101 Berlin