Advertisement

International Urogynecology Journal

, Volume 17, Issue 1, pp 22–26 | Cite as

Patients’ knowledge of potential pelvic floor changes associated with pregnancy and delivery

  • Mary T. McLennanEmail author
  • Clifford F. Melick
  • Beverly Alten
  • Jacqueline Young
  • Melanie R. Hoehn
Original Article

Abstract

Physicians cite pelvic floor injury as a major reason for Cesarean section as their personal preferred delivery mode. This study was undertaken to determine whether patients receive information about possible pelvic floor complications of pregnancy/delivery. Day 1 post-partum women completed a 52-item questionnaire assessing information given during routine antenatal care. Pelvic floor and general questions were intermixed. Of the 232 patients, the mean age was 26.9 years, with 59.5% white, 32.8% African-American and 7.7% other. Most (84.5%) had at least grade 12 education. The following percentage of patients reported receiving no information about: Kegel exercises 46.1%; episiotomy 51.3%; urinary incontinence 46.6%; fecal incontinence 80.6%; change in vaginal caliber 72.8%; neuropathy 84.9%. Counseling on all of these issues occurred significantly less frequently than education on general pregnancy topics. Our results suggest that knowledge and instruction of pelvic floor risks is very much lacking and provide us with an impetus to develop educational tools.

Keywords

Pelvic floor risks Pregnancy Knowledge 

References

  1. 1.
    Al-Mufti R, McCarthy A, Fisk NM (1997) Survey of obstetricians’ personal preferences and discretionary practice. Eur J Obstet Gynecol Reprod Biol 73:1–4PubMedGoogle Scholar
  2. 2.
    Land R, Parry E, Rane A, Wilson D (2001) Personal preferences of obstetricians towards childbirth. Aust N Z J Obstet Gynaecol 41:249–252PubMedGoogle Scholar
  3. 3.
    Nygaard I, Cruikshank DP (2003) Should all women be offered elective cesarean delivery? Obstet Gynecol 102:217–219PubMedGoogle Scholar
  4. 4.
    Meyer JH Jr (2003) Informed consent, informed refusal, and informed choices. Am J Obstet Gynecol 189:319–326PubMedGoogle Scholar
  5. 5.
    Stapleton H, Kirkham M, Thomas G (2002) Qualitative study of evidence based leaflets in maternity care. BMJ 324:639–643PubMedGoogle Scholar
  6. 6.
    Quinlivan JA, Petersen RW, Nichols CN (1999) Patient preference the leading indication for elective caesarean section in public patients – results of a 2-year prospective audit in a teaching hospital. Aust NZ Obstet Gynaecol 39:207–214Google Scholar
  7. 7.
    Lau TK, Wong SH, Li CY (1996) A study of patients’ acceptance towards vaginal birth after caesarean section. Aust NZ Obstet Gynaecol 36:155–158Google Scholar
  8. 8.
    Saisto T, Salmela-Aro K, Nurmi JE, Kononen T, Halmesmaki E (2001) A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol 98:820–826PubMedGoogle Scholar
  9. 9.
    Green JM, Coupland VA, Kitzinger JV (1998) Great expectations; a prospective study of women’s expectations and experiences of childbirth. Cheshire, England: Books for midwives Practice 114–115Google Scholar
  10. 10.
    Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348:900–907PubMedGoogle Scholar
  11. 11.
    Wilson PD, Herbison RM, Herbison GP (1996) Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG 103:154–161Google Scholar
  12. 12.
    Farrell SA, Allen VM, Baskett TF (2001) Anal incontinence in primiparas. J Soc Obstet Gynaecol Can 23:321–326Google Scholar
  13. 13.
    Fynes M, Donnelly VS, O’Connell PR, O’Herlihy C (1998) Cesarean delivery and anal sphincter injury. Obstet Gynecol 92:496–500PubMedGoogle Scholar
  14. 14.
    Snooks SJ, Henry MM, Swash M (1985) Fecal incontinence due to external anal sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature; a double pathology. Br J Obstet Gynaecol 92:824–828PubMedGoogle Scholar
  15. 15.
    Eason E, Labrecque M, Marcoux S, Mondor M (2002) Anal incontinence after childbirth. CMAJ 166:326–330PubMedGoogle Scholar
  16. 16.
    Sultan AH, Kamm MA, Hudson CN, Chir M, Thomas JM, Bartram CI (1993) Anal-sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911PubMedGoogle Scholar
  17. 17.
    Need JA (1987) Is “the trial of forceps”over? Med J Aust 146:613PubMedGoogle Scholar
  18. 18.
    Farrell SA (2002) Cesarean section versus forceps-assisted vaginal birth: It’s time to include pelvic injury in the risk-benefit equation. CMAJ 166:337–338PubMedGoogle Scholar
  19. 19.
    Faden RR, Becker C, Lewis C, Freeman J, Faden AI (1981) Disclosure of information to patients in medical care. Med Care 19:718–733PubMedGoogle Scholar

Copyright information

© International Urogynecology Journal 2005

Authors and Affiliations

  • Mary T. McLennan
    • 1
    Email author
  • Clifford F. Melick
    • 1
  • Beverly Alten
    • 1
  • Jacqueline Young
    • 1
  • Melanie R. Hoehn
    • 1
  1. 1.St. Louis University Department of Obstetrics, Gynecology and Women’s Health, Division of Urogynecology, St. Mary’s HospitalSt. Louis University School of MedicineSt. LouisUSA

Personalised recommendations