Urinary and faecal incontinence in later life due to vaginal delivery

[handlemecarefully]

I have read that it is estimated that around 10% of women suffer either urinary or faecal incontinence due to childbirth (sometimes the incontinence does not manifest until middle age or later).

I've previously had a vaginal delivery (terrible - won't bore you with details)and I am now being considered for elective c-section. However after reading the reassuring thread on 2nd vaginal births being easier I am being braver about possibly going through vaginal delivery again.

However does anybody know whether avoiding a 2nd vaginal birth has protective effects on the pelvic floor and is less likely to lead to later life incontinence,.... or is this locking the stable door after the horse has bolted (i.e. has any potential damage already been done through previous ventouse, forceps and episiotomy during first labour)?

Thank you mears, for your calm and kind reply to my rant. I feel much better now.

pupuce, the waters broke the day before and I had a dry birth (professional's expression, not mine, but it certainly felt as if it was scraping the sides).
smokey, ditto, word for word.

I was put under pressure to have an epidural although I didn't want one. The midwife (who was scarcely in the room) said that I was not coping well - don't know why - I wasn't shouting or complaining or anything. I had the epidural which went wrong and had a dural tap - the anaesthetist inserted the needle in the wrong place. It was not a godsend - it was a disaster - I could no longer push and it led to all the intervention and later problems.

The number of MW who can't tolerate other women's pain is frightenly high.... I come across this often where a mother refuses pain relief and the MW pushes her to have some !
Or they're bullied into "You don't need to / stop screaming like that!"

Smokey - epidurals are a godsend if they are inserted correctly and the woman wants it. Again I would never force a woman to have an epidural, it is her choice. I have seen women transformed once the pain of a protracted difficult labour has gone. However, there is the risk of the epidural not working and of a dural tap. In that case, it definately is not a godsend.

Droile - glad you feel better about that. I wouldn't like you to be upset and think I was trivialising your experience. Was a bit worried about you there.

I was told to stop screaming. I also remember coming round between contractions and being surrounded by doctors, one of whom didn't introduce herself but just sat fanning herself looking bored, as she was waiting for a colleague.

'Dry birth' is a very old fashioned term and certainly shouldn't be used by a professional. There certainly will not be as much fluid when the waters break before labour, but it is still continually produced in the womb.

Thanks mears, I'm OK now. I don't often get like that and always regret it when I do..

Droile - glad you feel better.... I can well imagine that yours and Smokey's experiences are very hard to remember positively - thank you for sharing your stories (I for one learn from them )

Found this on dry birth

I think it is good to get things off your chest so to speak. I would love to print out all the childbirth discussions and get midwives and doctors to sit down and read them. Like Pupuce I would like to thank everyone who shares their birth experiences because I really believe it makes us better carers. I am never ceased to be amazed at some of the experiences women have gone through.

Anyway, coming back to the original topic, I do not believe it was the pregnancy that caused my prolapse but the delivery. In fact when I was in labour the obstetrician asked if I rode horses as she said my perineum was so firm.

Even after the repair operation and the cs to avoid further damage, I am not as I used to be.

Just want to add my thanks to Mears' - not as a professional of course but as someone approaching this for the first time. This thread has made it much clearer to me that induction is not something to be taken lightly.

I don't have time to read all of thread as have to leave for the day but can I ask a question - I had Vontuse and Forceps (obviously was cut for this) and epidural and had my waters broken by MW... cut a long story short had traumatic delivery and a very unhappy consultant shouting at all the midwives in my room (about 1 dozen by this point) anyway... am I likely candidate for incontinence - should I look into it?? must admit things haven't been quite the same down there since.

yup jus because of the 24hr rule. waters broke at 9am, went to hospital, they wanted to keep me in overnight, i refused, promise to behve and be back at 7am the next day for induction. i was already dilating when i went back tho could feel no contrations, but they induced me anyway. bloody awful. with dd2, i work up with contactions got to hospital within 30mins and was already 6cm.

didnt have any inections or anything with dd1, all tests/swabs were clear, she was bang on date so i really think she would've arrived eventually perfectly fine and healthy without induction.

Isn't the evidence that in the vast majority of cases in the long term there is no statistical difference between incontinence between women who have vaginal or c/s birth - but surely there must be a difference when women have endured what Droile and Smokey have? In the third world incontinence (I mean dripping urine constantly) is a not uncommon outcome of difficult births. Those problems nearly always respond to surgical repair but some clearly don't.
I'm not going to say 'have a cs' but surely it's true that if you are pretty ravaged by a previous vaginal birth, then another can't possibly help, surely?

yes aloha, there are some pretty shocking stories of obstructed births in the third world resulting in fistulas and awful disability, being outcast,etc. I've been tempted to support those charities when the leaflets drop through the letterbox, as feel that there, but for the grace of God, go I.

When I worked at VSO, some of the reports from midwives on what women had gone through - and what they still endured - made my hair stand on end. Really knocks on the head all that sentimental stuff about 'traditional cultures' where childbirth is just one of the many happy events in a lady's day.

Made me think very differently about contraceptives like Depo-Provera as well, btw; sure, they were being marketed, but women were also making a choice out of the crappy available options (as we all do, come to that). As one midwife told me, 'I've seen a lot of women die in childbirth, and none die of Depo'.

Obstructed labour in the third world can mean a woman in the second stage for over a day whilst being taken to a medical facility. This is what leads to fistulas etc. Also there are many culural traditions in third world countries that interfere with the natural process of labour which are worse than the interventions we have here. Using rolled up ropes wrapped round the abdomen to force the baby down is one. Western women's main problem is that they are lax at doing pelvic floor exercises post delivery and continuing to do them for the rest of her life on a daily basis. Hands up all those who don't bother

Well, I am trying now you've mentioned it Mears

Another cause of fistulas is arrogant obstetricians who are crap at sewing.

Another cause of fistulas is arrogant obstetricians who are crap at sewing.

aaagh

I've always done them, even before I had children. I've always had a strong pelvic floor, luckily, otherwise I'd be in an even worse position now.

Speaking as someone who had Urinary Incontinence (note capital letters). It doesn't end 'life as we know it' - not pleasant admittedly, but I had an small op this July (keyhole) and it has been completely sorted ....so there is life after childbirth!!
However I'm not sure I would swap voluntary major surgery for the op I've just had.