Clinical Edge

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Childbirth Delivery Mode & Pelvic Floor Disorders

JAMA; 2018 Dec 18; Blomquist, Muñoz, et al

The risk of pelvic floor disorders varies by delivery mode after childbirth, with cesarean delivery presenting a lower risk compared to vaginal delivery, a recent study found. In the cohort of 1,528 women, researchers described the incidence of pelvic floor disorders after childbirth and identified maternal and obstetrical characteristics associated with patterns of incidence 1 to 2 decades after delivery. Participants were categorized into the following mode of delivery groups: cesarean birth, spontaneous vaginal birth (≥1 spontaneous vaginal delivery and no operative vaginal deliveries), or operative vaginal birth (≥operative vaginal delivery). Among the findings:

  • Compared with spontaneous vaginal delivery, cesarean delivery was associated with significantly lower hazard for stress urinary incontinence, overactive bladder, and pelvic organ prolapse.
  • Operative vaginal delivery was associated with significantly higher hazard of anal incontinence and pelvic organ prolapse.
  • A larger genital hiatus size was associated with increased risk of pelvic organ prolapse independent of delivery mode.


Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of delivery mode with pelvic floor disorders after childbirth. JAMA. 2018;320(23):2438–2447. doi:10.1001/jama.2018.18315.