Aufklärung über Schwangerschafts- und geburtsbedingte Veränderungen des weiblichen Beckenbodens aus urogynäkologischer Sicht

Abstract

Consideration of the potentially negative impact of pregnancy and childbirth on the female pelvic floor must be embedded into the broad context of advantages and disadvantages of elective Cesarean section. Other maternal and fetal morbidities must be taken into account and weighed up against each other. In case of an uncomplicated pregnancy and the absence of a risk profile for pelvic floor disorders, elective Cesarean does not represent an eligible alternative to vaginal birth for pelvic floor protection. Therefore, Cesarean does not have to be mentioned in the informed consent discussion in these cases. However, ongoing analyses of risk factors might help health care providers to identify women at a higher risk for pelvic floor disorders. In these cases, the potential negative impact of vaginal birth should be part of a risk-adapted consultation clearly focusing on restoring pelvic floor function after birth back to the antenatal status if possible, which may be more difficult than in women without risk factors. Elective Cesarean should be part of this consultation in these at-risk women, to support them in the sense of shared decision-making. Self-determination and long-term family planning issues are of major importance in this context.