Childbirth trauma

Abstract

Pelvic floor disorders are strongly associated with childbirth and are more prevalent in parous women. Pelvic floor trauma commonly occurs at the time of the first vaginal childbirth. Conventionally, childbirth trauma refers to perineal and vaginal trauma following delivery and the focus has been on the perineal body and the anal sphincter complex. However, childbirth trauma may involve different aspects of the pelvic floor. Pelvic floor trauma during vaginal childbirth may involve tissue rupture, compression, and stretching, resulting in nerve, muscle, and connective tissue damage. Some women may be more susceptible to pelvic floor trauma than others due to collagen weakness. Childbirth trauma affects millions of women worldwide. The incidence of perineal trauma is over 91% in nulliparous women and over 70% in multiparous women. A clinical diagnosis of obstetric anal sphincter injury (OASIS) is made in between 1% and 11% of women following vaginal delivery. Increased training and awareness around OASIS is associated with an increase in the reported incidence. Short- and long-term symptoms of childbirth trauma can have a significant effect on daily activities, psychological well-being, sexual function, and overall quality of life.