# Information on long-term ill effects of vaginal birth?



## thedoorchick (Nov 23, 2004)

Hello. This is actually my first post, but I have lurked for some time. We do not have children yet but will be TTC very soon.

I have come upon a question that I could not find an answer to online or anywhere else, and was hoping someone else had seen info on it.

I know someone who is having a scheduled C-section for the child (her first) that she's now carrying. She always talked as if she was leaning that way, but was convinced at one point to at least give vaginal birth some consideration.

Recently, she stated that her OB had given her some information that had just recently been discovered about how women who birth vaginally have problems later in life (in their 60's and beyond) with their uterus and other organs "falling out" because of the "damage" that was done by the vaginal birth. I simply could not believe it, and she was not able to provide any source for the info other than that it was what her OB told her.

That also, by the way, neatly ties up the issue of how unnecessary C-sections place a burden on health care costs nationwide. Supposedly it is cheaper long-term to have a C-section because these issues caused by vaginal birth will cost insurance companies much more money to fix later in life.

If she chooses to have a C-section, that is of course her decision, and none of my business. But, if this information is flat out wrong (and I strongly believe it is, though I can't find proof anywhere), then it irks me that she's using that as her "reason." I worry that someone else might rely on it as facts when evaluating their own decision.

TIA to anyone who can help!


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## QDB (Aug 14, 2003)

I am not sure if this is what was meant but I think if you are not diligent about kegels then surgery can be required. I am talking about things I know little about, admittedly, but I do know that my grandmother had to have surgery a year ago because her bladder had fallen - the only explanation I could get out of her!

I am still trying to really visualize a fallen bladder!

I think it has to do with pregnancy maybe? I seriously doubt it has anything to do with vaginal birth -

Anyone more informed care to chime in? :LOL


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## Greaseball (Feb 1, 2002)

Most likely it has to do with managed vaginal birth, which includes forceps/vacuum deliveries and episiotomies. Cutting into the vagina is bad for it!

But I hear a lot of doctors are pushing for c-secs for 1st time moms...and a lot of moms think it will be easier and safer.


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## schatz (May 6, 2003)

well.... my grandmother who vaginally delivered 8 kids (2 were twins) had to have surgery a number of years back for something like the OB mentioned. I think it had more to do with the bladder than the uterus. I think things just got all stretched out and dropped as she aged. Actually, as I type this, I think it had more to do with incontinence in her bladder related to having so many kids. A lot of women leak urine (my mom included who only had two kids) as they age.

That's all the info I have on this -- it certainly wouldn't make me run out and have a c-section.


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## NightOwl (Sep 12, 2004)

I'm no expert or anything, but I have a great grandaunt who had her uterus fall. She said that it was falling down out of her vagina and she had to have a hysterectomy because of it. And then she was supposed to insert something into her vagina every night to keep it from closing up. But she said that was too much of a hassle and she let it close up. Apparently the doctor told her that it was because of vaginal birth that it had happened. She said she had a complately natural birth with her only child. That's all I know about that.

But I also know that my mother, who had c sections with both children, gets infections in her uterus a lot. And my grandmother had a c section with her 2nd and there were many complications to where she couldn't have more children and had to have a hysterectomy before menopause.

So...the way I see it...it depends on your body. This may seem silly/strange...but it reminds me of my cats. I have one cat who had 15 kittens and they were all healthy and fine and she is living to a ripe old age with no problems. But I know another cat who had 5 kittens, some were stillborn, and now she has health problems. I think when it comes to birth it just depends on your body, your genes, etc.


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## crazy_eights (Nov 22, 2001)

There have been numerous studies that have shown that c/sec does not prevent prolapse in old age. The most well known is one conducted amongst elderly nuns that had never given birth and it was found that they had prolapses at approximately the same rate as women that had given birth vaginally. Also, vacuum and forceps extractions correlate more highly with prolapse and women of a certain generation routinely had forceps deliveries (it was an obstetric fad in the '40's and '50's). So the current research saying 'elective c/sec to prevent prolapse' is rather disingenuous. They are comparing apples and oranges!


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## pamamidwife (May 7, 2003)

I wouldn't say vaginal birth is to blame.

Why on earth would we be designed to birth vaginally, only to have it ruin our bodies?

Here is my list of problems that have contributed to uterine prolapse, bladder prolapse and urinary incontience:

*Forced pushing, usually on the back
*Deep episiotomies
*Forceps
*Sedentary lifestyles
*Obesity
*Continuing hormone medications - The Pill and Hormone Replacement Therapy
*Poor nutrition
*Dehydration

So, while it can be really simple to blame it on vaginal birth alone, there's a host of other issues that go along with it.

In my eyes, cesarean has much more risk to the mother. Sure her vagina may be unstretched, but the risk of losing your uterus during the surgery is greater.


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## Quirky (Jun 18, 2002)

Also, just as pregnancy itself does a number on your breasts, so that even if you don't breastfeed they will still be forever changed, pregnancy itself can do a number on your bladder and uterus. Cutting the baby out is not necessarily going to change that. Genetics have a big part to play, too.

But even if it were true that c-sections lowered the risk for later prolapse, etc., I would still go for a vaginal birth every time. It's not only better for baby, but the risks of c-sections are very serious for women, and include effects of anesthesia, infection, hemorrhage, and death, and also more than double the risk of future stillbirths.

Especially in this day and age, if she allows her first to be a section that's probably what she'll end up with for all future babies - increasing the odds that something bad will happen because of the repeated surgeries.


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## USAmma (Nov 29, 2001)

I would rather have the risk of vaginal damage, than have someone cut into my abominal muscles unless it was an emergency situation. I have had two vaginal births and the only thing I have to show for it is an extra skin tag down there. I've had a weak bladder long before I had kids and giving birth never made it any weaker.

Darshani


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## philomom (Sep 12, 2004)

I'm no expert, but I'm sure that cutting through several layers of my body would cause more injury than pushing a baby out of my vagina. After all, that's what it was meant to do!


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## paquerette (Oct 16, 2004)

I don't think it specifically addresses prolapses/later complications, but you might want to get your friend a copy of Henci Goer's "Thinking Woman's Guide to a Better Birth" (or buy it for yourself and loan it to her, you'll want it later







). It gives a ton of reasons why vaginal birth is preferable to C-section, and also warns about the dangers of other routine interventions.


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## liawbh (Sep 29, 2004)

I don't have the source, but I heard that prolapse is actually more common in the US and recently than in the past and in other cultures.
The pressure to get up and about and the isolation make prolapse more likely in later years. Women who can spend more time recovering, or who have family/friends caring for them in the pp stage have lower rates of prolapse.


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## greenluv (Jul 26, 2002)

You might ask your friend if she's ever seen the clamp they use during a c/s birth to hold the bladder out of the way. Yeah, it's an unattractive instrument.

I am convinced that my 4 c/s births have had way more impact on my bladder than just being pregnant ever did.







:


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## fiikske (Jun 29, 2004)

Hi,

I'm from Belgium, and there, c-sections are not seen as the solution to that problem. Yet, what every doctor will insist on is to exercise all the muscles that keep the tissues in place back down there. I don't know what the english name is for those muscles. These muscles are completely stretched during pregnancy (by supporting the weight of the baby and everything) but also during vaginal birth. A couple of days after giving birth, the midwife will tell you to start doing exercises whichi would feel like "holding your pee" or alike. Doing such exercises and similar ones apparently keeps exercising those muscles, hence, avoid the symptom that some day they're not able to hold the organs at their supposed place anymore.

I think what I'm writing is a bit confusing ;-) But that is because I don't know the exact terminology.

Regards,
Fiikske


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## elvispupy (May 21, 2004)

There is a booklet from the Maternity Center Association and endorsed by several other maternal health organizations called What Every Pregnant Woman Needs To Know About Cesarean Section . It includes info about pelvic floor damage and how c/s doesn't protect you from it. It also compares all the risks of vaginal birth v.s c/s. It is a wonderful resource and every pregnant woman should read it. It is available as a free PDF download at the link above, or you can purchase a printed copy for $4 from ICAN or MCA.


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## TurboClaudia (Nov 18, 2003)

I'm not an expert on pelvic health, but I have learned more than a few things over the past few years about this topic.

The pelvic floor is the fancy name for the network of muscles and connective tissues that support the organs of the pelvis (contained within the bones of the hips). This includes the vagina, the uterus, the ovaries, the urinary bladder and the rectum.

"Falling" or bulging of the bladder, uterus or rectum into the vagina, or in some extreme cases, all the way through the vagina and to the outside of the body, is called prolapse.

Kegel exercises work the pubococcygeal muscles (the one that you relax when you need to pee) and associated muscles and help to strengthen the floor. Practicing proper posture also helps to strengthen the pelvic floor.

I agree with most of what everyone else posted regarding the risks of vaginal birth being lesser than the risks of cesarean birth.

I am still looking for documentation about the nun study but have been unsuccessful in locating any.

There is a new book out about pelvic floor health written by an obstetrician that I glanced at, and it is definitely written from the viewpoint that birthing vaginally or by cesarean is a woman's choice and she should take into account her future pelvic health when making this decision.

There is also a great field of physical therapy specializing in pelvic floor rehabilitation that every woman should know about. It has been around for a while but has been gaining reknown in the past few years.

warmly,
claudia


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *TurboClaudia*
I am still looking for documentation about the nun study but have been unsuccessful in locating any.

Here you go: Buchsbaum GM, et al. Prevalence of urinary incontinence and associated risk factors in a cohort of nuns. Obstet Gynecol 2002; 100( 2):226-9.

And an excerpt: A recent survey of 149 postmenopausal, nulliparous [never given birth] nuns (mean age, 68 years) revealed that 50% reported urinary incontinence, and 29.7% of these described stress urinary incontinence.


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## Peppamint (Oct 19, 2002)

This is a great thread! What great info!


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## nmccarroll (Oct 17, 2004)

Quote:


Originally Posted by *Mom2six*
The most well known is one conducted amongst elderly nuns that had never given birth and it was found that they had prolapses at approximately the same rate as women that had given birth vaginally.

The only person in my extended family who's had surgery to correct a problem supposedly associated with vaginal childbirth/avoided by cesarean birth is a first cousin twice removed (i.e. my grandmother's cousin) who had a hysterectomy at age 76 for a prolapsed uterus. She is a nun...

Nikki


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## thedoorchick (Nov 23, 2004)

Thank you so much for all the responses! This is so very helpful.

Unfortunately, I don't see any way my friend will change her mind about the C-section, and if I loaned her my copy of Thinking Woman's Guide, it would probably end up in the trash.









I mainly just wanted to have some details to be able to rebut that argument if it comes up again. Again, not that her prenatal health is my business, but I don't want her convincing other woman that a C-section is safer.


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## tinyshoes (Mar 6, 2002)

Right on, Turbo.

Great info, mamas.

Love it, pamamidwife.

My mother had 3 babies vaginally, and chose to have a hysterectomy because of both her bladder and rectum prolapsing into her vagina. (The bladder and rectum are the front and back sides of every woman's vagina, and so those 'walls' would just be sagging inwards in a prolapse situation.)

After my second child was born, I noticed less tone in my pelvic floor and worried I would share her fate.....after visiting a physical therapist who specializes in pelvic floor issues, it was determined that a whole host of muscular factors were contribuiting to my slacky neitherregions, and now that I engage my ab muscles, my glutes, inner and outer thighs, and hamstrings, my pelvic floor is strong (because it's not doing the work of holding up my skeleton anymore!) and my bladder isn't saggy.

Now it's clear to me that my thin but out-of-shape mother needed to tone her butt, do some exercise, stand up straight. Instead, an OB/GYN advised the radical surgical option--the popular option.

Women's bodies are just failures, right? SURE, they can make a baby......but it's best to CUT the baby out, because letting the baby come naturally will just unravel the woman. And if there's any funny stuff with a mother's uterus, well, CUT that out, too. What is this mass hysteria, ha ha ha......







:

NEXT part of my soapbox:

Gotta quote Shelia Kitzinger as she discusses 20th century OBs such as Dr. Joseph DeLee, inventor of the Prophylactic Forceps Delivery (to prevent prolapse) in her book, Rediscovering Birth:

Quote:

Why should we concider it other than reckless to allow the child's head to be used as a battering ram wherewith to shatter a resisting outlet? Why not open the gates and close them after the procession has passed?
And so it is now, with OB/GYNs recommending a c-sec to prevent prolapse.

(By the way, many of the women my pelvic floor physical therapist saw had c-secs. Pregnancy can do a number on a woman's body--her posture, her muscle use, her abs, all that weight on the pelvis...these things, not squeezing out a baby, can contribute to problems.)


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## tweedybird (Nov 19, 2004)

I'm really glad I found this thread, all the information was great! I've been very conflicted about this issue, I plan on getting pregnant for the first time soon.
My mother had a vaginal birth with me (her first) and need a c-section with my brother because he was in the wrong position. She is now 53 and last year she had an operation because her bladder had fallen. She told me that operation was the worst thing she ever had to go through, the recovery is horrible and took way too long. She said recovering from a c-section is nothing compared and if having one means I won't have the bladder problem later I should go for it. That added to my fear of vaginal births and I'm seriously considering having a scheduled c-section, although to tell you the truth I heard it's not so easy to find a doctor who will agree to that. Thedoorchick, if you're friend is from NY, any chance I can have her doctor's name, just in case?
Has anyone her had a vaginal a a c/s? any advise?
I was just reading on the c/s support thread all the stories about the women who realy wanted a vaginal birth and couldn't have it and I feel really guilty about choosing a c/s.


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## bravofrenchie (Oct 15, 2004)

This is from http://www.mwsexual.com/readingroom/...-exercises.htm

"-Go to the bathroom and sit on the toilet. In the middle of your stream of urine, stop and start the stream several times. The muscles you use to do this are your PC muscles. At first, you may find that you are also squeezing your anal muscles; as you become experienced with kegel exercises, try to separate out the muscle groups that you are able to exercise by squeezing.

-Now that you have located your PC muscles, you can exercise them while your bladder is completely empty. First, try squeezing your PC muscles as hard as you can for a count of three seconds. Then let them relax. To begin with, see how many times you can do this before the muscles feel tired.

-Now figure out a suitable exercise routine just as you would if you were trying to tone and strengthen a different muscle group by going to the gym every other day. For example, suppose you start by being able to do only five strong squeezes; try doing three sets of five once or twice a day for a week, and then try increasing this to three sets of eight strong squeezes.

-If you work up to three sets of thirty or more strong squeezes, you are probably healthy enough for most purposes, and need only to maintain this level of fitness by doing these three sets four times a week (instead of once or twice a day).

-Experiment by varying the type and timing of the PC squeezing you do as you train these muscles: slow clenches, many quick flutters, and so on. This will make you more familiar with these muscles notice also when your abdominal muscles or your anal muscles feel like they also want to join in the exercise."

I've also found that there are two sets of muscles in the vagina, and with more exercices, I can now flex each set by itself, both together, or each in turn. Makes things interesting for your DP. I've also seen devices for sale to help with the exercises, seeing how long you can hold it inside, ect. Not sure if they're really necessary, but again, they may make things interesting.


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## Kelly71 (Nov 19, 2001)

Quote:


Originally Posted by *philomom*
I'm no expert, but I'm sure that cutting through several layers of my body would cause more injury than pushing a baby out of my vagina. After all, that's what it was meant to do!


Quote:


Originally Posted by *pamamidwife*
Why on earth would we be designed to birth vaginally, only to have it ruin our bodies?


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## its_our_family (Sep 8, 2002)

This is a great thread!

Just a note... my mom had 2 vag deliveries both were rather speedy. Her gyn told her that she "blew out her cervix". She has the beginnings of a prolapsed uterus. I was talking to her about it and she had never eve heard of kegels









I've had 2c/bs and I haven't even started to think about the problems I wll have in the future


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## tinyshoes (Mar 6, 2002)

Nice, bravofrenchie.

* * *

y'know, every time I read the title for this thread:

Information on long-term ill effects of vaginal birth?

I want to yell out these thread suggestions:

Information on long-term ill effects of USING MY KNEES WHEN I WALK?

and

Allowing my eyes to function as designed?

Because as we use our bodies, and age, our body parts change. It's not neccessarily a defect or a problem. Sure, marathon runners can damage their knees, injury can cause problems, and by the time we're all 80 or 90, our knees might work differently than when we were 20, but this is not an inherent flaw for which people should be seeking out electric wheelchairs (like seeking a c-section to 'protect' against prolapse.)

(And tweedybird, if you are worried about bladder injury and childbirth, a prominant risk factor for c-sections is damage to the bladder, as the bladder is affected by invasive abdominal surgery. There's a thread in the Birth Stories area of mdc where a fellow mdc mama shares the heartbreak of damage done to her bladder during a c-sec. It would be important to evaulate all areas of risk for vaginal and c-sec birthing if you're especially worried bladder issues.)


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## darsmama (Jul 23, 2004)

My grandmother had 10 kids, 13 pregnancies, 1 set of twins.

She said her insides were all falling out from so many kids and pregnancies. All were vaginal.

I really, really, hate hearing how kegals are a cure for everything. I do kegals everyday and still should wear heavy pads because I have such a weak bladder. I always have, but it is worse since Darlene's been born.


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## its_our_family (Sep 8, 2002)

I don't think kegels cure everything. But I think they help.

I've gone through 2 pgs, even though never delivered vag, and don't have bladder problems. But it could be a number of things. I think the kegels make me feel I've done something to help though.


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## Peppamint (Oct 19, 2002)

Quote:


Originally Posted by *its_our_family*
This is a great thread!

Just a note... my mom had 2 vag deliveries both were rather speedy. Her gyn told her that she "blew out her cervix". She has the beginnings of a prolapsed uterus. I was talking to her about it and she had never eve heard of kegels









I've had 2c/bs and I haven't even started to think about the problems I wll have in the future









A friend of mine's 2nd baby came down so fast that she had hemorroids and tore (pushed in lithomy/semi sitting position)... within two years she needed surgery for her bladder.

It must be a combination of genetics and being predisposed to prolapse and then the way your body is treated. I'm sure for some moms, a c/s may have caused less damage than forceps, a 4th degree tear, hemorroids etc etc. But I personally choose to go the natural route.


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## tinyshoes (Mar 6, 2002)

Quote:


Originally Posted by *darsmama*
My grandmother had 10 kids, 13 pregnancies, 1 set of twins.

She said her insides were all falling out from so many kids and pregnancies. All were vaginal.

I really, really, hate hearing how kegals are a cure for everything. I do kegals everyday and still should wear heavy pads because I have such a weak bladder. I always have, but it is worse since Darlene's been born.

I understand!

Kegels will strenghten pelvic floor muscles and increase vaginal tone.

For many women, this will arrest the desent of the uterus or bladder & rectum. BUT not for all, which is why kegels don't cure all prolaspes.

There are all sorts of things that can cause a prolasp-y feeling in a woman--I think it's valuable for a worried woman to make an appointment with a pelvic floor rehab specialist, who has an understanding of the muscles of the pelvic area, the physics involved with day-to-day living, lifting, peeing, baby-birthing, etc.

There are lots of informative threads about this here at mdc....I've searched for a few, and I just noticed...we've already been on threads together discussing this topic! LOL

Every vagina that births a baby won't have prolapsing problems, just like every butt pooping won't develop hemmoroids. But yikes--see a specialist, someone in the know, if things get wacky!

Busybusymama, did you know this?
Studies I've read at Medscape (and other places) that compare the effects of vaginal vs. cesarian births for women and their pelvic strength & damage always assume the data you pointed out:

Quote:

c/s may have caused less damage than forceps, a 4th degree tear, hemorroids etc etc.
Kind of an unfair comparison made by the OB/GYN crowd: well, a c-sec is less damaging to a vagina, what with the lack of episiotomy and forceps!







(one article on the topic I've bookmarked so it's handy is this one: Vaginal Delivery Affects Pelvic Organ Support)


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## thepeach80 (Mar 16, 2004)

I just gave birth via VBAC to my 2nd son! It was wonderful compared to what I went through w/ my first delivery. I did tear quite badly b/c they had to get him out fast and I still feel better this time. I've also had no problems w/ my bladder this time as compared to my c/s. After my c/s I couldn't feel the urge to pee and every time I got up, I wet myself b/c it seemed I just couldn't hold it in (this happened for a good 48 hours and then I just leaked a little after that for a while). Except for the first time I went pee this time (I couldn't feel the urge and couldn't go) I've felt every urge to pee and I haven't even leaked urine, let alone gone all over myself. I know this is all short term, but I definitely don't see c/s as the answer.


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## Peppamint (Oct 19, 2002)

Quote:


Originally Posted by *tinyshoes*
Kind of an unfair comparison made by the OB/GYN crowd: well, a c-sec is less damaging to a vagina, what with the lack of episiotomy and forceps!







(one article on the topic I've bookmarked so it's handy is this one: Vaginal Delivery Affects Pelvic Organ Support)

No kidding. Heaven forbid they put away their scissors and forceps and encourage moms to assume what pushing position is most effective or spontaneous.


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## mamaley (Mar 18, 2002)

Quote:

I want to yell out these thread suggestions: Information on long-term ill effects of USING MY KNEES WHEN I WALK? Allowing my eyes to function as designed?
tinyshoes, you rock!


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