Incontinence, painful sex common after giving birth

NEW YORK (Reuters Health) - A year after giving birth, many women are plagued by urinary incontinence, pain during sex, and other problems, UK researchers report.

Eighty-seven percent of mothers who responded to a survey complained of at least one health problem. Problems were particularly common among women who had delivered with the assistance of forceps.

Women rarely seek help for after-birth health problems, Dr. Amanda Williams of the University of Birmingham and colleagues note, so doctors, nurses and midwives should address these issues proactively with their patients.

Little information is available on whether problems relating to the perineum -- the area between the rectum and vulva -- persist long after childbirth, so Williams and her team surveyed 2,100 women who delivered infants and then contacted them again 12 months later. A total of 482 women responded to the second survey.

Urinary incontinence was the most common problem reported, with roughly 54 percent reporting stress incontinence (the inability to hold urine when sneezing, lifting or experiencing some other type of stress); 37 percent having urge incontinence, meaning they had difficulty holding urine when experiencing the urge to urinate; and 33 percent reporting that they leaked urine on a continual basis.

Sexual problems were also frequent, with about 54 percent of women reporting at least one, for example decreased libido or satisfaction with sex, and 30 percent reporting vaginal pain during sex.

Women who had forceps births were more likely to have urinary incontinence than those who had C-sections or non-instrumental births, and also started having sex later after delivery. However, delivery with the help of a ventouse -- a vacuum-like device sometimes used to assist in childbirth -- was not linked to increased risk of any type of perineal problem.

Women who had delivered vaginally had a higher prevalence of perineal problems than those who delivered via C-section, the researchers found. But C-sections were not completely protective against such problems; about 28 percent of women who had delivered surgically reported having developed at least one perineal problem afterwards.

The researchers call for more research into long-term outcomes with various types of deliveries, and urge that the forceps be used only when ventouse delivery is not possible.

SOURCE: Journal of Clinical Nursing, March 2007.