An increase among women electing to have caesarean sections in recent years has been due in large part to a concern that giving birth vaginally will lead to a prolapse bladder// and uterus in later life, and the issue has been hotly debated in the medical community.

New research from the University of Michigan Health System establishes one of the strongest connections yet discovered between muscle damage that can occur during vaginal deliveries and pelvic organ prolapse, a condition that causes the uterus, bladder or bowel to fall down later in a woman’s life. This is a very common problem and requires surgery in more than 200,000 women each year. Rates were particularly high when forceps had been used to assist the delivery.

Even so, the researchers caution against using these findings as support for more elective C-sections because that would result in numerous women having an operation they do not need. Rather, they say, the study results should be used to help determine how to prevent these injuries in the first place.

The study – appearing in the February issue of the journal Obstetrics & Gynecology – found major defects of the levator ani, an important muscle that supports the bladder and uterus, among 55 percent of women with prolapse and just 16 percent of women who don’t have prolapse.

'Our findings are an important step forward in the search to identify what causes pelvic organ prolapse and subsequent difficulties with other problems, such as incontinence,' says lead author John O. L. DeLancey, M.D., the Norman F. Miller Professor of Obstetrics and Gynecology at the U-M Medical School and director of pelvic floor research.

'The next step is for researchers to look at ways of preventing and treating these injuries of the levator ani muscle in order to reduce the rate of pelvic organ prolapse later in life,' he says.

Pelvic organ prolapse can mean the falling of the bladder, uterus, vag
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