For many women, pregnancy, as well as labor and delivery, represent the key physiological events predisposing them to urinary incontinence and associated pelvic floor dysfunction. Our knowledge of obstetrical pelvic floor injuries, and their connection to incontinence and pelvic floor disorders thereafter, has vastly increased in recent years. Primary care clinicians and those working with women through the perinatal care period should be aware of the potential effects of pregnancy and childbirth on the pelvic floor as well how to promote optimal pelvic health.
Professional associations are concerned about the increase of intervention during childbirth, as it introduces unnecessary risks for mother and baby. According to a review of the evidence, social and cultural changes have fostered an insecurity in women regarding their ability to give birth without technological intervention. Further, the publication of numerous clinical practice guidelines in the last few years actually confer the notion that a physiologic birth protects the pelvic floor. Other aspects of upstream care for the pelvic floor in the perinatal care period have been been also substantiated and corroborated in recent years. This presentation will review that evidence-base related to the promotion of optimal pelvic health through the perinatal care period.
Learning Objectives:
1) Describe perinatal-related factors that contribute to urinary incontinence
2) Discuss aspects of care that require further exploration to promote pelvic health through the perinatal care period
3) Apply recent best-practice guidelines to address identified contributing factors
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