Reply to Focus on Infants During Childbirth Leaves US Moms in Danger

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Reply to "Focus on Infants During Childbirth Leaves US Moms in Danger"

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]
Right, show me the well designed clinical trial showing that better POSTURE will reduce maternal mortality.

Also the second stage of labor is the stage you push, so that's where pelvic injury would happen. And obviously there can still be damage in a short labor. If you really want to avoid it, get a c section. [/quote]
NP here.  I actually thought it was pretty well-established that many pelvic floor issues are the result of pregnancy itself, not L&D.  Given that sometimes people who have c-sections get them, there has to be ways other than vaginal delivery that cause it.  FWIW, I'm 10 mos PP with my second, pushed 3+ hours with both kids, and I do not leak pee. [/quote]
Yes, some weakening is caused by pregnancy alone. But there is a lot of research on pelvic damage caused specifically by vaginal delivery. Some research shows that muscle damage is as much as 80%, although that doesn't mean 80% will have a prolapse. None of this is to say that everyone should get a c section (I guess that's what the troll thinks I am saying). But the point is that avoiding serious pelvic injury and informed consent should be a goal of maternity care that cares about women. So for instance a woman would be properly advised about the risks of prolonged pushing, forceps, vacuum, and [b]everyone would get assessed for pelvic rehab after birth. [/b][/quote]
Thanks for this.  I think the bolded above would be a great, concrete change that should be made to PP care.  Right now, it seems like women have to seek out help from an OB who may or may not be sympathetic to their concerns...and that's for the small fraction of women who bother to ask in the first place.  Most women do not.  I only asked because of posters on DCUM who suggested one should do so if you have PP incontinence.  But my OB, rightly from what I can gather, said to wait until after 4mos PP...and my symptoms did resolve by that point.

I also think more education in general about pelvic floor issues would be good.  It's shocking to me that it's not discussed at all.  My first delivery ended up being a vacuum birth.  And while the OB on call who stitched me up afterward commented on how little damage I had, no one ever told me to look out for signs of pelvic floor damage.  Again, I didn't end up having any long-term problems, but it's odd that no one said anything.  In my case, for very specific reasons in both of my deliveries a C-section would also have carried a fair amount of risk (particularly my second), so I do feel I received appropriate care despite my extended pushing...but obviously that's not true for everyone.[/quote]

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