How The Use of Forceps During Delivery Impacts Urinary Incontinence in the Postpartum Period
By Berrin Boyce
As a pelvic floor PT working in Boulder with many people during their pregnancies I often hear the question: “What can I do to decrease the risk of developing urinary incontinence or pelvic floor issues after delivery?” I educate people on movement during labor, positioning during delivery, and the benefits of pelvic floor PT following delivery, but there are other circumstances that can affect one’s likelihood of developing persistent urinary incontinence in the postpartum period.
A study by Arya et al 2001, looked at the incidence of urinary incontinence in 3 groups of women following various types of vaginal deliveries. The first group included 150 women who each had a spontaneous vaginal delivery (meaning no instruments were used to assist in delivery), the second group was 75 women who had a vacuum assisted delivery, and the third group included 90 women who had a forceps assisted delivery. At 2 weeks postpartum all three groups reported similar amounts of urinary incontinence. However, at the 3 month and 12 month follow-up, the women who had a forceps assisted delivery did not see an improvement in urinary symptoms, while the women who had undergone both the spontaneous and vacuum assisted deliveries did see significant improvement in urinary incontinence. The authors also concluded that urinary incontinence did not seem to have any relationship with epidural use, degree of perineal lacerations, length of pushing time, or size of the baby.
Overall, hardly anyone goes into labor and delivery planning to have an instrumental delivery (use of forceps or vacuum), however it sometimes becomes medically necessary for the health or mother or baby to use assistance. It is important to talk with your healthcare provider who plans to be at your delivery to see what their common practices are, and what types of interventions you both feel comfortable with if assistance is needed.
Click here for more information about positions to labor in to reduce the likelihood of a forceps assisted delivery.
Click here to learn ways to reduce significant perineal injury during delivery.
If you are experiencing urinary urgency or incontinence, click here to schedule an appointment today to see if physical therapy can help you!