Natural births raise risk of incontinence

Women who give birth by caesarean section are far less likely to develop bladder control problems later in life than those who deliver the old-fashioned way.

But pregnancy itself also seems to do some damage to a woman's ability to control her bladder after childbirth, according to a study published in the New England Journal of Medicine. Women who had caesareans were more likely to be incontinent than women who never had a child.

A team led by Dr Guri Rortveit of the University of Bergen surveyed more than 15,000 women under 65 and matched them to national birth records to look for factors that increased the risk of incontinence.

For childless women, the rate was 10.1 per cent. For women who had given birth only through caesarean section, the rate was 15.9 per cent. It jumped to 21 per cent among women who had only vaginal deliveries.

The trend was strongest among women who suffer from stress incontinence, in which sneezing, laughing, coughing or heavy lifting can cause urine to leak.

The researchers did not see any relationship between the method of delivery and "urge incontinence", where there is a sudden urge to urinate.

They calculated that about 35 per cent of incontinence cases could be eliminated if all women delivered by caesarean section.

However, they stressed that "these findings should not be used to justify an increase in the use of caesarean sections", which carry serious risks that vaginal deliveries do not.

The Rortveit team found that women who had a caesarean after labour were no more likely to develop bladder problems than women who had an elective caesarean and never experienced labour.

That finding may resolve the question of whether labour itself increases the risk of incontinence. Drugs or surgery, or behaviour control methods used with special exercises, can help women control incontinence.

In the United States, about a quarter of all deliveries are by caesarean - one of the highest rates in the world.

- REUTERS