Exploring Pelvic Changes: Do Pregnancy and Birth Leave Scars?

Selected pelvic features, formerly "parturition scars," have long been interpreted as osteological indicators of pregnancy and childbirth, presumably caused by biomechanical stresses. Yet, most evidence derives from archaeological collections lacking detailed documented reproductive histories. This study examined whether parity is associated with classic pelvic features in a clinical sample of women with known reproductive histories and, for comparison, in men. In addition, we evaluated urinary incontinence as a functional outcome related to reproductive histories.

Pelvic CT scans from 84 individuals (39 parous women, 20 nulliparous women, 25 men) were assessed for five pelvic features: dorsal pubic pitting, extended pubic tubercle, preauricular sulcus, sacral preauricular extension, sacral preauricular notch. Reproductive history and urinary incontinence were recorded. Group differences were analyzed using nonparametric and χ² tests. Age-adjusted binary logistic regression was performed to assess the association between parity and urinary incontinence.

Skeletal pelvic features were similarly frequent in parous and nulliparous women. The preauricular sulcus was present in approximately half of all women and absent in men, indicating a sex-associated pattern rather than an association with parity. No other individual pelvic feature showed consistent differences by parity, only by sex. Combinations of pelvic features were rare. Urinary incontinence was more prevalent among parous women; parity remained associated with incontinence after age adjustment. Incontinent women had a slightly higher number of pelvic features, on average, but this association was not statistically significant.

Classic skeletal pelvic features lack specificity for pregnancy or childbirth and cannot reliably predict parity.