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Faecal incontinence after childbirth

C MacArthur¹, D E Bick, M R Keighley

¹Department of Public Health and Epidemiology, Medical School, University of Birmingham, Edgbaston, UK.

British Journal of Obstetrics and Gynaecology

|January 1, 1997

Summary

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Postpartum faecal incontinence affects 4% of women, often linked to instrumental deliveries like forceps or vacuum extraction. Many women with new onset incontinence do not seek medical help, highlighting a need for better identification and treatment strategies.

Area of Science:

Obstetrics and Gynecology
Pelvic Floor Disorders
Women's Health

Background:

Postpartum faecal incontinence is a significant concern affecting women's quality of life.
Previous data on the prevalence and obstetric risk factors for new-onset postpartum faecal incontinence is limited.

Purpose of the Study:

To determine the prevalence and severity of new postpartum faecal incontinence.
To identify specific obstetric risk factors associated with its development.

Main Methods:

A cohort study involving 906 women interviewed approximately 10 months after delivery.
Data collected via home-based interviews for symptom assessment and hospital records for obstetric details.
Focus on new-onset faecal incontinence, including frank incontinence, soiling, and urgency.

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Main Results:

Four percent (36/906) of women developed new faecal incontinence post-birth, with 22 experiencing unresolved symptoms.
Instrumental vaginal deliveries (forceps or vacuum extraction) were identified as significant risk factors.
Emergency caesarean sections were associated with incontinence in some cases, while elective sections showed no increased risk.

Conclusions:

New-onset postpartum faecal incontinence is more prevalent than previously understood.
Instrumental deliveries are key risk factors, emphasizing the need for careful management during childbirth.
There is a critical gap in women seeking medical attention for these symptoms, necessitating improved awareness and intervention strategies.