Word: pelvically
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...your report "Too Posh To Push," about the increase in scheduled Csections [April 19]: Are women seeking caesarean births because they are worried only about fitting their babies into their schedules? Hardly. Your story noted some risks of natural childbirth (pelvic-floor damage and incontinence) but focused primarily on nonmedical reasons for C-sections. Most men, however, would not volunteer to spend the next 40 years with bladder and bowel problems. Why should women? More time needs to be spent on women's health issues and less on preserving low surgical birth rates and saving money. KARI ZANGERLE Phoenix, Ariz...
...health of the mother or child. But the committee fell short of offering guidelines, citing lack of evidence. Dr. Laura Riley, of Boston's Massachusetts General Hospital and the current chair of the ACOG obstetrics practice committee, says studies haven't fully explored the issues many women fear most: pelvic-floor damage and incontinence. "The studies are still out," says Riley, but in reference to her personal practice, she adds, "My thought is, a vaginal delivery is safer for the mother...
...case in point is Dr. Kim Warner, 36, chair of the obstetrics and gynecology department at St. Joseph Hospital in Denver. When her first child was due last year, she scheduled her own C-section. Warner had spent the past five years surgically reconstructing pelvic-floor muscles and repairing leaky bladders in women who had experienced difficult natural deliveries. She didn't want to risk a hard labor herself...
...meantime, patients are usually given several options. The first line of treatment may be simple changes in behavior--losing weight, reducing intake of liquids or cutting back on irritants like caffeine, alcohol and cigarettes. If the patient's pelvic floor is weak, she will need to learn how to train her muscles with Kegel exercises--pelvic contractions that are commonly taught to prevent SUI after childbirth but that can also help restore control. Dr. Norton likens the urethra to a garden hose and the pelvic floor to the ground beneath it. When a cough comes along, it's like someone...
Biofeedback techniques can help women isolate and work the pelvic muscles. A study published last July in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION showed that biofeedback-assisted behavioral training reduces episodes of SUI almost 70%. Electrical stimulation also helps some women strengthen their pelvic muscles...