Birth mode is not your postpartum care plan

A new systematic review published Aug 12 compared reported elective cesarean with vaginal delivery across 12 observational studies. The pooled association favored reported elective cesarean for postpartum stress urinary incontinence (RR 0.47) and pelvic organ prolapse (RR 0.56), but evidence certainty was low or very low; pelvic floor muscle strength did not differ significantly. Most studies did not clearly report labor before cesarean, and assessment timing varied. 1

That is a useful correction to a very personal question: delivery mode can change the risk estimate, but it cannot tell you whether your body needs care. A U.S. military medical-center quality-improvement project used standardized screening at a 2-week phone call and 6-week visit; referrals rose from 17.2% to 33.1% in that setting. At your next visit, name the symptom you are having and ask whether pelvic floor screening or PT is available. 2