Incontinence A Common Postnatal Problem

In her thesis, Women's health after childbirth, postgraduate student and midwife Erica Schytt takes an all-inclusive approach to the question of how childbirth affects mothers' physical health. Her survey included some 2,500 Swedish women, who were asked to complete a series of questionnaires on physical symptoms and rate their health on a scale of one to five, from the start of their pregnancy until after the delivery.

The thesis shows that most of the women were troubled by at least one symptom for their entire first year, and that a quarter of them had five or more symptoms. The most common complaint was exertion incontinence, which no less than 22% of the women suffered a year after childbirth.

"This is serious, as it's often a chronic problem," says Dr Schytt.

Women who suffer from obesity or constipation, who have already had a child, or who are older than 35 are at particular risk of developing exertion incontinence, while the chances were lower for those who had had a caesarean. However, Dr Schytt stresses that this is not to be taken as an argument for opting for a caesarean, as the operation has its own dangers.

Other common complaints after delivery were fatigue, headaches, and neck, shoulder or lower back pain. Pain from the caesarean operation, pain during intercourse and haemorrhoids were common after two months, but for most women these problems had ceased after a year.

Despite a number of physical complaints, most of the women described themselves as feeling well. To the question: "All in all, how would you describe your present state of health"", 91% responded "good" or "very good" two months after childbirth. When the question was asked again after one year, the number had dropped slightly to 86%.

According to Dr Schytt, these figures are better than for women of the same age in the normal population.

"Either giving birth makes you healthy, or healthy women have babies," she says. "It's probably the latter, but I daresay it's also the case that women experience powerful elation after giving birth that takes their mind off any ailments that they might also expect to be only temporary."

Dr Schytt thinks that her results can be of use in postnatal care.

"Most women recover after childbirth, but there are those who don't, and it's these we need to get to," she says. "The two-month postnatal check up is an important opportunity for midwives and doctors to identify and deal with women's physical problems and other risk-factors of poor self-rated health."