Patients' knowledge of potential pelvic floor changes associated with pregnancy and delivery.

Physicians cite pelvic floor injury as a major reason for Cesarean section as their personal preferred delivery mode. This study was undertaken to determine whether patients receive information about possible pelvic floor complications of pregnancy/delivery. Day 1 post-partum women completed a 52-item questionnaire assessing information given during routine antenatal care. Pelvic floor and general questions were intermixed. Of the 232 patients, the mean age was 26.9 years, with 59.5% white, 32.8% African-American and 7.7% other. Most (84.5%) had at least grade 12 education. The following percentage of patients reported receiving no information about: Kegel exercises 46.1%; episiotomy 51.3%; urinary incontinence 46.6%; fecal incontinence 80.6%; change in vaginal caliber 72.8%; neuropathy 84.9%. Counseling on all of these issues occurred significantly less frequently than education on general pregnancy topics. Our results suggest that knowledge and instruction of pelvic floor risks is very much lacking and provide us with an impetus to develop educational tools.

Patients' satisfaction with and attitudes toward vaginal delivery.

OBJECTIVE: To determine patient satisfaction with delivery mode and whether information on urinary incontinence would modify their decision. STUDY DESIGN: Postpartum women completed an anonymous questionnaire regarding their delivery, complications, types of information received during pregnancy, and delivery and satisfaction with their mode of delivery. Various risk scenarios for urinary incontinence ranging from 10-50% were presented. RESULTS: One hundred ninety-two ethnically and economically diverse patients responded: 86.4% reported receiving sufficient information on the risks of delivery, and 61.5% thought that cesarean section would not help prevent urinary/fecal incontinence. Irrespective of the magnitude of risk, few patients (5.7-21.9%) chose cesarean section to prevent urinary incontinence. CONCLUSION: Patients were happy with their delivery mode. Most thought that they obtained sufficient information on the various types of delivery available. They would not have chosen a cesarean section over a vaginal delivery even if the risks of urinary incontinence were much higher than currently reported.