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Aust N Z J Obstet Gynaecol. 2015 Aug;55(4):309-14. doi: 10.1111/ajo.12286. Epub 2014 Dec 24.

Psychological and somatic sequelae of traumatic vaginal delivery: A literature review.

Author information

1
Department of Obstetrics and Gynaecology, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, New South Wales, Australia.

Abstract

This literature review seeks to examine current knowledge of birth trauma associated with major pelvic floor dysfunction by interpreting and critically appraising existing published material. A search of the literature for peer reviewed journal articles was conducted between September and December 2013 of the following databases: PubMed; Wiley Online; MEDLINE; OvidSP; ScienceDirect; MD Consult Australia; Biomed Central; Sage; Cochrane Database of Systematic Reviews. Unpublished interviews from mothers who attended two tertiary teaching hospitals in Sydney, Australia and international Internet blogs/websites were also utilised. Maternal birth trauma seems to be a common cause of pelvic floor dysfunction. Women who have sustained birth trauma to the levator ani muscle or the anal sphincters are often injured more seriously than generally believed. There often is a substantial latency between trauma and the manifestation of symptoms. Urinary and faecal incontinence, prolapse and sexual dysfunction are commonly seen as too embarrassing to discuss with clinicians, and frequently, new mothers have inaccurate recollections of obstetric procedures that occurred without much explanation or explicit consent. Moreover, somatic trauma may contribute to psychological trauma and post-traumatic stress disorder. The link between somatic and psychological trauma is poorly understood.

KEYWORDS:

avulsion; birth trauma; levator ani; pelvic floor injury; post-traumatic stress disorder

PMID:
25537397
DOI:
10.1111/ajo.12286
[Indexed for MEDLINE]

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