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Thursday, January 5, 2012

The Misogyny of Childbirth and Motherhood

There is nothing that is more in the female domain than childbirth and motherhood, and over the last few years, I have come to the conclusion that there is also nothing that is more of a hotbed of unadulterated mysogyny than the discourse on childbirth and motherhood.
And much of the hate is levelled at women, by other women - most of whom are claiming to be feminists while they seek to disenfranchise other women who don't happen to share their same views or wouldn't happen to make the same choices.
The women who trailblazed the freedoms that today we take for granted, would hang their heads in shame and disgust at the current situation. They fought so women could choose to meaningfully and fully participate in society. They fought so that women could be autonomous individuals - who are empowered with the right to free choice.
Would a real 'feminist' sink so low as to outrightly disparage another woman for freely making a decision that is different from her own? Would a real 'feminist' disparage another woman who is working to provide unbiased information that allows other women to make informed decisions? Would a real 'feminist' willfully keep information from other women, to manipulate the choices made by other women? Would a real 'feminist' hold dear to an ideology and continue to repeat its myths, long after it has been debunked? Would a real 'feminist' reduce a woman down to a bodily function and place process ahead of outcomes?
A person who would disenfranchise and disempower other women from freely making informed mothering and childbirth choices is not a feminist, never has been and never will be. That person is a misogynist in the purest sense of the word.
Its sad - that motherhood and childbirth is a bastion of mysogyny, when it should be the first frontier of true feminism.

http://awaitingjuno.blogspot.com

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Neurourol Urodyn 2002;21(1):2-29.

The risk of lower urinary tract symptoms five years after the first delivery.

Viktrup L.

Source

Department of Obstetrics and Gynecology, Glostrup County Hospital, University of Copenhagen, Denmark. viktrup@dadlnet.dk

STUDY:To estimate the prevalence and 5-year incidence of lower urinary tract symptoms (LUTS) after the first delivery and to evaluate the impact of pregnancy per se and delivery per se on long-lasting symptoms.

METHODS:A longitudinal cohort study of 305 primiparae questioned a few days, 3 months, and 5 years after their delivery. The questionnaire used was tested and validated, and the questions were formulated according to the definitions of the International Continence Society (ICS). Maternal, obstetric, and neonatal data concerning every delivery and objective data concerning surgeries during the observation period were obtained from the records. From the sample of 278 women (91%) who responded 5 years after their first delivery, three subpopulations were defined: 1) women without initial LUTS before or during the first pregnancy or during the puerperal period, 2) women with onset of LUTS during the first pregnancy, and 3) women with onset of LUTS during the first puerperium. The risk of LUTS 5 years after the first delivery was examined using bivariate analyses. The obstetric variables in the bivariate tests with a significant association with long-lasting urinary incontinence were entered into a multivariate logistic regression.

RESULTS:The prevalence of stress and urge incontinence 5 years after first delivery was 30% and 15%, respectively, whereas the 5-year incidence was 19% and 11%, respectively. The prevalence of urgency, diurnal frequency, and nocturia 5 years after the first delivery was 18%, 24%, and 2%, respectively, whereas the 5-year incidence was 15%, 20%, and 0.5%, respectively. The prevalence of all LUTS except nocturia increased significantly during the 5 years of observation. The risk of long-lasting stress and urge incontinence was related to the onset and duration of the symptom after the first pregnancy and delivery in a dose-response-like manner. Vacuum extraction at the first delivery was used significantly more often in the group of women with onset of stress incontinence during the first puerperium, whereas an episiotomy at the first delivery was performed significantly more often in the group of women with onset of stress incontinence in the 5 years of observation. The prevalence of urgency and diurnal frequency 5 years after the first delivery was not increased in women with symptom onset during the first pregnancy or puerperium compared with those without such symptoms. The frequency of nocturia 5 years after the first delivery was too low for statistical analysis.

CONCLUSION:The first pregnancy and delivery may result in stress and urge incontinence 5 years later. Women with stress and urge incontinence 3 months after the first delivery have a very high risk of long-lasting symptoms. An episiotomy or a vacuum extraction at the first delivery seems to increase the risk. Subsequent childbearing or surgery seems without significant contribution. Long-lasting urgency, diurnal frequency, or nocturia cannot be predicted from onset during the first pregnancy or puerperium.

Copyright 2002 Wiley-Liss, Inc.

PMID:

11835420

[PubMed - indexed for MEDLINE]

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Neurourol Urodyn. 2004;23(1):2-6.

Cesarean section: does it really prevent the development of postpartum stress urinary incontinence? A prospective study of 363 women one year after their first delivery.

Groutz A, Rimon E, Peled S, Gold R, Pauzner D, Lessing JB, Gordon D.

Source

Urogynecology and Pelvic Floor Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, Israel. agroutz@yahoo.com

Abstract

AIMS:Stress urinary incontinence (SUI) in young women is usually the result of pelvic floor injury during vaginal delivery. Whether cesarean section delivery may prevent such injury is questionable. We undertook a prospective study to compare the prevalence of SUI among primiparae 1 year after spontaneous vaginal delivery versus elective cesarean section, or cesarean section performed for obstructed labor.

METHODS:Three hundred and sixty-three consecutive primiparae were recruited immediately after delivery and were followed for 1 year. Women were asked upon recruitment whether they had ever experienced SUI before pregnancy. Those who had SUI before pregnancy were excluded. Thus, only cases of de novo childbirth-associated SUI were analyzed. Patients were divided into three subgroups according to the mode of delivery: spontaneous vaginal delivery (n = 145), elective cesarean section (n = 118), and cesarean section performed for obstructed labor (n = 100). Patients who underwent elective cesarean section were not given a trial of labor. Cesarean sections for obstructed labor were performed at a mean cervical dilatation of 8.7 +/- 1.6 cm and arrest of 184 +/- 24 min. Prevalence, frequency, and severity of postpartum SUI, as well as demographic and obstetric parameters, were analyzed in each subgroup.

RESULTS:The three subgroups were comparable with respect to maternal age, weight, and height. Prevalence of postpartum SUI was similar after spontaneous vaginal delivery (10.3%) and cesarean section performed for obstructed labor (12%). However, SUI was significantly less common following elective cesarean section with no trial of labor (3.4%, P < 0.05). Approximately half of the symptomatic patients in each subgroup reported either moderate or severe symptoms, however, only 15-18% expressed their desire for further evaluation.

CONCLUSIONS:Prevalence of postpartum SUI is similar following spontaneous vaginal delivery and cesarean section performed for obstructed labor. It is quite possible that pelvic floor injury in such cases is already too extensive to be prevented by surgical intervention. Conversely, elective cesarean section, with no trial of labor, was found to be associated with a significantly lower prevalence of postpartum SUI. Whether the prevention of pelvic floor injury should be an indication for elective cesarean section is yet to be established.

Copyright 2003 Wiley-Liss, Inc.

PMID:

14694448

[PubMed - indexed for MEDLINE]

 

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Eur J Neurol. 2006 Dec;13(12):1374-7.

The number of pregnancies is a risk factor for Alzheimer's disease.

Colucci M, Cammarata S, Assini A, Croce R, Clerici F, Novello C, Mazzella L, Dagnino N, Mariani C, Tanganelli P.

Source

Department of Neurology, P.A. Micone Hospital, Genova, Italy. monica.colucci@asl3.liguria.it

AbstractEpidemiological data show a higher prevalence of late-onset Alzheimer's disease (AD) in women. The estrogenic deficiency in the post-menopausal period is suspected to be the cause of the gender-related risk of the disease, but studies on the estrogenic therapy and occurrence of AD were not consistent and sometimes contradicting. The aim of this study is to investigate whether a higher exposure to endogenous estrogens is associated with lower risk of dementia or not. Two hundred and four AD patients and 201 control women were considered. By interviews, we evaluated different variables, indirectly correlated to estrogenic natural exposure, as well as educational level and head trauma. These data were correlated in the AD group with the disease progression, as well as with the age at onset. Unexpectedly, we found a significant higher number of pregnancies in the AD than in the control group. Within the AD cases, the number of lifetime pregnancies is related to an earlier onset of the disease. As previously reported, we confirmed that the educational level is a protective factor and that major head trauma represents a risk factor in developing AD. The higher number of pregnancies and a less frequency of nulliparous women, indirectly relate the AD group to a higher estro-progestinic exposure. These findings suggest that it is the increase of progesterone or estrogens level--and not the estrogens decrease, as previously indicated by other authors--that could play a role in the Alzheimer's pathology.

PMID:

17116223

[PubMed - indexed for MEDLINE]

 

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Obstet Gynecol. 2011 Oct;118(4):777-84.

Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth.

Handa VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Muñoz A.

Source

Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Vhanda1@jhmi.edu

Abstract

OBJECTIVE:To estimate differences in pelvic floor disorders by mode of delivery.

METHODS:We recruited 1,011 women for a longitudinal cohort study 5-10 years after first delivery. Using hospital records, we classified each birth as: cesarean without labor, cesarean during active labor, cesarean after complete cervical dilation, spontaneous vaginal birth, or operative vaginal birth. At enrollment, stress incontinence, overactive bladder, anal incontinence, and prolapse symptoms were assessed with a validated questionnaire. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification system. Logistic regression analysis was used to estimate the relative odds of each pelvic floor disorder by obstetric history, adjusting for relevant confounders.

RESULTS:Compared with cesarean without labor, spontaneous vaginal birth was associated with a significantly greater odds of stress incontinence (odds ratio [OR] 2.9, 95% confidence interval [CI] 1.5-5.5) and prolapse to or beyond the hymen (OR 5.6, 95% CI 2.2-14.7). Operative vaginal birth significantly increased the odds for all pelvic floor disorders, especially prolapse (OR 7.5, 95% CI 2.7-20.9). These results suggest that 6.8 additional operative births or 8.9 spontaneous vaginal births, relative to cesarean births, would lead to one additional case of prolapse. Among women delivering exclusively by cesarean, neither active labor nor complete cervical dilation increased the odds for any pelvic floor disorder considered, although the study had less than 80% power to detect a doubling of the odds with these exposures.

CONCLUSION:Although spontaneous vaginal delivery was significantly associated with stress incontinence and prolapse, the most dramatic risk was associated with operative vaginal birth.

 

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Am J Obstet Gynecol. 2010 May;202(5):488.e1-6. Epub 2010 Mar 12.

Correlation between levator ani muscle injuries on magnetic resonance imaging and fecal incontinence, pelvic organ prolapse, and urinary incontinence in primiparous women.

Heilbrun ME, Nygaard IE, Lockhart ME, Richter HE, Brown MB, Kenton KS, Rahn DD, Thomas JV, Weidner AC, Nager CW, Delancey JO.

Source

Department of Radiology, University of Utah, Salt Lake City, UT, USA.

Abstract

OBJECTIVE:The objective of the study was to correlate the presence of major levator ani muscle (LAM) injuries on magnetic resonance imaging (MRI) with fecal incontinence (FI), pelvic organ prolapse (POP), and urinary incontinence (UI) in primiparous women 6-12 months postpartum.

STUDY DESIGN:A published scoring system was used to characterize LAM injuries on MRI dichotomously (MRI negative, no/mild vs MRI positive, major).

RESULTS:

Major LAM injuries were observed in 17 of 89 (19.1%) women who delivered vaginally with external anal sphincter (EAS) injuries, 3 of 88 (3.5%) who delivered vaginally without EAS injury, and 0 of 29 (0%) who delivered by cesarean section before labor (P=.0005). Among women with EAS injuries, those with major LAM injuries trended toward more FI, 35.3% vs 16.7% (P=.10) and POP, 35.3% vs 15.5% (P=.09), but not UI (P=1.0).

CONCLUSION:

These data support the growing body of literature suggesting that both EAS and LAM are important for fecal continence and that multiple injuries contribute to pelvic floor dysfunction.

Copyright (c) 2010 Mosby, Inc. All rights reserved.

PMID:

20223445

[PubMed - indexed for MEDLINE]

PMCID: PMC2866791

 

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