There may be, and researchers are currently working on some possible strategies.
Doctors have suspected for years, but only just confirmed with MRI, that vaginal deliveries can severely tear the levator ani muscles in the pelvis. These tears, according to a study published in February in the journal Obstetrics & Gynecology, can lead later in life to uterine prolapse, in which the uterus bulges into and sometimes falls out of the vagina, and possibly to incontinence, or leakage of urine, as well.
The study, funded by the National Institutes of Health, suggested that the use of forceps — large tweezer-like instruments used to pull babies that are stuck from the birth canal — raises the risk of injury to pelvic muscles. Forceps stretch muscles too quickly and allow doctors to put as much as 50 pounds of force on the muscles, far more than the force from an unaided delivery.
While there are roughly 80,000 surgeries a year in women to shore up leaking bladders, there are 200,000 for uterine prolapse, said gynecologist Dr. John DeLancey, first author of the study and director of pelvic floor research at the University of Michigan Medical School.
The risk of torn pelvic floor muscles is not a reason to request a Cesarean section, warned Dr. Michael Aronson, a urogynecologist and director of women’s health services at the University of Massachusetts Medical Center. But the study does suggest that, with 3 million live vaginal births a year in this country, doctors may be able to learn to manage labor better.
One take-home lesson from the study, said DeLancey, is for women and their doctors to “limit forceps to use only when necessary.” Another option, suggested by several other studies, may be to pre-stretch pelvic floor muscles by doing special exercises in the last month of pregnancy.