The story below appeared on the BBC News website last week, and I wanted to post it here in its entirety as an example of the terrible reality of childbirth that some women endure. That is not to say that this story should scare women away from giving birth vaginally if that is what they would like to do, but when informing women about the risks and benefits of ALL delivery types, I think that it is unethical if we fail to mention the possibility of pelvic floor problems such as incontinence and prolapse.
BBC News story: "It should have been the most perfect day of Nicki James-Eyer's life.
Just three hours after her first contraction the flight attendant gave birth to Jessica.
It had been the natural birth Nicki had expected, but the strain on her body had been intolerable.
Within six months she was faecally incontinent and over a decade later Nicki, from South Glamorgan, is still having problems.
Taken seriously
"As she was my first baby, I didn't really know what to expect after the birth. But a few weeks later I could hardly walk," said Nicki.
Her doctor was unsympathetic and simply put it down to the birth.
Over the next three months she saw a number of GPs who dismissed her concerns.
Finally she was diagnosed with a prolapse of the bowel and given surgery, but this left her incontinent.
"I was just 31-years old having what should have been the time of my life. I had just got married, I had a baby, and then my life just fell apart.
"It was horrendous."
Further surgery
She had further surgery in 2000 to enlarge her rectum and solve the incontinence and for a while things were better. She even managed to have a second child by caesarean.
But in 2006 she suffered a bowel infection and now needs further surgery, and her incontinence continues.
"I think childbirth is not the natural thing everyone says it is. There are problems that can happen and I think that people don't talk about them - women's bits and poo are taboo.
"My birth was very simple, so I should not really have had any problems, but nobody knows what is going to happen putting your body through that.
Up to one in every 10 new mums, like Nicki, have bowel problems as a result of childbirth.
But many do not know that they can get help, or where to go.
Common problems
Mr Charles Knowles, consultant colorectal surgeon, agreed that problems after childbirth were more common than expected.
"As many as one in 10 may have some degree of problem.
"Problems as severe as those experienced by Nicki are fortunately rare but there are few studies that have surveyed just how widespread such problems are."
He said the body was put under severe pressure.
"A number of changes occur to the pelvic floor muscles in late pregnancy due to the physical pressure of the baby. These combined with any trauma (tears or episiotomy) that may occur during delivery can result in weak sphincter muscles and laxity of the pelvic floor causing problems of incontinence."
Deborah Gilbert of the charity Bowel and Cancer Research said: "Childbirth is the commonest cause of faecal incontinence worldwide.
"The frequency of occurrence of incontinence and the problems that it causes for the thousands of women who suffer it are greatly underestimated because they are either too embarrassed to come forward or because they feel that doctors will be unable to help them.
"We are making the first steps to identifying the scope of the problem by running a survey for women on our website."
"We urge anyone who is suffering in this way to visit the site and complete the survey which we hope will lead to better service provision for women like Nicki in future."
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