Introduction and hypothesis: Significant breakthroughs in our understanding of pelvic floor dysfunction have occurred in the past two decades. The next step is to translate this understanding into effective preventative and early intervention strategies to minimize maternal morbidity from vaginal birth. We have learned enough to chart a course toward prevention.
Methods: This article outlines some major advances in understanding the pathophysiology of pelvic floor dysfunction and suggests strategies for future prevention research.
Results: Vaginal birth is the primary risk factor for the development of pelvic floor disorders and this is compounded by forceps use. Age, race, and genetics are also risk factors. Steps to prevent or minimize the development of pelvic floor problems include moderating forceps use and utilizing risk assessment tools to offer cesarean delivery to those at greatest risk.
Conclusion: These actions would represent one giant step forward in advancing the practice of obstetrics into the modern age of personalized medicine.
Keywords: Anal incontinence; Levator ani injury; Pelvic floor dysfunction; Pelvic organ prolapse; Prevention; Urinary incontinence.