Now that common belief may need to be adjusted. New research from a University of Rochester Medical Center study appearing in a recent issue of Obstetrics and Gynecology journal shows that childbirth may not even be a factor in whether a woman suffers urinary incontinence after menopause.  According to local ob/gyn specialist Walter Guth, MD, with OBG-1, the results are quite convincing.  It's very common for doctors to think that vaginal delivery puts a woman at risk of urinary incontinence. Actual studies on childbirth and urinary incontinence are divided. Some show a risk, others fail to find one.  But Dr. Guth says the methodology used in this study will alleviate many concerns about vaginal delivery and incontinence. 

Researchers studied pairs of postmenopausal sisters. In each pair, one sister had at least one child by vaginal delivery. The other never had a child. Regardless of how the researchers looked at it, the results came out the same.  "Researchers found no difference in urinary incontinence between the sisters who had had a vaginal delivery and those who had never given birth,’ says Dr. Guth.  "There was no difference in type of incontinence, overall prevalence of incontinence, or severity of incontinence."

The researchers looked first at whether the women suffered urinary incontinence, and then, more specifically, at whether they suffered stress incontinence (involuntary urination caused by activity such as coughing), urge incontinence (urination caused by overactive bladder), or mixed incontinence. They also looked at incontinence severity. In every regard, the women who gave birth were no more likely to suffer urinary incontinence than their childless sisters. “Childbirth was not at all indicated as a risk factor for incontinence,” says Dr. Guth. 

Another significant and unexpected finding from the study was the genetic link identified for urinary incontinence.  Researchers found that while having a child wasn't a risk for urinary incontinence, having a sister with the problem was a different story.  In most cases, if one sister experienced problems with urinary leakage, the other did also – in more cases than could be accounted for by chance alone.  “This study helps confirm the idea that there is some genetic component that may predispose an individual for incontinence,” says urologist Kenneth Verheeck, MD, with the Urology Center of Southwest Louisiana.  “The risk of incontinence is going to be greater for a woman whose mother or sister experience incontinence than for someone with no family members who have this problem."

Dr. Verheeck explains that not all women are built the same way. Women who are related are more likely to have the same pelvic floor structure.  “By the same token, this means vaginal delivery has different consequences for different women. Some women are going to be able to produce multiple children by vaginal delivery and never have a moment's setback. Others are going to have a single child, and their pelvic floor will be damaged forever, leading to future problems with incontinence. We do know that having a family history of similar problems with pelvic floor damage during childbirth puts a woman at higher risk for these problems herself."

Both Dr. Guth and Dr. Verheeck say that any specific concerns or problems a woman has regarding incontinence should be discussed with her physician.   There are preventive steps and many treatment options.