It's Not All About Birth: Biomechanics Applied to Pelvic Organ Prolapse Prevention


  • Katharine K. O'Dell CNM,

    PhD, Assistant Professor of Obstetrics and Gynecology, Corresponding authorSearch for more papers by this author
    • Katharine K. O'Dell, CNM, PhD, is a novice researcher and an experienced nurse-midwife, having graduated from Frontier Nursing Service in 1978. She is an Assistant Professor of Obstetrics and Gynecology at the University of Massachusetts Medical School and Graduate School of Nursing in Worcester, MA, with a practice that includes office-based urogynecology.

  • Abraham N. Morse MD

    Search for more papers by this author
    • Abraham N. Morse, MD, is a Board Certified Urogynecologist and Assistant Professor of Obstetrics and Gynecology at the University of Massachusetts Medical School. He received his early training in medicine and biomechanics through the dual degree program of Harvard University and the Massachusetts Institute of Technology.

University of Massachusetts Medical School, Jaquith 434, 119 Belmont St, Worcester, MA 01605. E-mail:


Pelvic organ prolapse is a common and costly women's health problem. Prevention of prolapse continues to play a role in the debate about the risks and benefits of elective cesarean section, making this an important topic for midwives to understand. While some women appear to be at higher risk for prolapse because of intrinsic anatomic and physiologic factors, others have modifiable risk factors that can be addressed by health care providers. This article discusses the current knowledge related to the etiology of prolapse and related components of pelvic anatomy. Biomechanical principles are then applied to enhance the understanding of prolapse development and prevention. Clinical recommendations are based on current evidence regarding topics such as physical activity during pregnancy, treatment of vaginal atrophy, and optimal pelvic floor muscle exercises.