• anal incontinence;
  • caesarean section;
  • pelvic organ prolapse;
  • pregnancy;
  • urinary incontinence
  • • 
    Caesarean section may reduce the risk of postnatal pelvic floor dysfunction; long-term benefits are less clear.
  • • 
    Non-obstetric factors such as age, obesity and family history are independent factors that confer significant risk of pelvic floor dysfunction.
  • • 
    Further research, perhaps using pelvic floor imaging, may improve our understanding of the nature of the injuries.

Learning objectives:

  • • 
    To review the literature on obstetric risk factors for pelvic floor dysfunction.
  • • 
    To be able to counsel women on the place of caesarean section in protecting the pelvic floor.

Ethical issues:

  • • 
    Insufficient information is available for counselling on the impact of obstetric events on pelvic floor symptoms when women have completed their reproductive life.

Please cite this article as: Dolan L. An update on damage to the pelvic floor in childbirth. The Obstetrician & Gynaecologist 2009;11:157–162.