When a pregnant woman’s labor is difficult, doctors often must choose between performing a c-section or using instruments to delivery the baby through the birth canal. Now, new research suggests that a cesarean is less likely to cause sexual and urinary problems for the mother.

Dr. Rachel E. Liebling, from Royal United Hospital, Bath, UK, and colleagues assessed the outcomes of 393 women who had a difficult pregnancy delivered by c-section or with the use of instruments such as forceps. The findings are published in the American Journal of Obstetrics and Gynecology.

Women who had an instrument delivery experienced urinary incontinence more often than the women who had a c-section. This was first noted six weeks after delivery, but the difference was still apparent a year later. In contrast, the type of delivery did not seem to influence bowel function.

Women in the instrument group were also more likely to complain of painful sexual intercourse.

“Interestingly,” the authors write, “despite the higher rate of (sexual and urinary problems), women in the instrumental delivery group still favored a vaginal delivery when questioned about future deliveries.”

In fact, “we would support a decision to attempt an instrumental vaginal delivery,” Liebling told Reuters Health, “if the obstetrician involved felt that this was appropriate.”

“We have come to this conclusion,” the physician added, “as neither mode of delivery, cesarean section or instrumental delivery,” is without its disadvantages.

SOURCE: American Journal of Obstetrics and Gynecology, July 2004.