The Epidemiology of Fecal Incontinence after Childbirth

Fecal incontinence is thought to be a common condition with profound social impact. Obstetric delivery is thought to be the leading contributor to development of fecal incontinence in women. There are no population-based studies of fecal incontinence following childbirth; the highest-risk period. Previous studies examining postpartum fecal incontinence are from single institutions, populations that are subject to referral bias, and small numbers; making generalizability of the results impossible. The primary goal of this proposal is to provide population-based information on incidence, and risk factors with essential correlation with anatomic/physiologic findings and longitudinal follow-up. The specific aims of this proposal are to: - Provide population-based estimates of incidence of fecal incontinence in all postpartum women delivering in Oregon state. - Identify contributing modifiable and non-modifiable risk factors for the development of postpartum fecal incontinence. - Explore in depth a possible causal relationship between obstetric delivery methods and postpartum fecal incontinence. - Develop a cohort of women with postpartum fecal incontinence to follow longitudinally to identify factors that predict the likelihood of resolution, recurrence or worsening of symptoms. - Correlate anatomic and physiologic findings to symptoms of fecal incontinence. - Understand the physical, psychological, social ramifications of fecal incontinence. These data will provide a better understanding of the extent of the problem and will provide data essential for future trials of prevention and treatment of fecal incontinence.