الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The pelvic floor supports the pelvic organs and an intact system of muscles, connective tissue , and innervation is important for normal support and function (1). Pregnancy and childbirth are the strongest risk factors for the development of pelvic floor dysfunction (2). Vaginal delivery has been shown to result in mechanical disruption of the pelvic floor and pudendal nerve injury. During the second stage of labour, the baby’s head distends and stretches the pelvic floor. Over stretching during vaginal delivery causes varying degrees of muscular, neuromuscular and connective tissue damage. This damage may result in dyspareunia, perineal pain, urinary and or fecal incontinence and genital prolapse (3,4,5,6). Routine midline episiotomy increases the risk of third and fourth degree perineal laceration which may lead to fecal incontinence. Routine use of mediolateral episiotomy doesn’t prevent urinary incontinence or severe perineal tears (1). It is evident that vaginal delivery can damage the pelvic floor. Elective cesarean section can certainly prevent mechanical trauma to the pelvic floor but carries significant health risks for both the mother and the child, including increased incidences of postpartum hysterectomy, adhesions, ileus, and placental implantation problems in future pregnancies(102). So the decision of vaginal or cesarean delivery must be taken after a discussion with women about the benefits and risks and this decision is supported by her request(155).