Roughly three million women in the United States give birth vaginally each year [1]. Clinically, the vagina undergoes pronounced adaptations up to the time of delivery, presumably to afford passage of the fetus [2]. Our group has suggested that if these adaptations are not sufficient or if fetus size is too large, an injury to the vagina or its supportive tissues will likely result. Vaginal injury at the time of delivery occurs quite frequently and research examining the levator ani muscle, the major muscular component of the pelvic floor, revealed injury in up to 20% of women who have given birth vaginally [3]. Therefore, vaginal birth is considered one of the greatest risk factors for pelvic floor disorders (i.e. urinary dysfunction and pelvic organ prolapse) later in life.

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