The lifetime risk for a woman to undergo surgery for either vaginal prolapse or urinary incontinence is high. Previous studies have shown that pregnancy and childbirth are risk factors for developing prolapse. There is a lack of studies that follow women several years after delivery aiming to find whether symptoms of prolapse are linked to delivery method, ie vacuum, forceps, normal vaginal delivery and cesarean section. The investigators plan this study is to get more knowledge about pathology of prolapse and incontinence, to enable development of preventive strategies for these conditions.

Aim of the study is to determine whether the prevalence of symptoms and performed surgery for urogenital prolapse differs among women delivered by vacuum, forceps, normal vaginal delivery and cesarean section 15-20 years after their first delivery.

The investigators identify women that delivered their first child at St. Olavs Hospital, Trondheim, Norway between 1990-1997. Questionnaires will be sent to 2500 women (PFIQ-7, PFDI-20, PISQ-12), 600 of whom will get a clinical examination, where pelvic floor musculature is examined by palpation and 4D ultrasound, and a POP-Q quantification of prolapse performed.

Inclusion Criteria:

• first delivery in time period 1990-1997
• vaginal birth, spontaneous, forceps or vacuum extraction, or cesarean section
• residency in Klæbu, Malvik, Melhus, Midtre Gauldal, Rissa, Selbu, Trondheim, Tydal, Åfjord at the time of first delivery

Exclusion Criteria:

• stillbirth
• breech birth
• congenital Abnormalities
• residency outside the 9 selected communities
• forceps delivery following previous vacuum extraction delivery or spontaneous vaginal birth
• vacuum extraction delivery following previous forceps delivery or spontaneous vaginal birth
• Vaginal birth following previous cesarean section

Women who delivered their first child at St. Olavs Hospital, Trondheim (Norway) between 1990-1997