CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Incontinence of stool and flatus are frequent complications of childbirth. We examined the prevalence and possible causes of these adverse outcomes in a large cohort of women. ⋯ Anal incontinence is associated with forceps delivery and anal sphincter laceration. Anal sphincter laceration is strongly predicted by first vaginal birth, median episiotomy, and forceps or vacuum delivery but not by birth weight or length of the second stage of labour.
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The number of family physicians practising obstetrics in Canada is declining. On the assumption that factors related to the obstetrics training of family medicine residents may be influencing this trend, we conducted a cohort study of residents' stated intentions with regard to practising obstetrics, their educational experiences and their subsequent obstetric practice. ⋯ Residents who have positive attitudes toward obstetrics at the end of their training and who intend at that time to perform deliveries are more likely to be doing so 2 years later, especially if they practise in communities of 15,000 or fewer people.