Which of the following is a risk factor for pelvic organ prolapse?

• A. Vaginal childbirth.
• B. Cesarean delivery without labor.
• C. Regular exercise.
• D. Hormone replacement therapy.

Answer: (A)

Vaginal childbirth stands out as a key risk factor because delivering through the birth canal can stretch and even tear the pelvic floor muscles and supporting connective tissues. This damage weakens the support for pelvic organs, such as the bladder, uterus, and vaginal apex, making prolapse more likely over time, especially with multiple vaginal deliveries or difficult labors. In comparison, cesarean delivery without labor avoids the major pelvic floor trauma associated with vaginal birth and is not considered a risk factor for prolapse. Regular exercise tends to strengthen the pelvic floor rather than worsen it, and hormone replacement therapy can help maintain tissue integrity, so neither is a risk factor in this context.