Vaginal delivery is one of the main causes of anal incontinence. While previously postpartum anal incontinence was attributed to neurological damage to the pelvic floor and the rectal sphincter, today we know that mechanical injury plays an important role, especially when symptoms start soon after delivery. Risk factors for postpartum fecal incontinence are: forceps delivery, nulliparity, birth weight over 4 kilograms and persistent occiput posterior presentation of the fetal head. Anal incontinence developed in 42% of women who had posterolateral episiotomy. Therefore, the main focus of the treating physician should be on prevention by avoiding birth trauma followed by early recognition and skilful correction.