Women's reluctance to seek help for stress incontinence during pregnancy and following childbirth

doi:10.1054/midw.2001.0259

Midwifery

Volume 17, Issue 3, September 2001, Pages 212-221

https://doi.org/10.1054/midw.2001.0259 Get rights and content

Abstract

Objective: to identify whether women were made aware of stress incontinence around the time of childbirth, whether symptomatic women sought help from professionals caring for them at this time, to look at what help they receive in the first instance and to understand why some of those experiencing it chose not to seek help.

Design: a qualitative survey was conducted using semi-structured interviews.

Setting: interviews were conducted in participants' own homes.

Participants: 42 women who reported symptoms of stress incontinence at eight weeks postpartum, and 15 women who were symptomatic one year following the birth of their baby.

Findings: women were reluctant to seek help, although they were often inconvenienced and troubled by the condition. This was predominantly due to the nature of the condition itself, although the relationship with their health care professionals was also a consideration in some cases. The majority of women were not provided with information on the condition but wanted health professionals to provide a warning that the condition could occur. They also wanted health professionals to seek out information about symptoms, rather than the women themselves having to broach the subject. The first line of treatment at this time was usually a recommendation to perform pelvic floor exercises.

Implications for practice: health professionals caring for women during pregnancy or following the birth of their baby need to raise awareness of the condition, the treatment available, and to be pro-active in seeking out those experiencing incontinence rather than expecting women to approach them for help.

References (41)

D Bick et al.
Attendance, content and relevance of the six week postnatal examination
Midwifery
(1995)
S Boblin et al.
Health care providers' knowledge, attitudes and decisions about incontinence care
Clinical Effectiveness in Nursing
(1999)
L Mason et al.
The prevalence of stress incontinence during pregnancy and following delivery
Midwifery
(1999)
H Rekers et al.
Urinary incontinence in women from 35–79 years of age: prevalence and consequences
European Journal of Obstetrics, Gynecology and Reproductive Biology
(1992)
B Roe et al.
Help seeking behaviour and health and social services utilisation by people suffering from urinary incontinence
International Journal of Nursing Studies
(1999)
PD Ashworth et al.
The meaning of incontinence: a qualitative study of non-geriatric urinary incontinence sufferers
Journal of Advanced Nursing
(1993)
L CM Berghmans et al.
Conservative treatment of stress urinary incontinence in women: a systematic review of randomised clinical trials
British Journal of Urology
(1998)
D Bick et al.
Identifying morbidity in postpartum women
Modern Midwife
(1994)
NA Black et al.
The effectiveness of surgery for stress incontinence: a systematic review
British Journal of Urology
(1996)
H Blomquist et al.
The occurence of symptoms and the proportion treated in Swedish infants and their mothers
Scandinavian Journal of Primary Health Care
(1991)

J Bowers

Is the six week postnatal examination necessary?

Practitioner

(1985)

JC Brocklehurst

Urinary incontinence in the community – analysis of a MORI poll

British Medical Journal

(1993)

S Brown et al.

Maternal health after childbirth: results from a randomised trial in Australian general population practice

British Journal of Obstetrics and Gynaecology

(1998)

S Brown et al.

Physical Health problems after childbirth and maternal depression at six to seven months postpartum

British Journal of Obstetrics and Gynaecology

(2000)

D Button et al.

Consensus guidelines for the promotion and management of continence by primary health care teams: development, implementation and evaluation

Journal of Advanced Nursing

(1998)

C Carver et al.

Assessing coping strategies: a theoretically based approach

Journal of Personality and Social Psychology

(1989)

Dept of Health, 1993, Changing Childbirth, Report of the Expert Maternity Group, HMSO,...

W Francis

The onset of stress incontinence

Journal of Obstetrics and Gynaecology

(1960)

DK Gjerdingen et al.

Changes in women's physical health during the first postpartum year

Archives of Family Medicine

(1993)

C Glazener

Postpartum problems

British Journal of Hospital Medicine

(1997)

Cited by (52)

Knowledge of pelvic floor disorders in peripartum women: A systematic review
2021, Progres en Urologie
La grossesse et le post-partum sont des périodes de la vie au cours desquelles peuvent apparaître des troubles pelvipérinéaux (TPP).
L’objectif de cette revue est de préciser les connaissances des femmes en période périnatale sur les TPP, leurs facteurs de risques et les mesures préventives.
Une revue systématique a été réalisée à partir des bases de données PubMed, Cochrane Library, LISSA et Kinédoc et à partir des mots-clés « knowledge », « awareness », « beliefs », « pelvic floor », « post-partum », « pregnancy ». Seules les études, rédigées en anglais ou en français, évaluant les connaissances des femmes à l’aide d’un questionnaire, ont été incluses dans la revue. La recherche a été effectuée sans limitation temporelle et jusqu’au 10 mai 2020.
Au total, sur 240 études, 14 études transversales ont été retenues, regroupant un échantillon de 3950 participantes.
Les thèmes abordés dans les questionnaires ont été l’anatomie, la fonction du plancher pelvien, l’ensemble des TPP, leurs facteurs de risque et les mesures préventives. Les scores de connaissances des femmes interrogées sur ces différents thèmes sont faibles. Il a également été montré que l’éducation des femmes sur les facteurs de risque et les mesures préventives concernant la survenue des TPP était incomplète.
Au final, les femmes en période périnatale ont peu de connaissances sur les TPP.
Pregnancy and postpartum are periods of life during which pelvic floor disorders (PFD) can occur.
The aim of this review is to make an inventory of what women in the perinatal period know about PFD, their risk factors and preventive measures.
We performed a systematic review of the literature in PubMed, Cochrane Library, LISSA and Kinédoc databases by using the keywords “knowledge”, “awareness”, “beliefs”, “pelvic floor”, “postpartum” and “pregnancy”. We included studies written in English or French, assessing women's knowledge using a questionnaire and published up to May 2020 with no restriction on start date.
A total of 14 cross-sectional studies were selected from 240 studies, with a sample size of 3950 participants.
The topics covered in the questionnaires were anatomy, pelvic floor function, all PFD, risk factors and preventive measures. Overall, women's knowledge of the perinatal period is limited. It has also been shown that education of women on risk factors and preventive measures regarding the occurrence of PFD was incomplete.
To conclude, the knowledge of women in the perinatal period about PFD is limited.
An exploration of osteopaths’ views and experiences regarding the identification of, and provision of advice for, urinary incontinence in women: A qualitative study using framework analysis
2018, International Journal of Osteopathic Medicine
Citation Excerpt :
Fostering a trusting relationship and therapeutic environment where women feel comfortable disclosing information of a sensitive nature is clearly a necessity if more women are to feel able to discuss their urinary symptoms [20]. Reinforcing this principle, the importance of having a relationship with a GP and a lack thereof having a negative impact on help-seeking behaviour for UI has been reported [22], and lack of approachability a barrier to mentioning symptoms [23]. An aim of this study was to explore why osteopaths might not explicitly ask about UI.
Urinary incontinence (UI) may be defined as a storage symptom of the lower urinary tract resulting in the involuntary loss of urine. UI is common in women, but many of those affected do not mention symptoms to healthcare providers. The prevalence of the condition makes it likely that a large proportion of women attending for osteopathic care will be affected by symptoms of UI. It is not known whether osteopaths routinely ask about urinary UI, or provide advice.
The primary aim of this research was to explore osteopaths’ views and experiences regarding the identification of UI in women.
This research was undertaken as an exploratory, qualitative study. A purposive sample of 11 osteopaths participated in semi-structured interviews. The data were analysed using a framework approach.
A wide variation in views and experience of identifying and providing advice for urinary incontinence in women was found. Identification of UI occurred either by practitioners asking about symptoms; by following up on comments or observations; or, by patient led discussions.
This study has identified barriers to discussing UI in routine osteopathic consultations. UI is common in women and those affected are often reluctant to seek help. Women can be helped to improve their symptoms if they are given appropriate advice. More awareness of the condition and appropriate advice may encourage more osteopaths to consider UI as part of routine care.
Factors affecting help-seeking behaviour of women with urinary incontinence; a commentary providing insights for osteopaths
2016, International Journal of Osteopathic Medicine
Urinary incontinence (UI) is a common condition, affecting approximately one third of women over the age of forty. Recommended first-line management in the majority of cases consists of simple, conservative, self-help measures, and the condition is often highly preventable and treatable. Despite this, many affected by symptoms do not seek help from healthcare providers and do not mention their symptoms when attending for appointments. Rather than seeking help, women will often adopt coping strategies, sometimes to the detriment of their health and wellbeing. Osteopaths are likely to encounter a large proportion of women experiencing symptoms of UI, but may be unaware that their patients are affected by the condition. An extensive body of literature examining the factors that may affect the help-seeking behaviour of women experiencing UI exists and an exploration of this was undertaken in order to consider these factors in the context of osteopathic practice. The factors affecting whether an individual would seek help for urinary symptoms can be described in terms of the triggers that prompt an individual to seek help and also in terms of the barriers that might prevent or delay this. An appreciation of these, along with the risk factors and treatment options may be considerations for osteopaths when treating their female patients. The implications for providing advice to patients should be considered in light of this.
Predicting delay to treatment of urinary incontinence among urban community-dwelling women in China
2015, International Journal of Nursing Sciences
To determine the effect of socioeconomic factors and variables related to delay to treatment on Chinese women with urinary incontinence (UI).
We conducted a cross-sectional survey involving 346 incontinent women living in three urban communities. We enrolled a representative subsample of 196 women who sought treatment for UI within the next six months in the study. Socioeconomic and clinical characteristic data were collected using a self-administered questionnaire and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form.
Of the 196 women (age [mean and standard deviation] 51.58 ± 7.91 years), the delay ranged 1–15 years; 64 women (32.7%) reported a >3-year delay. Age (odds ratio [OR] = 1.98, 95% confidence interval [CI]: 1.31–3.00), lower UI severity (subjective) (OR = 2.32, 95%CI: 1.38–3.87), and non-mixed UI (stress or urgency UI alone, OR = 1.60, 95%CI: 1.11–2.32) were risk factors for longer delay.
Women who were older, had lower subjective UI severity, and who reported only stress or urgency UI tended to delay treatment longer; such patients should be targeted for health education and intervention regarding UI in urban communities.
Women's experiences, beliefs and knowledge of urinary symptoms in the postpartum period and the perceptions of health professionals: A grounded theory study
2017, Primary Health Care Research and Development
Prevalence and course of pregnancy symptoms using self-reported pregnancy app symptom tracker data
2023, npj Digital Medicine

View all citing articles on Scopus

^f1: (Correspondence to LM)

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Regular ArticleWomen's reluctance to seek help for stress incontinence during pregnancy and following childbirth

Abstract

Midwifery

Clinical Effectiveness in Nursing

Midwifery

European Journal of Obstetrics, Gynecology and Reproductive Biology

International Journal of Nursing Studies

The meaning of incontinence: a qualitative study of non-geriatric urinary incontinence sufferers

Journal of Advanced Nursing

Conservative treatment of stress urinary incontinence in women: a systematic review of randomised clinical trials

British Journal of Urology

Identifying morbidity in postpartum women

Modern Midwife

The effectiveness of surgery for stress incontinence: a systematic review

British Journal of Urology

The occurence of symptoms and the proportion treated in Swedish infants and their mothers

Scandinavian Journal of Primary Health Care

Is the six week postnatal examination necessary?

Practitioner

Urinary incontinence in the community – analysis of a MORI poll

British Medical Journal

Maternal health after childbirth: results from a randomised trial in Australian general population practice

British Journal of Obstetrics and Gynaecology

Physical Health problems after childbirth and maternal depression at six to seven months postpartum

British Journal of Obstetrics and Gynaecology

Consensus guidelines for the promotion and management of continence by primary health care teams: development, implementation and evaluation

Journal of Advanced Nursing

Assessing coping strategies: a theoretically based approach

Journal of Personality and Social Psychology

The onset of stress incontinence

Journal of Obstetrics and Gynaecology

Changes in women's physical health during the first postpartum year

Archives of Family Medicine

Postpartum problems

British Journal of Hospital Medicine

Regular Article
Women's reluctance to seek help for stress incontinence during pregnancy and following childbirth