Women's Experiences, Beliefs and Knowledge of Urinary Symptoms in the Postpartum Period and the Perceptions of Health Professionals
The study was developed after research with older women suffering urinary symptoms showed that many had tolerated social, psychological and hygiene effects on their lives for some time. There is evidence that some symptoms in later life may originate from pregnancy and childbirth. However, whist there is evidence that pelvic floor muscle exercises can be effective in the short term, there is a paucity of research on the reasons why women tolerate symptoms in the postnatal period rather than seek help. It was also unclear what significance the interactions with health professionals had in aiding or suppressing help-seeking. The aim of this qualitative study was to use grounded theory methodology to describe women’s experiences and knowledge of urinary symptoms in the postnatal period and the perceptions of health professionals. Fifteen women were interviewed in the postnatal period, and one woman was interviewed twice. From the interviews and observations of antenatal clinics and postnatal groups three categories emerged; messages women receive, seeking and understanding information and responding to the messages. Views and knowledge of health professionals were obtained through two focus groups of five. From the analysis of the findings the following five categories emerged; clarifying pathways of care, clarifying education, improving communication, understanding actions and serious issues. The core category arising from this; overcoming barriers to facilitate empowerment, revealed barriers that women and health professionals must overcome in order to approach the issue of urinary incontinence collaboratively. This study identified that there can be problems with communication at all levels between women and health professionals, resulting in poor communication regarding urinary symptoms and accessing treatment. Furthermore, superficial education regarding pelvic floor muscle exercises and dysfunction, both in the antenatal and postnatal periods, coupled with difficulties with disclosure on a sensitive subject could be disempowering for women and health professionals. In particular, women found the possibility of an examination so soon after delivery worrying. Normalisation was a negative but powerful influence on women, encouraged by friends and family. It is suggested that, by developing interventions that enable women and health professionals to overcome the barriers of communication and knowledge exchange, women could be empowered in relation to their physical health after childbirth to manage their urinary symptoms. Empowerment for women, therefore, with regard to postnatal urinary symptoms means being able to believe that looking after the pelvic floor is normal rather than accepting urinary symptoms after childbirth as inevitable.