Women's perception of postpartum pelvic floor dysfunction and their help-seeking behaviour: a qualitative interview study.

Aims: To explore women's perception of postpartum pelvic floor dysfunction and their help-seeking behaviour.

Methods: We interviewed 26 patients from two family practitioners' populations in the Netherlands 1 month to 1 year after their vaginal delivery. The semi-structured interviews were independently encoded and analysed by three researchers according to a scoring list on determined topics. Three researchers independently coded themes discussed by the interviewees that matched main topics from the interview guide. In the case of encoding differences, the researchers deliberated on them until consensus was reached.

Findings: All women suffered from pelvic floor dysfunction such as urinary incontinence, pelvic floor pain, prolapse, haemorrhoids, anal fissure, constipation and dyspareunia. Midwives and gynaecologists did not prepare them for postpartum pelvic floor problems. The women did not expect the problems to be that severe. They hoped their problems would improve by themselves. The women talked to close initiates (female relatives and friends who had had deliveries themselves), who confirmed that the problems were an inevitable consequence of vaginal delivery and that there were no real treatment options. The women indicated they needed professional information about their pelvic floor problems but were ashamed to talk about them outside their inner circle.

Conclusions: These women are uninformed about postpartum pelvic floor problems. They discuss their pelvic floor dysfunction with close initiates who feed their hope that the problems will resolve spontaneously. The women are not stimulated to seek professional help. However, the women do indicate they need professional information. They want to understand their problems and know how to deal with them. It is time for doctors and midwives to focus on the mother's health after delivery so that mothers will suffer less from pelvic floor problems, have more awareness of what they can do about them and call in medical aid.