Pelvic Floor Dysfunction In Rural Postpartum Mothers In The Usa: Prevalence, Severity And Psychosocial Correlates

Abstract

PURPOSE: The purpose of this study was to characterize pelvic floor dysfunction (PFD) among postpartum women residing in rural communities (<50,000 residents) in the United States and explore the demographic, knowledge level, and psychosocial correlates of PFD. METHODS: A cross-sectional survey utilizing a convenience sample of rural postpartum women in the United States was employed. A survey packet comprised of the Pelvic Floor Disability Index (PFDI-20) and Prolapse and Incontinence Knowledge Questionnaire (PIKQ) as well as the Edinburgh Perinatal Depression Screening (EPDS), items from the Canadian Sexual Health Indicator (CSHI) survey, and demographic questions were distributed via electronic link via social media recruitment. Descriptive statistics were calculated and multivariate logistic regression was used to assess the factors associated with PFDI-20 score. RESULTS: : A total of 383 participant responses were analyzed. The majority of postpartum women have limited knowledge of the pelvic floor despite experiencing moderate symptoms of dysfunction. Most women report symptoms primarily related to urinary and colorectal/anal distress. Women report being moderately confident in their ability to utilize sex protection. Over half of women scored ≥14 on the EPDS indicating probable depression. Women with high scores on the EPDS and low scores on the PIKQ have significantly greater odds of reporting moderate to severe PFD. Women who reported not breastfeeding or who were engaging in hard exercise on a regular basis had significantly greater odds of reporting moderate to severe PFD. CONCLUSIONS: Rural women with low pelvic health knowledge and probable depression are at increased risk of suffering from greater severity of PFD. Increased opportunities for education on how to engage in pelvic floor muscle strengthening during the perinatal period are needed. In addition, future research should continue to explore the relationship between PFD and psychosocial correlates like confidence in contraception use and postpartum depression.