Urinary Incontinence and Constipation During Pregnancy and After Childbirth

Abstract

Summary A total of 2,062 women (858 primigravidae, 1, 057 multigravidae [2–4], and 147 multigravidae [5+] participated in a study to assess the impact of pregnancy upon continence and constipation. A questionnaire was administered on the maternity wards of the Rotunda Hospital, Dublin, two or three days after delivery and a follow-up questionnaire was mailed at three months to a cluster sample of women who gave birth during a randomly selected month. A further follow-up questionnaire was mailed nine months after the birth to a random sample of the multiparous (2–4) group who indicated leaking on the first questionnaire. Of the total number of women questioned initially, 59% experienced some degree of leaking, the incidence of which significantly increased with parity (x 2 = 56.26; p = 0.0001). The incidence of incontinence before pregnancy was 31% in the multiparous (2–4), 44% in the multiparous (5+) and 11% in the primiparous group. Of the total women questioned 35% suffered from constipation, the incidence of which also significantly increased with parity (x 2 = 6.034; p = 0.049). At three months post partum, 63% of the 152 respondents who returned the follow-up questionnaire were still leaking. The second postal questionnaire indicated that 33% of the respondents 72 were still leaking at nine months. The results of this study have established the scale of the clinical problem of post-partum urinary incontinence. Consequently, a ‘promotion of continence questionnaire’ has become an integral component of post-natal physiotherapy care at this centre.