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Knowledge of Pelvic Floor Disorders in Obstetrics

Mckay, Elishia R., MD*; Lundsberg, Lisbet S., PhD*; Miller, Devin T., MD*; Draper, Ashley, MSN; Chao, Jamie, MD, MS*; Yeh, Judy, MD; Rangi, Sabrina, BA*; Torres, Priscilla, RN§; Stoltzman, Michelle, MD; Guess, Marsha K., MD*

Female Pelvic Medicine & Reconstructive Surgery: August 2, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000604
Original Article: PDF Only

Objectives The aim of this study was to investigate knowledge and demographic factors associated with a lack of knowledge proficiency about urinary incontinence (UI) and pelvic organ prolapse (POP) among pregnant and postpartum women.

Methods This was a cross-sectional survey of women receiving antepartum and postpartum care at 9 Connecticut sites. Knowledge was assessed using the validated Prolapse and Incontinence Knowledge Questionnaire. Lack of knowledge proficiency was defined as less than 80% and less than 50% correct responses on the Prolapse and Incontinence Knowledge Questionnaire UI and POP subscales. Logistic regression was used to evaluate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs). P < 0.05 was considered statistically significant.

Results Surveys from 399 diverse pregnant and postpartum women were analyzed. Three quarters showed a lack of knowledge proficiency about UI and POP (74.2%, 70.6%). After adjustment, increased odds of lacking UI knowledge proficiency were associated with primiparity versus nulliparity (OR, 4.73; 95% CI, 2.24–9.98), Hispanic versus white race (OR, 2.72; 95% CI, 1.18–6.01), and having a high school diploma/General Education Development/less (OR, 3.17; 95% CI, 1.34–7.48) or some college (OR, 2.55; 95% CI, 1.08–6.01) versus bachelor's degree; greater lack of POP knowledge proficiency was associated with having a high school diploma/General Education Development versus bachelor's degree (OR, 2.11; 95% CI, 1.05–4.26) and never seeing a urologist/urogynecologist versus those who had (OR, 0.30; 95% CI, 0.12–0.77). Women working in a medical field versus those who did not demonstrated decreased odds of lacking UI and POP knowledge proficiency (ORs, 0.26 [95% CI, 0.13–0.52] and 0.38 [95% CI, 0.21–0.70]).

Conclusions Pregnant and postpartum women lack knowledge about UI and POP. Preconceptional counseling provides an opportunity for educational intervention.

From the *Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine;

Yale School of Nursing, New Haven, CT;

Danbury Hospital/Western Connecticut Health Network, Danbury, CT;

§Yale New Haven Hospital and Department of Obstetrics and Gynecology; and

Department of Obstetrics and Gynecology, Yale New Haven Health Bridgeport Hospital, New Haven, CT.

Correspondence: Marsha K. Guess, MD, Division of Urogynecology and Reconstructive Surgery, The University of Colorado Anschutz Medical Campus, 12631 E 17th Ave B198-2, Aurora, CO 80045. E-mail:

This article was accepted for poster presentation at the International Urogynecologic Association 41st Annual Meeting; Cape Town, South Africa; August 2 to 6, 2016.

The authors have declared they have no conflicts of interest.

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