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Understanding Vaginal Childbirth: What Do Women Know About the Consequences of Vaginal Childbirth on Pelvic Floor Health?

Dunbar, Ann PT, DPT, MS1; Ernst, Annette MS, OTR/L1,*; Matthews, Catherine MD2; Ramakrishnan, Viswanathan PhD3

Journal of Women's Health Physical Therapy: May/August 2011 - Volume 35 - Issue 2 - p 51–56
doi: 10.1097/JWH.0b013e3182266996
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Objective: (1) Determine whether women who have undergone vaginal childbirth understand the impact of childbirth on pelvic floor health, (2) evaluate differences in knowledge between women with and without private insurance, and (3) determine predictors of knowledge for pelvic risk.

Methods: A total of 205 postpartum women completed a questionnaire assessing their understanding of the impact of childbirth on pelvic floor health. As a proxy for socioeconomic status, data were collected and compared from 2 groups, those with private insurance (n = 98) and those without (n = 107). A pelvic risk knowledge score (PRKS) was calculated by summing the number of vaginal deliveries and those questionnaire items indicating awareness of risk. Statistical analysis included univariate analysis, multiple linear regression analysis, and the Fisher exact test.

Results: Overall, 71% of women surveyed were unaware that vaginal delivery would increase risk of future pelvic floor disorders. While 58% had heard of Kegel's exercises in all, 33% of the noninsured group was familiar compared to 85% of the insured group. Overall, 73% thought that pelvic muscle exercises could lessen the chance of developing bladder/bowel problems later. Adjusting for the demographic variables and completing the multivariate analysis of the PRKS, age (P < .0054) and the variable “Knowledge of Kegel's exercise” (P < .0332) were significantly associated with PRKS suggesting that women who recognize the risk of vaginal delivery for pelvic floor injury are older and are familiar with Kegel's exercises.

Conclusions: The results of this study support the need to develop broad learning opportunities that encourage postpartum pelvic floor health.

1OT/PT Department, Virginia Commonwealth University Medical Center, Richmond, Virginia.

2Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina, Chapel Hill, North Carolina.

3Biostatistics and Epidemiology Division, Medical University of South Carolina, Charleston, South Carolina.

* Retired.

Copyright © 2011 Section on Women's Health, American Physical Therapy Association
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