“Sometimes I laugh so hard, tears run down my legs…”
This recollection offers a glimpse into one of the most pervasive experiences related to childbirth and the pelvic floor. Incontinence and pelvic floor dysfunction (PFD) have been ignored and normalized to such an extent that suffering is now an expected part of parenthood. Maternity care, including community midwifery, has yet to fully embrace the magnitude of pelvic floor dysfunction and the overwhelming impact it has on birth and a client’s quality of life.
The most common and persistent complication from PFD is stress urinary incontinence (SUI). The prevalence of incontinence is hard to measure accurately because of the stigma and socialized shame associated with the condition, but several researchers have recorded that more than 40% of childbearing women report urinary incontinence up to 5 years postpartum. Still other sources record SUI prevalence closer to 80% for the general female population.
Research also notes that pelvic floor dysfunctions rarely occur in isolation—close to 50% of PFD patients have multiple dysfunctions that coexist. Research from 2019 indicates comorbidity occur 59% of the time for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) during pregnancy. Records show that the prevalence of surgical intervention for PFD is 1 in 5 for 80-year-old women in the United States which poses a significant financial burden that will continue to increase as the population ages.
The pervasiveness of SUI and PFD is a crisis within maternity care because the prevailing standard of care is ignorance, inaction, and acceptance. Parents and maternity care providers neglect reporting and discussing the symptoms of SUI because of cultural taboos and a lack of understanding about PFD. There is a clear need for evidence-based clinical guidance for maternity care providers to screen for and discuss the risk of developing SUI and pelvic floor dysfunction in pregnancy and the postpartum period.
This website is an extension of a Master’s Project created at Bastyr University by Olivia Joy Kimble, SMW, CD(DONA). This project is a declaration of recognition and love to the people and parents who have struggled with pelvic floor dysfunction without support or help from the medical community for decades. Your struggles and experience are not invisible.
