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Bladder care in the context of motherhood: Ensuring holistic midwifery practice

02 June 2016
Volume 24 · Issue 6


Bladder care throughout the childbearing continuum is one of the essential components of midwifery care, as health of the urinary tract affects both short-term and long-term maternal wellbeing. Throughout antenatal, intrapartum and postnatal care, midwives have the opportunity to safeguard bladder function and to promote normality. As frontline practitioners during pregnancy and childbirth, midwives are ideally placed to facilitate sensitive discussions about bladder function, considering an individualised baseline for each woman's wellbeing and recognising when deviations from the normal process occur (Strahle and Stainton, 2006). With a sound understanding of the physiology and anatomy underpinning bladder care, midwives can educate women about changes during pregnancy, providing reassurance and gold-standard care. A holistic midwifery consideration of both the physiological and psychosocial wellbeing of all women is paramount (Fritel et al, 2016), especially when considering invasive procedures such as catheterisation and the long-term sequelae associated with bladder dysfunction.

The physiological processes of pregnancy and birth involve dramatic changes in the urogenital system, impacting women's bladder health in both the short and long term, and influencing psychological wellbeing (Fritel et al, 2016). The midwife's role involves working alongside women in a trusting, supportive capacity. This uniquely places midwives to engage in meaningful discussions with women about their individual bladder function as part of the development of a trusting midwife–woman dynamic (Strahle and Stainton, 2006). In order to provide a high standard of care, competent skills should be used alongside the best available evidence (Page and McCandlish, 2006; Page, 2008) and midwives should discuss bladder health with sensitivity, acknowledging that matters including stress incontinence, voiding issues, urinary tract infections (UTIs) and pelvic floor dysfunction may be sensitive subjects for women to divulge.

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