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Lack of care? Women's experiences of maternity bladder management

02 January 2019
19 min read
Volume 27 · Issue 1

Abstract

Background

A healthy urinary system is vital to every woman's life, and the relationship between childbirth and bladder dysfunction has been well documented in the medical literature.

Aims

To explore women's bladder care experiences during the antepartum, intrapartum, and postpartum periods.

Methods

An exploratory, descriptive research study with nine in-depth semi-structured interviews.

Findings

Thematic analysis showed three themes: ‘muddling through to earn “a badge of honour”’, ‘caring for a baby, but who cares for me?’ and ‘do you speak bladder language?’ with an overarching theme of ‘lack of bladder care’. Women's experiences reflected a lack of understanding, information, and promotion regarding bladder care, aggravated by the use of ambiguous language when professionals communicated with women about bladder health.

Conclusions

Bladder care was very limited for women during the antepartum, intrapartum and postpartum period although reports of urinary incontinence were frequent. Bladder care could therefore be characterised as ‘lack of bladder care’. Clinicians should become more proactive in delivering information and promoting bladder health during these periods but that attention needs to be paid to communication methods.

Although a healthy urinary system is an essential aspect of every woman's life, health professionals often neglect bladder management during pregnancy, labour, and puerperium (Carr and Cook, 2009). The relationship between childbirth and bladder dysfunction is well documented in the medical literature (Chaliha, 2006); however, experiences in maternity bladder care have not been published, and no research has been developed to address this topic to date. Stress urinary incontinence is estimated to be present in over 150 million women worldwide (Irwin et al, 2011), although childbirth is not the only risk factor (Stothers and Friedman, 2011). Modern western lifestyle activities—such as obesity, constipation, smoking, caffeine and alcohol consumption, and certain forms of exercise—contribute to the development of stress urinary incontinence in young nulliparous women of childbearing age (O'Connell et al, 2001). According to 2014/2015 statistics, in England, approximately 58% of women were obese or overweight, 28% ate the recommended five portions of fruit and vegetables a day, 31% played sport at least once per week (NHS Digital, 2016a), and 44% had drank alcohol once a week or more (NHS Digital, 2016b).

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