Women's Explanations for Urinary Incontinence, Their Management Strategies, and Their Quality of Life During the Postpartum Period

PURPOSE: Although pregnancy is a risk factor for urinary incontinence (UI), minimal information is available to help clinicians understand postpartum women's experiences of UI. Our aim was to explore postnatal women's explanations for UI, strategies for managing and dealing with UI, rationale for not doing anything about UI, and its influence on their quality of life. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: The participants were 75 women who had given birth to live children at Viborg Hospital in Denmark during a 3-month period from November 2002 to January 2003 and who had experienced UI since giving birth. METHODS: UI questionnaires were mailed to women who had given birth at Viborg Hospital during a 3-month period. The questionnaire included the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and the General Continence Questionnaire. A follow-up letter was sent to potential participants 2 weeks after the initial mailing. RESULTS: The most frequently reported lower urinary tract symptoms were small amounts of urine leakage (59%) and leakage related to physical activity, coughing, or sneezing (55%). Half the women reporting these symptoms indicated that they were moderately or greatly bothered by them. Living with UI affected the willingness of some women to go to places where they were unsure about the availability of toilets (27%), as well as the way in which they dressed (31%). Some women reported diminished ability to have sexual relations (23%) and reduced involvement in physical and recreational activities (23%). UI was associated with feelings of frustration (25%) and embarrassment (25%). Most participants (76%) perceived that they had become incontinent due to weakened pelvic floor muscles and because they had not performed sufficient pelvic floor muscle exercises. The most common management strategies for UI were more frequent toileting (64%) and pad use (56%). Some women (24%) reported that they had done nothing about their UI. CONCLUSION: Given the profound impact UI usually exerts on the lives of postpartum women and the common use of ineffective management strategies, healthcare clinicians need to actively screen for and treat this condition.