Prevention and treatment of peripartum urinary incontinence—a survey of hospital-based maternity services in Ireland

• Published in: International Urogynecology Journal Vol. 33; no. 12; pp. 3481 - 3489
• Main Authors: Daly, Deirdre, Moran, Patrick, Wuytack, Francesca, Cusack, Cinny, Hannon, Kathleen, Begley, Cecily
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2022; Springer Nature B.V
• Subjects: Education; Electronic health records; Exercise Therapy - methods; Female; Gynecology; Health promotion; Hospitals; Humans; Ireland; Maternal child nursing; Medicine; Medicine & Public Health; Midwifery; Original Article; Pelvic Floor - physiology; Pelvis; Peripartum Period; Physical therapy; Postpartum Period - physiology; Pregnancy; Prevention; Urinary incontinence; Urinary Incontinence - prevention & control; Urology; Womens health; Ireland; Urinary incontinence; Pregnancy; Pelvic floor; Survey; Postpartum
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-022-05361-9

Introduction and hypothesis
Considerable proportions of pregnant and postpartum women experience urinary incontinence, but to our knowledge, there are no national data on the preventative and treatment services available in Ireland’s 19 maternity hospitals.
Methods
Ethical approval was granted. A national benchmarking survey on the range and type of services on prevention and treatment of urinary incontinence during pregnancy and postpartum was developed. Directors of Midwifery and Nursing in each hospital identified midwives and women’s health physiotherapists to complete the survey. Data were analysed descriptively, and results presented as proportions.
Results
Responses were received from 17 hospitals. Women were asked about urinary incontinence during their first booking visit in 6 hospitals, during all antenatal visits in 2 and the onus was on women self-reporting symptoms in 9. Pelvic floor muscle exercises were taught in antenatal classes in 14 hospitals and management of urinary incontinence in 9. In hospital postpartum, midwives in 13 hospitals asked women about urinary incontinence. All women were seen by a physiotherapist in 7 hospitals and only those who were referred in 6. Women could access the hospital’s physiotherapy services up to 6 weeks postpartum in 3 hospitals, up to 6 months or 1 year in 5 and beyond 1 year in 6.
Conclusions
Geographical inequity exists in the services offered to pregnant and postpartum women nationally. This indicates that many pregnant and postpartum women, both continent and incontinent, cannot avail themselves of preventative and treatment services within the maternity hospital system and points to the need to review, reconfigure and resource services.