August 23rd, 2019

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Do Obstetrical Providers Counsel Women About Postpartum Pelvic Floor Dysfunction?
Authors:  Sybil G. Dessie, M.D., Michele R. Hacker, Sc.D., Laura E. Dodge, M.P.H., and Eman A. Elkadry, M.D.
  OBJECTIVE: To assess prenatal counseling practices of obstetrics providers related to postpartum pelvic floor dysfunction at centers with integrated urogynecology services.

STUDY DESIGN: A cross-sectional survey was distributed to obstetrical providers through urogynecology colleagues. The survey included questions about level of training as well as counseling practices related to common postpartum pelvic floor symptoms. All statistical tests were two-sided, and p values <0.05 were considered statistically significant.

RESULTS: A total of 192 surveys were received; 19 respondents did not perform their own prenatal counseling and were excluded. Among the remaining 173 respondents, 94 (56.3%) of those who answered the question reported never discussing postpartum urinary incontinence, and 73.7% reported never discussing postpartum fecal incontinence during prenatal counseling. Obstetrics and gynecology residents were significantly less likely than attending physicians to report discussing various pelvic floor dysfunction topics in prenatal counseling. Among those who reported not counseling women regarding pelvic floor dysfunction, the most common reason cited was lack of time (39.9%) followed by lack of sufficient information (30.1%).

CONCLUSION: Prenatal counseling of pelvic floor dysfunction risk is lacking at all levels of obstetrical training. Limitations of time and information are the obstacles most often cited by providers.
Keywords:  fecal incontinence, incontinence, pelvic floor disorders, pelvic organ prolapse, postpartum pelvic floor disorder, prenatal counseling, urinary incontinence
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