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A scoping review exploring stigma associated with postpartum urinary incontinence

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Abstract

Introduction and hypothesis

Postpartum urinary incontinence (UI) is prevalent, yet health-seeking behaviours for prevention and treatment are markedly low. Health-related stigma refers to conditions that may be socially devalued and considered deviating from “expected norms” and is a barrier to equitable health care. It may be plausible that stigma is associated with postpartum UI and leads to avoiding health-seeking behaviours, which this scoping review sought to examine and summarize.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews was followed. The following keywords were used to develop a search strategy: Postpartum, Urinary Incontinence and Stigma. The search was carried out on PubMed, PsycInfo, Scopus, CINAHL, Web of Science and ProQuest Dissertation and Theses Global. All study designs (clinical trials, observational studies, qualitative studies) were eligible for inclusion. Data were extracted and mapped to identify causal factors of postpartum UI stigma and implications for outcomes and behaviours.

Results

Twelve studies were included. Most studies utilized questionnaires assessing constructs related to quality of life that also captured potential stigma, or interviews. Sources of postpartum UI stigma included community values surrounding UI and self-stigma, whereby participants directed stereotypes associated with urinary leakage towards themselves. Implications of postpartum UI stigma included negative mental emotions such as shame and embarrassment, which led to avoiding situations where they needed to disclose symptoms, including in health care environments.

Conclusions

Future research requires a purposeful assessment of postpartum UI stigma to learn from lived experience how to mitigate stigma and improve quality of care.

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Authors and Affiliations

  1. Kinesiology, Sport and Recreation, University of Alberta, 116 Street and 85 Avenue, Edmonton, AB, T6G 2R3, Canada

    Jordyn M. Cox & Taniya S. Nagpal

  2. AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain

    Miguel Sánchez-Polán & Ruben Barakat

  3. H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisboa, Portugal

    Patrícia Mota

  4. Univ Lisboa, Fac. Motricidade Humana, CIPER, LBMF, 1499-002, Lisboa, Portugal

    Patrícia Mota

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  4. Ruben Barakat
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Contributions

J.C. and T.S.N. conceptualized the study. J.C. led the study methods, including screening and data extraction, with support from M.S.-P. and T.S.N.. J.C. led data interpretation, with support from all authors. P.M. and R.B. provided essential expertise on the health condition (urinary incontinence) and study population (pregnancy). J.C. and T.S.N. drafted the manuscript. All authors reviewed and approved the manuscript.

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Correspondence to Taniya S. Nagpal.

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Cox, J., Sánchez-Polán, M., Mota, P. et al. A scoping review exploring stigma associated with postpartum urinary incontinence. Int Urogynecol J 34, 1997–2005 (2023). https://doi.org/10.1007/s00192-023-05526-0

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  • DOI: https://doi.org/10.1007/s00192-023-05526-0

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