How Does Stigma Associated with Postpartum Urinary Incontinence Affect Health-seeking Behaviours?
Bibliographic record
Abstract
Introduction: Postpartum urinary incontinence (PPUI) affects 30–33% of individuals after childbirth, yet health-seeking behaviours remain low despite the availability of prevention and treatment resources. Stigma associated with PPUI may serve as a barrier to seeking resources to manage PPUI such as communication with healthcare providers (HCPs), engaging in physical activity including pelvic floor muscle training (PFMT), and accessing social support. Previous research has not conceptualized the role of stigma in shaping these health behaviours, particularly among racially diverse populations. This study aimed to examine the stigma associated with PPUI and its influence on health-seeking behaviours including interactions with HCPs, physical activity, and social support. A secondary objective was to assess whether further disparities are faced by racialized women experiencing PPUI and associated stigma. Methods: Semi-structured interviews were conducted with participants who self-identified as experiencing PPUI and had delivered a child in Canada within the last two years. Purposeful sampling ensured racial diversity. Using a qualitative descriptive approach, inductive content analysis identified themes related to stigma and health-seeking behaviours. The Health Stigma Discrimination Framework was also used to organize causal factors of PPUI stigma and to help explain stigma responses and their connection to specific behaviours. Findings: Fifteen individuals participated in interviews (nine identifying with racially diverse backgrounds). Six themes were developed: (1) defining PPUI stigma, (2) impact of PPUI stigma on healthcare access, (3) impact of PPUI stigma on physical activity and PFMT, (4) impact of PPUI stigma on social relationships, (5) racial and cultural nuances regarding PPUI stigma, (6) building awareness and support for PPUI to mitigate stigma. Participants described PPUI stigma as embarrassment and self-consciousness about leakage and odour, deterring seeking healthcare, physical activity, and discussing symptoms socially. Barriers to communicating openly with HCPs included shame and appointments being focused on infant health over personal concerns. PPUI stigma also impacted engagement in physical activity, with fears of leakage and odour leading participants to avoid high-impact exercises such as running, opting instead for lower-impact activities like walking. Socially, stigma was reinforced through cultural norms that discourage disclosure and dismissive attitudes, limiting conversations about PPUI with friends, family, and partners. However, some participants found support through peer networks and informal discussions with friends who had similar experiences. Racial differences also played a role in stigma perception, with some participants from racialized backgrounds describing additional barriers to disclosure with HCPs and social networks due to cultural norms emphasizing silence around women’s health issues. Conclusion: Findings from this study illustrate the impact of PPUI stigma on postpartum individuals, affecting their willingness to seek care, engage in physical activity, and receive social support. Interventions aimed at reducing stigma could focus on early education, routine postnatal health screenings that incorporate asking patients about PPUI symptoms, and peer support networks to normalize discussions about PPUI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".