Pelvic organ prolapse after vaginal birth: A qualitative study on treatment perspectives

Before undertaking any future interventions targeted at preventing pelvic organ prolapse (POP) after vaginal birth, a great depth of understanding of the condition is required. The aim of the paper is to explore postpartum women treatment perspective on POP. The study employed a qualitative descriptive design which involved 12 postpartum women with stages II and III of POP, after vaginal birth in our University Hospital from Constanta, Romania. Age, body mass index, education, parity, comorbidities, previous surgical interventions, and smoking status were evaluated. Each woman was given a semi-structured interview from April to September 2024 immediately and at 6-months after vaginal birth, during which their perspectives on different POP treatment were explored. The interviews were audio-recorded, transcribed verbatim and analyzed using content analysis. The mean age was 29.05 years (range 18-38 years). Most women had a body mass index <30 (66.66%), and 58.33% had a high school as education. There were 58.33% (n = 7) postpartum women with stage II POP with vaginal births without episiotomy and 41.66% on stage III POP (i.e., 4 women with vaginal birth and episiotomy and 1 woman at the 5th vaginal birth only). Four dominant themes emerged immediately after vaginal birth: speeding up the treatment decision for POP by symptomatology; friends and, less frequently, family or Internet, as influencing factors in the choice of treatments for POP; the perspective of a conservative treatment; supervised pelvic floor muscle training and other conservative treatment as the best choice in postpartum. Two themes emerged at 6-months after vaginal birth: desire of un-delaying the treatment, even in case of feeling improved POP symptoms at 6-months postpartum; and the choice of a simple treatment at 6-months, aiming the increasing quality of life. The preference into conservative treatment of postpartum women with POP, supervised pelvic floor muscle training most often indicated among them, could contribute to implement relevant adapted strategies in a field that need more research.