Maternal role and bonding implications of postpartum pelvic floor symptoms: a quantitative and qualitative...

Childbirth-related pelvic floor injuries and conditions (PFICs) can interfere with daily functioning and increase vulnerability to postpartum mental health concerns. In this study we explored the ways in which PFICs may also disrupt maternal role development and bonding.

Individuals with persistent postpartum pelvic floor concerns completed a cross-sectional survey that included validated measures of pelvic floor symptoms, parental competency, and role restriction, and an open-ended response question about the impact of pelvic floor symptoms on their relationship with their baby/children. We conducted independent samples t-tests, bivariate correlations, and multiple regression analyses for quantitative data and inductive thematic analysis for qualitative data.

Of the 222 participants, 56% indicated that their relationship with their baby/child had been impacted by their pelvic floor symptoms; this group reported, on average, greater parental competency difficulties (2.57 vs 2.33, p = .010) and a more restricted role (3.56 vs. 3.26, p = .014). Pelvic floor symptom-related distress scores were associated with greater parental competency difficulties and role restriction. Through thematic analysis we identified five major themes related to how PFICs affected the maternal-child relationship, including activity limitations (particularly carrying or babywearing), bonding difficulties, discrepancy between expectations and reality of motherhood due to PFICs, trouble being present with children, and regret or resentment towards their baby.

PFICs were meaningfully connected to difficulties with maternal role adjustment, maternal-child bonding, and overall wellbeing in the postpartum period. These findings highlight the value of integrating physical health considerations, including pelvic floor symptoms, into our understanding of maternal-child bonding.