“We don’t talk about it enough”: Perceptions of pelvic health among postpartum women in rural communities

Purpose: A descriptive qualitative study was conducted to explore perceptions and experiences related to pelvic health in the postpartum period among a cohort of women residing in communities with less than 50,000 residents. Methods: A semi-structured interview approach guided by the Theory of Planned Behavior was used. Postpartum individuals (<6 months since childbirth) were interviewed in the fall/winter of 2021–2022. Results: Specific to individuals’ attitudes toward pelvic health, women viewed Kegels as an important component to improving pelvic health but had a negative attitude toward their own pelvic health, often identifying their pelvic floor as “weak.” The subjective norms influencing a woman’s perception were typically, a positive influence by family/friends and the Internet, although the Internet was viewed as an insufficient resource. Healthcare providers were noted as an infrequent and ineffective resource for education and support in the postpartum period. Finally, women’s perceived behavioral control to manage their pelvic health was influenced by limited knowledge of pelvic health and time, and a desire for more education from their primary care provider and geographical barriers. Conclusion: Innovative strategies are needed to support postpartum women’s pelvic health within rural communities. Primary care providers may benefit from the development of “quick tips” by specialists, such as women’s health physical therapists, to optimize pelvic health discussions with their postpartum patients. Education interventions targeted toward postpartum women in rural communities should focus on strategies that address the geographic barriers identified while still providing individualized care. Options, such as webinars, telehealth, and text message interventions, could be considered.