The Importance of Information: Prenatal Education Surrounding Birth-Related Pelvic Floor Trauma Mitigates Symptom-Related Distress

Background: Birth-related pelvic floor trauma and its sequelae (PFTS) are associated with higher rates of perinatal mood and anxiety disorders in the fourth trimester. The fourth trimester is a critical window for long-term health outcomes, and identifying factors that buffer the impact of PFTS is an important research priority. Objectives: We hypothesized that lack of prenatal pelvic floor-focused education may be associated with greater distress following PFTS. Study Design: Hypotheses were investigated using a repeated-measures (study 1; n = 36) and cross-sectional (study 2; n = 226) design among participants reporting PFTS. Questionnaires were completed online, and included qualitative and quantitative responses. Methods: Study 1 participants completed a questionnaire within the first 8 weeks and approximately 3 months postpartum. Study 2 participants (≤5 years postpartum) completed a 1-time questionnaire. We examined associations among pelvic floor education, pelvic floor symptoms, and indices of mental health. Moderation analyses were conducted (study 2) to test whether the association between pelvic floor and mental health symptoms varied depending on level of discrepancy between postpartum expectation and experience. Results: In both studies, a high percentage of participants reported a lack of pelvic floor education, and significant associations were seen between pelvic floor and psychological symptoms. In study 2, individuals who reported high discrepancy between expectations and experience had the strongest associations between pelvic floor and psychological symptoms; for those reporting low discrepancy, the association was nonsignificant. Conclusion: Prenatal pelvic floor education is a key aspect not just in reducing risk of PFTS, but mitigating distress if it does occur.