Falling Out: Authoritative Knowledge and Women's Experiences with Pelvic Organ Prolapse

Abstract

Introduction Despite the high prevalence of pelvic organ prolapse many women suffer in silence, lacking the language and opportunity to describe their condition. There are limited descriptions of women’s experiences with pelvic organ prolapse in the literature. This qualitative study addressed the knowledge and experience of women with pelvic organ prolapse. Methods Semi-structured interviews were conducted with 13 women who had been previously diagnosed with pelvic organ prolapse. Transcripts of the interviews were reviewed and coded using a process of content analysis compared against the framework of authoritative knowledge, developed by Bridgitte Jordan. Results By applying the concept of “authoritative knowledge,” we identified three themes of how women construct understanding about their pelvic organ prolapse and how they demonstrate deference to the authoritative knowledge of medical providers. First, we found through women’s narratives that authoritative knowledge was held by the health care provider and is considered consequential and legitimate by all participants. Second, women reported that the health care provider’s authoritative knowledge was valued over personal, experiential knowledge. Finally, women describe how they work with their health care providers to create a system of authoritative knowledge as they seek treatment for or discuss their condition. Throughout the narratives, women’s experiences are not well acknowledged by themselves or the medical community, perpetuating the “hidden” nature of these conditions. Discussion This analysis provides qualitative evidence of Jordan’s authoritative knowledge: women and health care providers contribute to dimensions of authoritative knowledge surrounding pelvic organ prolapse. Despite what women experience, the health care provider’s definition and understanding of pelvic organ prolapse is seen as legitimate and consequential. Because of their construction of their condition, and the power dynamic at play, women are silenced and their expertise about their body is delegitimized, limiting their active participation in seeking care for this condition.

Online reported women's experiences of symptomatic pelvic organ prolapse after vaginal birth

“…Improved information about potential pelvic floor problems could help better prepare women to manage sPOP following vaginal birth. Sadly, several other studies have shown similar results as ours regarding miscommunication between women with pelvic floor injury and healthcare professionals [11,12,19,20]. Midwives, obstetricians and physiotherapists need to be aware of the discourse on these forums and take part in the dialogue in order to ensure professional support for these women.…”

A systematic review and meta‐synthesis of qualitative studies on pelvic organ prolapse for the development of core outcome sets

“…We included a total of 17 studies that evaluated POPrelated experiences of a total of 497 women by using different methodologies and tools for data collection. The main characteristics of the included studies 4,5,7,8,12,16,[26][27][28][29][30][31][32][33][34][35][36] are presented in Table 1.…”

“…Pelvic floor disorders and their impact on women are addressed in different ways and women's awareness of this condition is widely variable. [3][4][5][6] While some women may not seek medical care or wait for several years before seeking medical care for POP, 7,8 some women only disclose relevant information when asked questions directly about their symptoms and their impact on the quality of life, which also appears highly variable. [9][10][11][12][13] The impact on individual patients but also on clinical practice and research is therefore highly variable.…”

Predictive Factors for Pelvic Organ Prolapse in Iranian Women’s, An Ordinal Logistic Approc

“…There are common risk factors for POP, including aging, pregnancy, vaginal birth, birth trauma, chronic increases intra-abdominal pressure (obesity, chronic constipation, chronic coughing, repetitive heavy lifting), menopause, estrogen deficiency, genetic factor, prior surgery, myopathy, collagen abnormalities, smoking and lifestyle [3,12,13]. In prior, studies have used of X2, t-test, liner and logistic regression to find relationship between prolapse stage and risk factors.…”

“…It is a common condition among women [1,2]. POP can affect the women of all ages and is associated with functional problems of the pelvic floor [3].…”