Women’s experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal

Abstract

BackgroundAlthough uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women’s experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices.MethodsUsing a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September–December 2012. All interviews occurred in outreach clinics in villages of the Dhading district.ResultsStudy participants were 23–82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband’s sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women.ConclusionsUP adversely affects women’s daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP.

Experiences of Women Affected with Uterine Prolapse: A Qualitative Study from Baitadi District

“…Backache, lower abdominal pain and discharge were the major physical symptoms mentioned by the women, which was similar in other studies 4,15 . Difficulty during major activities such as walking, lifting and sitting was major complaints is documented in other study also 8 which causes several problem in their daily life.…”

“…Uterine Prolapse (UP) is a condition in which a woman's supportive pelvic muscles, tissues and ligaments break away from the body's internal structure and the uterus, rectum, or bladder drops into or out of the vagina 3 . Although uterine prolapse occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP 4 .…”

Health-Seeking Behaviors and Self-Care Practices of People with Filarial Lymphoedema in Nepal: A Qualitative Study

“…This study involved a deductive approach for content analysis [ 20 ]. A similar analysis framework has been used in Nepal before [ 21 ]. The transcript was saved in Microsoft Word 2007.…”

Age as the Risk Factor that Affected the Increased Degree of Uterine Prolapse

“…This certainly decreases the quality of life of a woman. (10) There are many government efforts that have been made in the prevention of risk factors that increase the incidence of uterine prolapse. This is done in order to improve the quality of human life in Indonesia, which has been scheduled in 5th point of Nawa Cita.…”