A Sisterhood of Women: The Process of Co-Creating Recommendations for Improved Pessary Self-Management Support

<b>Aims</b><br/>This work aimed to explore barriers to pessary self-management and co-create strategies to address these. <br/><br/><b>Design</b><br/>Participatory Action Research<br/><br/><b>Methods</b><br/>In October 2024, eight pessary using women living in the United Kingdom participated in cooperative inquiry, discussion and co-creation of strategies in two virtual workshops.<br/><br/><b>Results</b><br/>Pessary using women who participated in this research identified challenges affecting willingness to self-manage a pessary and proposed solutions to address these and better support women. Pessary practitioners should assess physical capabilities, consider softer, more malleable pessaries, and explore the possibility of a pessary applicator. Peer support was seen as empowering, enabling self-advocacy and improved care, therefore, establishing peer networks was prioritised. Major barriers included difficulty navigating services and limited access to a full range of pessaries, leading some women to buy devices online without medical oversight, creating a two-tier system based on ability to pay. The group called for improved, standardised pessary care, and for self-management to be reframed to avoid women feeling “fobbed off” through better follow-up, positive language, and compassionate care.<br/><br/><b>Conclusions </b><br/>The group identified strategies to address barriers to pessary self-management which require further exploration. Pessary practitioners have a responsibility to listen to these voices and take steps to improve care for women in the future.<br/>