Knowledge, practice patterns and preventive counseling regarding peripartum pelvic floor disorders among Swiss healthcare professionals

Abstract Pregnancy and childbirth are partly modifiable risk factors for pelvic floor disorders (PFD). Many women are neither aware nor informed about possible sequelae of childbirth. For higher awareness of this public health issue, the Swiss Society of Gynecology and Obstetrics published an information brochure with a focus on written health information and preventive strategies. Together with the launch of the brochure, an online survey was conducted to study the level of awareness of PFD (i) and to describe the current practice patterns and preventive measures among different health professionals (ii). From December 2022 to April 2023, an online survey in French, German and Italian was created and sent by the Swiss Society of Gynecology and Obstetrics, the Swiss Association of Midwives and the Association of Swiss Pelvic Floor Physiotherapists (pelvisuisse) to their members. The descriptive, cross-sectional survey consisted of 22 questions designed to assess the awareness, practice patterns, and preventive strategies towards educational resources. 211 professionals responded to the survey: 100 gynecologists, 75 midwives and 36 physiotherapists from all regions of Switzerland. Regarding awareness (i) respondents discuss in 68% possible consequences of pregnancy and childbirth on the pelvic floor with their patients. 20% discuss PFD only in case of risk factors or symptoms. Information on urinary incontinence (UI) is given by 44%, on pelvic organ prolapse (POP) by 33% and on fecal incontinence (FI) by 26%. For the practice patterns and prevention of PFD peripartum (ii) most participants recommend perineal massage (77%) and one in five pelvic floor physiotherapy. The mode of delivery regarding possible birth injuries is rarely discussed, unless the pregnant women ask for it (32%), whereas the consequences of Caesarean section (CS) are a frequent topic in the consultations (58%). To raise awareness of PFD during pregnancy and the postpartum period, a professional brochure represents an initial step toward offering appropriate support for healthcare providers. Integrating information about FI into counseling poses greater challenges compared to UI. This survey underscores the considerable potential for healthcare providers to enhance the frequency and scope of information and prevention efforts addressing PFD in peripartum women.