Associations of urinary incontinence and postpartum physical activity: a mixed methods investigation

Many women in the postpartum period (birth through 12 months after delivery) have low physical activity and are at risk for negative health conditions. These women may benefit from interventions designed to increase physical activity and improve health. Urine leakage is common in the postpartum period and may contribute to low physical activity. Yet, few studies have examined the influence of urine leakage on postpartum physical activity. This dissertation aimed to understand how and why urine leakage influences postpartum physical activity. First, 244 postpartum women completed online surveys to provide information on their physical activity and urine leakage. Next, 30 of those women who reported urine leakage in the online surveys were interviewed and asked about their experiences with urine leakage and physical activity. The results of the first study indicate that the severity of leakage, pattern of leakage, and level of bother due to leakage were related to postpartum physical activity. The second study showed that urine leakage was a barrier to postpartum physical activity leading women to stop activity, decrease intensity, or use compensatory strategies. Women want more guidance on managing leakage and returning to physical activity and would like an individualized, app-based intervention from a pelvic floor physical therapist which targets the pelvic floor and provides general exercise recommendations. Birth providers should screen women for leakage and refer them to pelvic floor physical therapists for more information on managing leakage and returning to physical activity. Further, postpartum physical activity interventions should be developed for women with leakage.