Access to Pelvic Health Physiotherapy Services During Pregnancy and Following Childbirth: A Cross-Sectional Survey

BACKGROUND: Pelvic health physiotherapy (PHPT) is a recommended, evidence-based approach in the management of pregnancy- and childbirth-related pelvic health conditions. However, it remains unclear how many women can access these services. Therefore, the aim of this study was to examine access to PHPT during pregnancy and after childbirth. METHODS: A cross-sectional study was conducted using an online survey. Women who had given birth in the past 4 years and resided in the province of Quebec (Canada) were eligible to participate. The survey included questions on obstetric history, pelvic health conditions, and access to services. Data were analyzed using descriptive statistics and logistic regression. RESULTS: Data from 3,822 women were included in the analysis. More than 95% of them reported at least one pelvic health condition that lasted for more than 3 months during pregnancy and/or in the postpartum period. Physiotherapists were the most frequently consulted specialists, with one-half of the women with pelvic health conditions (50.4%) seeking their services. Among the remaining one-half, the main reasons for not consulting PHPT included perceiving the issues as normal and self-resolving, a lack of awareness that PHPT could help, and the absence of a referral or recommendation. Accessing PHTP was most strongly associated with higher income and university education, third- or fourth-degree perineal tears, and experiencing diastasis recti or pelvic organ prolapse, with each of these factors associated with more than double the odds of consulting PHPT. CONCLUSIONS: The results reveal poor access in a population with a high need for PHPT services, largely due to insufficient knowledge about pelvic health conditions and a lack of awareness of the relevance of PHPT.