A systematic review of the effect of midwifery care for the bladder in Dissertation

A systematic review of the effect of midwifery care for the bladder in labour - Dissertation Example 3 p. 25 Fig. 4 p. 34 Fig. 5 p. 34 Table 1 p. 31 Table 2 p. 48 Chapter 1 Introduction Urinary incontinence (UI) is now being considered as one of the most prevalent conditions worldwide (Lapitan, 2009). Studies have shown that UI affects both men and women. However, it has also been observed that there is a significant difference in the distribution of UI between men and women. Agazzoti, Pesci, Gresce et al (2000) have found out that the prevalence of UI is significantly higher to women than men and that the difference in prevalence becomes more apparent if age is factored. In addition, it is also been learned that women have twice increased chances of being incontinent compared with men (Lapitan, 2009). This finding supports other studies claiming that women have risk increased in becoming incontinent (Ueda, Tamaki, Kageyama et al., 2000; Nelson, Fumer, Jesudason et al., 2001). Pregnancy and postpartum women are a special group with high prevalence of UI. Pregnancy –associated UI is considered as a transient condition in lieu of changes in the body of the pregnant woman, which â€Å"includes fluctuating hormonal levels, increased urine production and changes in the position and relations of pelvic structures in relation to the enlarging uterus occurring during gestation† (Lapitan, 2009, p. 4 -5). On the other hand, postpartum UI is attributed to the changes in the pelvic floor anatomy after childbirth. This condition is believed to be persistent among women (O’Connell, Hannah, Bailey et al., 2002). In effect, there are sufficient studies supporting the claim that there is prevalence of UI among pregnant women and women, in general (O’Connell, et al., 2002; Peake & Menderson, 2003; Samuelsson, Victor & Tibblin, 1997). In the face of this reality, the significant role of midwives in determining the extent of UI of pregnant women is essential in preparing and providing the necessary care that pregnant women needs as they undergo physiol ogical and social changes inherent in pregnancy. Although UI is not life threatening, studies have shown it contributes to a diminish quality of life (Lapitan, 2009; Wagg et al., 2007). In this regard, gaining an understanding of how midwives view incontinence in relation with pregnancy and labour provides a foundation with which responsive to the problem of UI can be framed. As such, this research will be dealing with midwives’ perception pertinent to bladder care. Background of the Study Pregnancy is a complex physiological and social event. However, the increasing intervention of medical technology and medical intervention in pregnancy have contributed to the medicalisation of pregnancy. Although the medicalisation of pregnancy has reduced significantly maternal mortality rate, there is now an increasing question regarding its necessity in terms of normal labour (Johanson, Newburn & Mcfarlane, 2002). The need for approach to pregnancy and birth not only from the perspectiv e physiology, but also from the view of the person – the pregnant woman- is increasingly gaining ground. In other words, the call for being