Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery

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 DESCRIPTION (provided by applicant): The Program Project, "Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery" uses mixed methods research to study the influence of intra-abdominal pressure, physical activity and strength on pelvic floor support and symptoms and the cultural context in which women experience those changes. Up to 1 in 7 women undergoes surgery for pelvic organ prolapse or urinary incontinence in her lifetime. Despite the high prevalence and high cost of treating these disorders, urgently needed prevention strategies are scare, reflecting the current state of knowledge. Supported by an exceptional institutional environment and a robust research infrastructure, this Program Project is uniquely positioned to address its primary hypothesis that understanding factors associated with pelvic floor support and symptoms after the first vaginal delivery will lead to developing and testing novel prevention strategies. In this mixed methods research, the core group of 11 investigators from 4 University of Utah colleges will build on the rich tradition of excellence at the University of Utah in research involving pregnant or postpartum women, bioengineering, exercise science, qualitative research, and pelvic floor disorders, to tackle together problems that continue to plague research in pelvic floor disorders. The scope of this project is relevant to the portfolio of the Gynecologic Health and Disease Branch within NICHD, which specifically includes pelvic floor disorders. The aim of this Program is to lay the groundwork for humanistic evidence-based interventions that mitigate the impact of vaginal delivery on deteriorations in pelvic floor support and symptoms with an eye toward early detection, prevention of future bothersome pelvic floor disorders, and provision of culturally sensitive clinical care and self-care resources. The Program will also promote career development of multi-disciplinary trainees in pelvic floor disorders and serve as a resource for future research collaboration in the prevention of pelvic floor disorders. To accomplish this aim, the Program structure includes 3 Cores, Administrative (A), Biostatistics (B) and Clinical Coordination (C), which in turn will support 3 Projects: Project 1: Intra-abdominal pressure and postpartum pelvic floor support and symptoms; Project 2: Physical activity, inactivity, and fitness: Impact on postpartum pelvic floor support and symptoms; and Project 3: The cultural context of postpartum pelvic floor support following vaginal delivery: a comparative ethnographic analysis of Mexican-American and Euro-American women. The Program creates a synergistic team of committed researchers and weaves their skills, ideas, and resources into an optimal environment in which to make discoveries that will improve the health of women.