The cultural context of postpartum pelvic floor support following vaginal delivery: a comparative ethnographic analysis of Mexican-American and Euro-American women

项目概要/摘要-项目3 本民族志研究的目的是了解产后盆底支持的文化背景 阴道分娩后，如墨西哥裔美国人和欧美女性所经历的那样。主要危险因素 盆腔器官脱垂（POP），主要由经产妇女经历，包括阴道分娩，家庭 历史和年龄;一些研究发现与西班牙裔遗产有关。预防措施已 研究不足，部分原因是女性很少就阴道炎的症状去看医生， 膨胀直到阴道壁下降到或低于处女膜的水平。预防盆腔炎的未来进展 地板障碍将只有实现如果研究工作是针对了解的影响， 变化以及预防战略的执行背景。目前，人们对如何做到这一点知之甚少 妇女开始意识到阴道支撑的早期变化及其对她们的意义。 具体来说，我们感兴趣的是早期发生的骨盆底变化，他们是如何感知，以及如何 妇女开始了解这些变化并作出反应。我们将探索经验- 通过采访生育过的妇女和她们的亲密的其他人（母亲，伴侣，姐妹篇， 关于文化知识的传播，包括发病、预防、管理和 自我护理，特别是与1）对阴道支持早期变化的暗示和理解，2） 与身体活动的相互作用，以及3）如何将这些知识转化为早期发现，改善护理， 生活质量 在目标1中，我们使用聚焦民族志的技术来描述墨西哥裔美国人和欧洲裔美国人 妇女的经验和文化知识的产后骨盆底支持的变化，包括如何早 变化与身体活动的相互作用。在目标2中，从整个母体P01获得的集体知识 该项目的新发现将被汇编成一个全国性的、基于网络的资源工具包 为妇女、她们的家庭和临床医生提供帮助。该工具包将包括一个检查表的早期骨盆底的变化，我们 将开发英语和西班牙语，并在本研究中初步验证。

Project Summary/Abstract – Project 3 The goal of this ethnographic study is to understand the cultural context of postpartum pelvic floor support following vaginal delivery, as experienced by Mexican-American and Euro-American women. Major risk factors for pelvic organ prolapse (POP), experienced primarily by parous women, include vaginal childbirth, family history, and age; some studies find an association with Hispanic heritage. Preventive measures have been understudied, in part because it is infrequent for women to visit a physician regarding symptoms of a vaginal bulge until the vaginal wall descends to or below the level of the hymen. Future advances in preventing pelvic floor disorders will only be achieved if research efforts are directed toward understanding the impact of early changes as well as the implementation context for preventive strategies. Currently, little is known about how women become aware of early changes in vaginal support and its meaning for them. Specifically, we are interested in the early occurrence of pelvic floor changes, how they are perceived, and how women come to understand these changes and respond to them. We will explore the experience inter- generationally by interviewing primiparous women and their intimate others (mothers, partners, sisters, confidants) regarding the transmission of cultural knowledge, including onset, prevention, management, and self-care, especially related to 1) inklings and understandings of early changes in vaginal support, 2) their interplay with physical activity, and 3) how to translate this knowledge into early detection, improved care, and quality of life. In Aim 1 we use techniques of focused ethnography to describe Mexican-American and Euro-American women's experiences and cultural knowledge of postpartum pelvic floor support changes, including how early changes interplay with physical activity. In Aim 2, the collective knowledge gained from the entire parent P01 and novel findings from this project will be compiled into a nationally-disseminated, web-based resource toolkit for women, their families, and clinicians. The toolkit will include a checklist of early pelvic floor changes that we will develop in English and Spanish and preliminarily validate in this study.