Women's perceptions of urinary incontinence during the postpartum period: systematic review of qualitative evidence

Abstract

[Abstract] Background: Urinary incontinence is a common condition in the postpartum period, although most women do not seek help because they believe that their problems resolve spontaneously. Urinary incontinence has been associated with feelings of distress, shame, anxiety, depression, and social isolation. This systematic review of qualitative studies aimed to enhance the knowledge of postpartum women's perceptions of urinary incontinence, particularly their feelings and problems in their daily lives.

Methods: This qualitative evidence review was registered in PROSPERO (CRD42024596647) and conducted in accordance with the ENTREQ reporting guidelines. From inception until 19th December 2025, a comprehensive search of qualitative findings was conducted across the MEDLINE, EMBASE, Web of Science, PsycINFO and CINAHL databases, and grey literature sources (the ProQuest Dissertations & Theses, OpenGrey, Google Scholar, and the Zenodo repository). Additionally, reference lists of the included studies were also screened. Studies reporting a qualitative analysis of the perceptions associated with urinary incontinence in postpartum women were included. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess study quality. A thematic synthesis approach was applied to generate codes and themes through inductive, data-driven analysis. The GRADE-CERQual approach was used to assess confidence in each synthesized finding.

Results: The review included 15 studies comprising 712 postpartum women (20–45 years old) who had delivered vaginally, by cesarean section, or via both modes. The postpartum period was defined as the first 12 months after childbirth. The review included studies from various countries, including Turkey, the Netherlands, Canada, the United Kingdom, Australia, China, Ireland and the United States, conducted between 1999 and 2025. Three analytical themes emerged: the perception of urinary incontinence as not a problem, the feelings associated with urinary incontinence, and problems in daily life. The GRADE-CERQual appraisal indicated high confidence in all synthesized findings.

Conclusions: This meta-synthesis highlights the impact of postpartum urinary incontinence on women’s well-being, causing discomfort, anxiety, and sadness despite its normalization. The findings emphasize the need for better education, healthcare, and support, with health professionals encouraged to provide early interventions to improve postpartum well-being.