Pregnancy-related pelvic girdle pain in Australia and the experiences of women and healthcare professionals

Abstract

Pregnancy-related pelvic girdle pain (PPGP) is the most commonly reported musculoskeletal disorder during pregnancy creating significant physical challenges and psychosocial impacts for women. However, there is little information about PPGP in Australia. The over-arching goal of this thesis was to acquire new knowledge about PPGP in Australia, specifically Western Sydney. The program of research sought to explore the following research questions:
1. What is the prevalence of PPGP and associated factors in an Australian population?
2. What is the lived experience of women with PPGP and impacts on daily life as well as the coping strategies that women with PPGP adopt and additional supports required to meet their care needs?
3. What are the views of HCPs towards PPGP and how it should be managed? Based on the work conducted in a series of three research studies, this thesis comprises seven published peer reviewed journal articles and one published guest editorial. Initially, the prevalence of PPGP and the risk factors associated with PPGP were investigated in an Australian context. In a large sample of pregnant women (n=780), almost half (44%) were classified with PPGP using the recommended classification system. A key finding was a history of low back pain or pelvic girdle pain and/or a family history of PPGP were strongly predictive of PPGP. Parity and time spent standing were also factors associated with PPGP. The knowledge of these factors may be used to develop the assessment procedure, such as a screening tool, to identify those at risk of developing PPGP.
In the second study, women with PPGP (n=20) were interviewed to describe their lived experience of PPGP. Thematic analysis revealed that women were unprepared for the pain, iv which impacted their daily lives and forced them to develop coping strategies, including greater social support, self-care and receiving care from healthcare professionals (HCPs). A directed content analysis was undertaken to extend the findings from this study, highlighting that the care needs of pregnant women with PPGP were not being met and that women required greater support from healthcare services, including early education and intervention, to help them manage PPGP.
The findings of these studies highlighted that while PPGP is a common problem in Australia, consistent with other countries, it is under-recognised by both women and HCPs and leads to challenges in the organisation of care and adequate support for these women. Through listening to women who suffer from PPGP and those who provide care for them, this thesis extends the current understanding of care provision for PPGP and underlines that improvements are required to meet women’s needs more effectively. This thesis makes a number of recommendations for clinical practice and supports an emphasis on adopting a feminist approach to empower Australian women to be able to participate in shared decision making during pregnancy.

Date of Award	2024
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Amitabh Gupta (Supervisor), Lucinda Chipchase (Supervisor) & Pranee Liamputtong (Supervisor)