KAPP-knowledge, attitudes, and practices of healthcare professionals on postpartum pelvic floor dysfunction: a cross-sectional study from Germany

Abstract

Introduction and Hypothesis Pregnancy and delivery are known risk factors for the development of pelvic floor dysfunction (PFD). An electronic cross-sectional survey was distributed to physicians, midwives, and physiotherapists in Germany, assessing demographics, knowledge, and awareness of postpartum PFD risk/protective factors, and personal or spousal preferences for cesarean section (CS) as a preventive measure. Differences across professional groups were also analyzed. Methods An anonymous online survey was conducted via Qualtrics from January 25 to April 15, 2025. The German-language survey targeted healthcare professionals involved in obstetric or postpartum care. Data analysis was performed using SPSS version 28.0 for Mac OS X. Chi-square tests compared binary and categorical variables. P values of < 0.05 were considered statistically significant. Results After excluding 129 incomplete or non-consented responses, 228 questionnaires were analyzed. The majority of respondents demonstrated a high level of awareness and knowledge regarding the impact of pregnancy and childbirth on pelvic floor health. However, only 36.8% reported routinely providing postpartum counseling for PFD prevention. While 79.8% regularly asked about PFD symptoms postpartum, counseling rates remained low, consistent with earlier findings. Differences emerged between professional groups: physicians were more likely than midwives to view CS as protective against PFD (28.8% vs. 9.3%) and to consider CS for themselves or their partners (27.2% vs. 8.3%). These findings highlight the need to integrate structured PFD counseling protocols into routine antenatal and postnatal care.