Falling Out: Authoritative Knowledge and Women's Experiences with Pelvic Organ Prolapse
Article first published online: 6 SEP 2012
© 2012 by the American College of Nurse-Midwives
Journal of Midwifery & Womens Health
Volume 57, Issue 5, pages 489–494, September/October 2012
How to Cite
Low, L. K. and Tumbarello, J. A. (2012), Falling Out: Authoritative Knowledge and Women's Experiences with Pelvic Organ Prolapse. Journal of Midwifery & Womens Health, 57: 489–494. doi: 10.1111/j.1542-2011.2012.00187.x
- Issue published online: 6 SEP 2012
- Article first published online: 6 SEP 2012
- embodiment/bodily experiences;
- health care;
- knowledge construction;
- lived experience;
- pelvic floor dysfunction;
- users’ experiences;
- women's health
Introduction: Despite the high prevalence of pelvic organ prolapse, many women suffer in silence, lacking the language and opportunity to describe their condition. There are limited descriptions of women's experiences with pelvic organ prolapse in the literature. This qualitative study addressed the knowledge and experience of women with pelvic organ prolapse.
Methods: Semistructured interviews were conducted with 13 women who had been previously diagnosed with pelvic organ prolapse. Transcripts of the interviews were reviewed and coded using a process of content analysis compared against the framework of authoritative knowledge, developed by Brigitte Jordan.
Results: By applying the concept of authoritative knowledge, we identified 3 themes of how women construct understanding about pelvic organ prolapse and how they demonstrate deference to the authoritative knowledge of medical providers. First, we found through women's narratives that authoritative knowledge was held by the health care provider and is considered consequential and legitimate by all participants. Second, women reported that the health care provider's authoritative knowledge was valued over personal, experiential knowledge. Finally, women described how they work with their health care providers to create a system of authoritative knowledge as they seek treatment for or discuss their condition. Throughout the narratives, women's experiences are not legitimized by the women or the medical community, perpetuating the “hidden” nature of these conditions.
Discussion: This analysis provides qualitative evidence of Jordan's authoritative knowledge: women and health care providers contribute to dimensions of authoritative knowledge surrounding pelvic organ prolapse. Despite what women experience, the health care provider's definition and understanding of pelvic organ prolapse is seen as legitimate and consequential. Because of their construction of their condition, and the power dynamic at play, women are silenced, and their expertise about their bodies is delegitimized, limiting their active participation in seeking care for this condition.