A silent burden—prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review

Abstract

Background Pelvic organ prolapse (POP), urinary incontinence, and infertility are all prevalent conditions associated with considerable reduction in quality of life. As a group, Aboriginal and Torres Strait Islander women may be at higher risk of these conditions, but studies are scarce. Objective To review the literature pertaining to the epidemiology, diagnosis, and management of these conditions in Indigenous Australian women. Search strategy Medline, Embase, and Scopus were searched for articles published between 1980 and 2021 pertaining to these conditions in Indigenous Australian women. Selection criteria Studies that did not directly address the epidemiology, diagnosis, and management of these conditions were excluded. Main results It was possible to identify only 11 papers dealing with these conditions in Indigenous Australian women. Only one dealt with POP and was a retrospective audit of a health outreach program in the Northern Territory concluding that there was significant underreporting of the condition. Five papers dealt with urinary incontinence and, again, described significant underreporting and poor referral pathways. Five papers reported small studies about infertility, one reporting poor engagement from clinical directors. Conclusion It was concluded that despite the importance of these conditions, there is almost no body of research and this is an urgent national problem.

The lives of women and babies matter: A call for action in Indigenous and First Nations women’s health and wellbeing

“…The issue highlights the voices of those usually not heard in research, in clinical care, and in health service design, [1][2][3][4][5][6] and calls out the silence and invisibility commonly imposed on Indigenous women. [7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…[7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…The articles in this special edition use positive approaches. This is done in order to empower women in healthcare, 12 to develop and trial culturally safe and community-based approaches, 2,6 to partner with communities, 3,5 to employ Indigenous methods and knowledge, 8,14 to privilege Indigenous voices, 4,9,10,11 to move towards risk assessment and management tailored to Indigenous populations and context, 15,16 and to explore women's experiences in new ways. 1,9,13 Much of the research responds to the silence/invisibility of First Nations and Indigenous women by challenging the norms of women's healthcare provision, such as persistent discrepancies in structural/social determinants of health, healthcare access and health outcomes, systemic racism, and trauma.…”

“…Whitson et al 11 reviewed the epidemiology, diagnosis, and management of pelvic organ prolapse, urinary incontinence, and infertility in Aboriginal and Torres Strait Islander women. This review draws attention to a dearth of research and concludes that "Indigenous women's health in areas of seemingly inordinate importance to non-Indigenous Australian women has been left far behind."…”

“…This review draws attention to a dearth of research and concludes that "Indigenous women's health in areas of seemingly inordinate importance to non-Indigenous Australian women has been left far behind." 11 Adcock et al 12 and Mitchell-Foster et al 6 used Indigenous research methodologies to explore HPV self-collection for cervical cancer screening in Aotearoa New Zealand and Canada, respectively. Adcock et al 12 found that for Māori women who were overdue for cervical cancer screening or had never had screening, HPV self-testing was acceptable and empowering, and had the potential to reduce inequities in cervical cancer.…”