Barriers and facilitators of seeking healthcare among women with symptomatic pelvic organ prolapse in Pretoria, South Africa: A hospital based cross-sectional study

Background Pelvic organ prolapse (POP) is a common condition affecting women globally, often leading to physical discomfort, reduced quality of life, and stigma. Delays in seeking healthcare for symptomatic POP (sPOP) are prevalent and influenced by psychosocial and contextual factors. Understanding these barriers and facilitators is critical to improving early detection and management. This study assessed the duration from symptom onset to healthcare-seeking and explored factors influencing care-seeking behavior among women with sPOP in Pretoria, South Africa. Methods A hospital-based cross-sectional study was conducted among 250 women diagnosed with sPOP at Steve Biko Academic Hospital, Pretoria. Structured interviews collected data on socio-demographic and obstetric characteristics, barriers, facilitators, and healthcare-seeking timelines. Data were analyzed using Stata version 18.0. Descriptive statistics summarized participant characteristics and care-seeking patterns, while logistic regression identified socio-demographic factors associated with delayed healthcare-seeking, defined as seeking care > 12 months after symptom onset. Results The mean age of participants was 64 years (SD ± 11.3), and most resided in urban areas (80.4%). Nearly one in five women (22.0%; 95% CI: 17–28%) delayed seeking care beyond 12 months. Common barriers included belief in spontaneous resolution (26.4%), normalization of symptoms as part of aging (24.4%), embarrassment (28.4%), fear of surgery (13.6%), and coping mechanisms (11.6%). The primary facilitator for care-seeking was worsening symptoms (84.4%), followed by social support from family and friends. Higher parity (3–4 children) was significantly associated with delayed care-seeking (OR = 2.28; 95% CI: 1.09–4.77). Conclusion Substantial delays in healthcare-seeking for sPOP persist despite urban residence and proximity to tertiary care. Misconceptions, stigma, and fear of treatment remain key barriers, while symptom worsening and social support encourage care-seeking. Targeted health education and community engagement are essential to promote early presentation and reduce morbidity.