Background: Ruptures in the pelvic floor muscles is the most common childbirth injury. It affects 70 – 85 percent of the Swedish women who gives birth every year. Childbirth injuries can cause lack of motor control of the pelvic floor muscles, decreased participation and activity in the womens every day life. It also can affect the qualilty of life. The physiotherapists role in care for these patients is to examine and treat the patients problems in a biopsychosocial way to work for health benefits and provide further injuries. Purpose: The purpose is to examine physiotherapists experience of examination and rehabilitation of women with ruptures in the pelvic floor muscles caused by childbirth injuries. Method: In a qualitative descriptive interview study with a appropriate selection, interviews was done with six physiotherapists who is operative in womens health. A semi structured interview guide was used and then a manifest qualitative analysis was done with an inductive approach. Result: The analysis process showed five main categories in terms of the physiotherapists experience of examine and treat women with muscle ruptures in the pevic floor caused by childbirth injuries: ’Examination and treatment in body structure and body function level’, ’to build trust between therapist and patient’, ’work with the patients fear-avoidance behaviour’, ’work in team with other professionals’ and ’inform the patient about the injury in early state’. Two of the five main categories were divided into under categories associated to the main categories. Conclusion: The informants in the study experienced that there is a necessity to examine and rehabilitate patients out of their individual needs. They experienced that it was important to talk about the worry a lot of the patients with injuries in the pelvic floor feel and to build trust to avoid catastrophizing and fear-avoidance behaviour. / Bakgrund: Bristningar i bäckenbotten till följd av förlossning drabbar 70 - 85% av kvinnorna som föder barn i Sverige varje år. En förlossningsskada kan leda till försämrad motorisk bäckenbottenkontroll, nedsatt aktivitets- och delaktighetsförmåga samt sänkt livskvalité. Fysioterapeutens roll är att undersöka och behandla patienterna med ett biopsykosocialt synsätt för att verka hälsofrämjande och skadeförebyggande. Syfte: Att undersöka fysioterapeuters erfarenheter av undersökning och behandling av kvinnor med förlossningsskada i bäckenbotten. Metod: I en kvalitativ beskrivande intervjustudie med ändamålsenligt bekvämlighetsurval intervjuades sex fysioterapeuter/sjukgymnaster verksamma inom området kvinnohälsa utifrån en semistrukturerad intervjuguide. En manifest kvalitativ dataanalys med induktiv ansats genomfördes. Resultat: I analysprocessen framkom fem huvudkategorier om informanternas erfarenheter av undersökning och behandling vid förlossningsskador i bäckenbottenmuskulaturen: undersökning och behandling på kroppsstruktur- och kroppsfunktionsnivå, att bygga förtroende mellan fysioterapeut och patient, arbeta med rädsla och undvikandebeteende hos patienten, samarbete med andra professioner och informera om skadan i ett tidigt skede. Två av de fem huvudkategorierna delades in i underkategorier. Slutsats: Utifrån studiens resultat visade informanternas samlade erfarenheter att behovet är stort att undersöka, individanpassa behandling och bemöta oro hos den berörda patientgruppen som drabbas av bäckenbottenskada. Även att bygga förtroende för att undvika katastroftankar och eliminera rädsla-och undvikande beteende hos patienterna.

Bakgrund Urininkontinens är ett av de vanligaste kroniska hälsoproblemen i samhället, där få söker vård för sina besvär, vilket innebär en försämrad livskvalitet. Resultatet huruvida träning påverkar urinläckage varierar i tidigare forskningsstudier.  Syfte Att undersöka punktprevalensen av ansträngningsinkontinens hos fysiskt aktiva nulliparous totalt och uppdelat på olika träningsformer, samt analysera korrelationen mellan upplevd besvärsgrad av urininkontinens och volymen av måttlig till hög aktivitetsnivå bland fysiskt aktiva nulliparous med ansträngningsinkontinens.  Metod Kvantitativ observationsstudie som utfördes via en webbaserad enkät baserad på IPAQ-SF och PFIQ-7. Fysiskt aktiva kvinnor mellan 16–55 år, som var födda med kvinnligt kön, ej fått barn eller varit gravida efter vecka 13 samt ej var elitidrottare inkluderades. Resultat 215 personer besvarade enkäten, 61 exkluderades. Av 154 deltagare upplevde 37 kvinnor besvär av ansträngningsinkontinens (prevalens 24%). De vanligaste aktiviteterna var löpning (prevalens 26%) och gym/styrketräning (prevalens 18%). Högintensiv träning hade en prevalens av ansträngningsinkontinens på 31–38%. Lågintensiv träning hade en prevalens på 19%. Ingen korrelation kunde påvisas mellan upplevda besvär av urininkontinens och volym av måttlig till hög aktivitetsnivå bland kvinnor med ansträngningsinkontinens (r = -0,0489) (p = 0,8). Konklusion Ansträngningsinkontinens är vanligt hos tränande nulliparous. Det är vanligare med ansträngningsinkontinens vid högintensiva aktiviteter jämfört med lågintensiva. Ingen korrelation kunde påvisas mellan upplevd besvärsgrad av urininkontinens hos kvinnor med ansträngningsinkontinens och aktivitetsnivå. Mer forskning kring träning som eventuell riskfaktor och som eventuell behandlingsmetod krävs. / Background Urinary incontinence is one of the most common chronic health issues in society where few seek care meaning a decreased quality of life. Research regarding how exercise affects urinary incontinence varies.  Purpose On one occasion examine the prevalence of stress urinary incontinence (SUI) in physically active (PA) nulliparous in total and divided by activity, and the correlation between perceived level of discomfort of urinary incontinence (UI) and volume of moderate to high activity level amongst PA nulliparous with SUI. Method Quantitative observational study conducted via a web-based survey based on IPAQ-SF and PFIQ-7. PA women, age 16-55, who were born with a female gender, hadn’t given birth or been pregnant after week 13 and weren’t elite athletes were included.  Result 215 women responded to the survey, 61 were excluded. Of 154 participants 37 women experienced SUI (prevalence 24%). Strength training (prevalence 18%) and running (prevalence 26%) were the most common activities. High-intensity training had a prevalence of 31–38%. Low intensity training had a prevalence of 19%. No correlation between experienced level of discomfort of UI and volume of moderate to high level of physical activity amongst women with SUI could be revealed. (r = -0,0489, p = 0,8).   Conclusion  SUI is common amongst exercising women without known risk factors. It is more common with SUI during high-intensity activities compared with low-intensity. No correlation was demonstrated between UI amongst women with SUI and activity level. Research regarding exercise as risk factors and treatment for UI is required.

Bakgrund: För vissa kvinnor kan förlossningen medföra komplikationer som kan leda till en förlossningsbristning. Bäckenbottenträning med fysioterapeut kan hjälpa i rehabiliteringen efter en förlossningsbristning. Samtidigt kan en förändrad livsstil med ett nyfött barn försvåra rehabiliteringen. Idag finns det inga tydliga riktlinjer på hur fysioterapi efter förlossningsbristning ska upprätthållas vilket kan medföra skillnader i rehabiliteringen. Syfte: Att undersöka och beskriva förstagångsföderskors upplevelser och erfarenheter av hur de implementerar den fysioterapeutiska rådgivningen av bäckenbottenträning de fått efter en förlossningsbristning.  Metod: En kvalitativ intervjustudie har genomförts med ett bekvämlighetsurval där fyra förstagångsföderskor och en omföderska intervjuades. Intervjuerna var baserade på en semistrukturerad intervjuguide. En kvalitativ innehållsanalys användes vid databearbetningen.  Resultat: Innehållsanalysen resulterade i fyra kategorier och åtta subkategorier gällande informanternas upplevelser och erfarenheter av bäckenbottenträning i vardagen. Informanterna beskrev yttre hindrande faktorer exempelvis tidsbrist och vardagssysslor som resulterade i minskad följsamhet till bäckenbottenträningen. Informanterna hade olika strategier där planering och socialt stöd var viktiga för att upprätthålla bäckenbottenträningen. Samtliga informanter uttryckte en önskan om mer uppföljning och tydligare instruktioner från fysioterapeuten, vilket kunde ha påverkat implementeringen av bäckenbottenträningen i vardagen.  Konklusion: Informanterna upplevde både underlättande och hindrande faktorer till utförandet av bäckenbottenträningen. Exempelvis var planering och socialt stöd underlättande medan tidsbrist och obehag var hindrande faktorer till att följsamheten upprätthölls. Önskan om mer uppföljning och tidigare fysioterapeutkontakt beskrevs som förbättringar till framtida postpartumvård. / Background: For some women, childbirth could bring complications that could lead to a birth injury. Pelvic floor muscle training (PFMT) with a physiotherapist could be a part of rehabilitation after a birth injury. Together with a changed lifestyle with a newborn child rehabilitation could be more difficult. Today, there are no clear guidelines on how physiotherapy after a birth injury should be maintained which can lead to differences in rehabilitation.  Objectives: To examine and describe new mothers' experiences of how to implement the physiotherapist’s advice of PFMT that they received after their birth injury.   Method: A qualitative method with semi-structured interviews with four first-time mothers and one mother of three, based on convenience sampling. Qualitative content analysis was used for data analysis. Results: The qualitative content analysis resulted in four categories and eight subcategories regarding the informants' experiences of PFMT in everyday life. Lack of time and chores were examples of obstructive factors that made it difficult with compliance in their PFMT. Planning and social support were examples of strategies that helped maintain PFMT. A desire for more follow-up and clearer instructions from the physiotherapist were expressed, which could have affected the implementation of their training in everyday life.  Conclusion: The informants experienced both facilitating and obstructive factors to practice PFMT. For example, planning and social support were facilitating factors, while lack of time and discomfort reduced compliance. More follow-up and earlier contact with the physiotherapist were described as desirable for future postpartum care.

Bakgrund: Graviditetsrelaterad bäcken- och ländryggssmärta är vanligt förekommande. Smärtan försvinner oftast efter förlossning men för 7–10% kvarstår den i mer än två år. Det finns väl utformade behandlingsrekommendationer för den gravida kvinnan, men desto mindre för kvinnor med långvariga smärtbesvär. Stabiliserande träning är en typ av behandling som kan innefatta övningar för de olika muskelsystem som stabiliserar vår bål. Syfte: Att genom en strukturerad litteraturstudie undersöka vilken effekt stabiliserande träning har avseende smärta och funktion vid långvarig bäcken- och ländryggssmärta hos kvinnor efter förlossning. Metod: Datainsamlingen genomfördes i de elektroniska databaserna PubMed, CINAHL och PEDro. Urval gjordes utifrån studiens syfte, frågeställningar och uppsatta inklusions- och exklusionskriterier. De potentiellt relevanta artiklarnas metodologiska och etiska kvalitetgranskades. Data extraherades, sammanställdes i tabeller och analyserades kvalitativt. Smärta skattades genom Visual Analogue Scale (VAS) eller Numeric Pain Rating Scale (NPRS), funktion genom Oswestry Disability Index (ODI) eller Modified Oswestry Disability Questionnaire (MODQ). Resultat: Totalt inkluderades sju randomiserade kontrollerade studier (RCT) och 393 studiedeltagare. Studiekvaliteten varierade, tre studier bedömdes ha hög risk för bias, tre medelhög och en låg. Fem av sju studier uppvisade en statistiskt signifikant förbättring av utfallsmåtten smärta och/eller funktion efter avslutad intervention till förde linterventionsgruppen. Slutsats: Litteraturstudien indikerar positiva resultat för effekter av stabiliserande träning som behandling till kvinnor med långvarig bäcken- och ländryggssmärta efter förlossning, avseende smärta och funktion. För att med högre tillförlitlighet få veta vilken effekt stabiliserande träning har jämfört med andra behandlingsmetoder, samt hur vi bör utforma träningen i klinik, behövs mer forskning på området. / Background: Pregnancy related pelvic- and low back pain is common. The pain often disappears after childbirth but for 7-10% this pain remains for more than two years. There are treatment recommendations for the pregnant woman but limited for women with long lasting pain after childbirth. Stabilizing training is a treatment that includes exercises for the different muscle systems that stabilize our trunk. Aim: Through this structured literature study investigate the effects of stabilizing training, on pain and disability, for women with persistent pelvic-and low back pain after childbirth. Method: Data collection was performed in the databases Pubmed, CINAHL and PEDro. Selection was made from the aim, inclusion-and exclusion criteria of the study. An assessment of quality and ethical aspects of the articles was made. Data were extracted, compiled in tables and analyzed qualitatively. Pain was estimated by Visual Analogue Scale(VAS)/Numeric Pain Rating Scale (NPRS), disability by Oswestry Disability Index(ODI)/Modified Oswestry Disability Questionnaire (MODQ). Results: Totally seven RCT-studies and 393 study participants were included. Quality of the studies varied, three studies assessed to be high risk of bias, three medium and one low risk.Five of seven studies showed statistically significant improvement by the outcomes pain and function to advantage the intervention group. Conclusion: The review indicates positive results for the effects of stabilizing training for women with pelvic- and low back pain after childbirth. To assess the effects of stabilizing training with higher reliability, and how we should design the training in clinic, more research is needed.

Sammanfattning Bakgrund Urininkontinens är ett av de vanligaste kroniska hälsoproblemen i samhället, där få söker vård för sina besvär, vilket innebär en försämrad livskvalitet. Resultatet huruvida träning påverkar urinläckage varierar i tidigare forskningsstudier.  Syfte Att undersöka punktprevalensen av ansträngningsinkontinens hos fysiskt aktiva nulliparous totalt och uppdelat på olika träningsformer, samt analysera korrelationen mellan upplevd besvärsgrad av urininkontinens och volymen av måttlig till hög aktivitetsnivå bland fysiskt aktiva nulliparous med ansträngningsinkontinens.  Metod Kvantitativ observationsstudie som utfördes via en webbaserad enkät baserad på IPAQ-SF och PFIQ-7. Fysiskt aktiva kvinnor mellan 16–55 år, som var födda med kvinnligt kön, ej fått barn eller varit gravida efter vecka 13 samt ej var elitidrottare inkluderades. Resultat 215 personer besvarade enkäten, 61 exkluderades. Av 154 deltagare upplevde 37 kvinnor besvär av ansträngningsinkontinens (prevalens 24%). De vanligaste aktiviteterna var löpning (prevalens 26%) och gym/styrketräning (prevalens 18%). Högintensiv träning hade en prevalens av ansträngningsinkontinens på 31–38%. Lågintensiv träning hade en prevalens på 19%. Ingen korrelation kunde påvisas mellan upplevda besvär av urininkontinens och volym av måttlig till hög aktivitetsnivå bland kvinnor med ansträngningsinkontinens (r = -0,0489) (p = 0,8). Konklusion Ansträngningsinkontinens är vanligt hos tränande nulliparous. Det är vanligare med ansträngningsinkontinens vid högintensiva aktiviteter jämfört med lågintensiva. Ingen korrelation kunde påvisas mellan upplevd besvärsgrad av urininkontinens hos kvinnor med ansträngningsinkontinens och aktivitetsnivå. Mer forskning kring träning som eventuell riskfaktor och som eventuell behandlingsmetod krävs. / Abstract Background Urinary incontinence is one of the most common chronic health issues in society where few seek care meaning a decreased quality of life. Research regarding how exercise affects urinary incontinence varies.  Purpose On one occasion examine the prevalence of stress urinary incontinence (SUI) in physically active (PA) nulliparous in total and divided by activity, and the correlation between perceived level of discomfort of urinary incontinence (UI) and volume of moderate to high activity level amongst PA nulliparous with SUI. Method Quantitative observational study conducted via a web-based survey based on IPAQ-SF and PFIQ-7. PA women, age 16-55, who were born with a female gender, hadn’t given birth or been pregnant after week 13 and weren’t elite athletes were included.  Result 215 women responded to the survey, 61 were excluded. Of 154 participants 37 women experienced SUI (prevalence 24%). Strength training (prevalence 18%) and running (prevalence 26%) were the most common activities. High-intensity training had a prevalence of 31–38%. Low intensity training had a prevalence of 19%. No correlation between experienced level of discomfort of UI and volume of moderate to high level of physical activity amongst women with SUI could be revealed. (r = -0,0489, p = 0,8).   Conclusion SUI is common amongst exercising women without known risk factors. It is more common with SUI during high-intensity activities compared with low-intensity. No correlation was demonstrated between UI amongst women with SUI and activity level. Research regarding exercise as risk factors and treatment for UI is required.

American maternal health is a concern and has even been described as a “crisis” (Gingrey, 2020). The US is an outlier in maternal health in comparison to other industrialized countries with more than a 50% increase in maternal death rates comparatively speaking (Taylor et al., 2022). A significant change in postpartum care must occur. Hope Health Today LLC, the proposed continuing education Limited Liability Company (LLC), will be the catalyst to this health care change. Hope Health Today LLC’s initial continuing education program will positively educate healthcare providers to better serve this at-risk population. Hope Health Today LLC will provide professional education for licensed occupational therapists, physical therapists, physicians, nurses, and midwives. The initial continuing education (CEU) course will be a holistic guide for Diastasis Recti Abdominis (DRA) recovery and postpartum care. The course will cover pelvic floor and deep core anatomy, a 20-week diastasis recti abdominis recovery program, postpartum body mechanics, breast feeding positions, roles and interpersonal relationships, signs of postpartum depression, and return to intimacy. HopeHealth Today LLC aims to make a positive impact for postpartum families. Making a change at the policy level through American College of Obstetrics and Gynecology (ACOG) to provide a 4-week pelvic floor therapy referral to all postpartum patients. Hope Health Today LLC will advance the profession of occupational therapy through advocating for a women’s health board certification through American Occupational Therapy Association (AOTA) and improving quality postpartum patient outcomes through providing research based continuing education for health care providers. HopeHealth TodayLLC will educate the public through social media. HopeHealth TodayLLC will advance the current state of postpartum care. The ambition of this company is to educate the public to know what to expect from their women’s health providers and what to ask for if care is not reaching appropriate standards.

Bakgrund: Förlossningsskador är vanligt förekommande och graderas på en skala mellan 1–4 beroende på typ av skada och kan påverka individens sexuella funktion samt livskvalitet. Bäckenbottenträning är en vanlig behandlingsmetod för kvinnor efter förlossning.  Syfte: Denna systematiska litteraturstudie syftade till att undersöka det aktuella vetenskapliga underlaget gällande effekten av bäckenbottenträning efter en obstetrisk skada på sexuell funktion och/eller livskvalitet, samt om bäckenbottenträning kan medföra eventuella biverkningar.  Metod: En systematisk litteraturundersökning i databaserna; PubMed, Cinahl och Scopus. De inkluderade artiklarnas risk för snedvridning granskades enligt PEDro-skalan samt enligt en lokal bedömningsmall inspirerad av GRADE  Resultat: Fem artiklar inkluderades. En av fem studier hade signifikant skillnad mellan grupp gällande sexuell funktion efter bäckenbottenträning samt en studie visade signifikant skillnad rörande symtom relaterat till sexuell funktion. En av tre visade signifikant skillnad rörande livskvalitet efter bäckenbottenträning. Tre studier granskade eventuella biverkningar av träningen och fann inga. PEDro granskningen indikerade låg risk för snedvridning i alla fem artiklar. Den lokala bedömningsmallen inspirerad av GRADE visade en mycket låg evidens för bäckenbottenträningens effekt på sexuell funktion och livskvalitet efter obstetriska skador. Konklusion: Bäckenbottenträningens effekt efter en obstetrisk skada på sexuell funktion och/eller livskvalitet har vissa signifikanta effekter. Inga rapporterade biverkningar av bäckenbottenträningen enligt de inkluderade studierna. PEDro-granskningen visade låg risk för snedvridning. På grund av studiernas heterogenitet samt en mycket låg evidensstyrka är det svårt att fastställa effekten på sexuell funktion och livskvalitet. Fler studier av hög kvalitet behövs för vidare slutsatser om detta. / Background: Birth injuries are common and rated from 1-4 depending on the type of injury and can affect the individual's sexual function and quality of life. Pelvic floor training is a common treatment method for women after childbirth. Objective: To explore the scientific evidence regarding the effect of pelvic floor training post-obstetric injury on sexual function and/or quality of life and potential side effects.   Method: A systematic literature search conducted in the databases; PubMed, Cinahl and Scopus. The article’s risk of bias was assessed using the PEDro scale and a local tool inspired by GRADE  Results: Five articles were included. One study demonstrated significant differences in sexual function between groups and one study showed difference in symptoms related to sexual function after pelvic floor training. One in three studies found improved quality of life post-training. No side effects were reported in three studies. The PEDro-scale found low risk of bias regarding all articles. Local tool inspired by GRADE assessment of certainty showed very weak evidence for training's impact after obstetric injuries on sexual function and quality of life. Conclusion: Pelvic floor training post-obstetric injury has certain significant effects on sexual function and/or quality of life. No side effects were reported, however, due to heterogeneity and very weak evidence determining it effect on sexual function and quality of life remains challenging. More high-quality studies are needed for further conclusions on this matter.

No description available.

Yes / Evidence-based national guidelines recommend that women practise pelvic floor muscle exercises (PFMEs) during their first pregnancy in order to reduce the likelihood of becoming incontinent of urine. Adherence to these exercises during pregnancy is low, although little is known about the factors that influence some women to exercise during pregnancy while others do not. The aim of this study was to increase understanding of the motivating factors for, and barriers to, performing PFMEs during a first pregnancy using data gathered from four qualitative interviews. Analysis of the interview transcripts revealed four relevant themes: knowledge and understanding; experience of incontinence; attitude to incontinence; and cues to exercise. Having adequate knowledge of the PFMEs and the benefits of these exercises, knowing an incontinent woman of the same age and believing that the PFMEs would prevent incontinence, and having a regular cue to exercise prompted exercise adherence. Recommendations are made for practice and further research.

The uterosacral ligaments (USLs) are important anatomical structures that support the uterus and apical vagina within the pelvis. As these structures are over-stretched, become weak, and exhibit laxity, pelvic floor disorders such as pelvic organ prolapse occur. Although several surgical procedures to treat pelvic floor disorders are directed toward the USLs, there is still a lot that is unknown about their function. These surgeries often result in poor outcomes, demonstrating the need for new surgical approaches and biomaterials. The first chapter of this dissertation presents a review of the current knowledge on the mechanical properties of the USLs. The anatomy, microstructure, and clinical significance of the USLs are first reviewed. Then, the results of published experimental studies on the {emph{in vivo}} and {emph{ex vivo}}, uniaxial and biaxial tensile tests are compiled. Based on the existing findings, research gaps are identified and future research directions are discussed. The second chapter proposes the use of planar biaxial testing, digital image correlation (DIC), and optical coherence tomography (OCT) to quantify the deformations of the USLs, both in-plane and out-of-plane. Using virgin swine as an animal model, the USLs were found to deform significantly less in their main direction (MD) of {emph{in vivo}} loading than in the direction perpendicular to it (PD) at increasing equibiaxial stresses. Under constant equibiaxial loading, the USLs deformed over time equally, at comparable rates in both the MD and PD. The thickness of the USLs decreased as the equibiaxial loading increased but, under constant equibiaxial loading, the thickness increased in some specimens and decreased in others. The third chapter presents new experimental methods for testing the {emph{ex vivo}} tensile properties of the uterosacral ligaments (USLs) in rats. USL specimens were carefully dissected to preserve their anatomical attachments, and they were loaded along their main {emph{in vivo}} loading direction (MD) using a custom-built uniaxial tensile testing device. This chapter reports the first mechanical data on the rat USLs in isolation from surrounding organs. It is also the first experimental study to provide measurements of the inhomogeneous deformations of the USLs during loading along their main textit{in vivo} loading direction, revealing that the USLs may behave as auxetic structures. The fourth and final chapter presents preliminary findings on novel imaging applications to characterize the evolving structure of the USLs before, during, and after tensile pulling along the ligaments' main textit{in vivo} axis of loading. Rat USLs were excised using the proposed novel dissection method and pulled uniaxially as was performed in the previous chapter. Before and after mechanical testing, second harmonic generation (SHG) was used to image collagen and muscle within the three anatomical regions of the USLs. During mechanical testing, OCT was used to collect out-of-plane images of the cervical/intermediate regions of the USL specimens, resulting in 3D volume scans of the regions. SHG images showed the USLs to have complex microstructures with significant wavy collagen bundles interwoven with muscle bundles. Preliminary observation of the microstructure during testing revealed interwoven sections of tissue with collagenous fibers that reoriented in all directions illustrating how the USLs may expand laterally during uniaxial loading, causing the auxetic properties documented in the previous chapter. Though more quantitative work remains to be done, the findings presented in this dissertation improve our understanding of how the USLs deform with increasing load, such as what occurs during pregnancy. Together, these studies serve as a springboard for future investigations on the supportive function of the USLs in animal models by offering guidelines on testing methods that capture their complex mechanical behavior. / Doctor of Philosophy / The uterosacral ligaments (USLs) are important anatomical structures that support the uterus and vagina and are often used to restore the support of pelvic organs during surgeries for pelvic organ prolapse. These surgeries often result in poor outcomes, demonstrating the need for new surgical approaches and graft materials. Due to their supportive role, the mechanical properties of the USLs are important for their physiological function, and they must be investigated to improve current treatment strategies for pelvic organ prolapse. To this end, we designed new equipment, dissection, and testing methods to characterize the mechanical behavior of the USLs using swine and rats as animal models. We provided the first three-dimensional characterization of time-dependent deformations of swine USLs as they were pulled along their two physiological loading directions using advanced imaging methods, including digital image correlation and optical coherence tomography. We isolated the USLs from rats with their anatomical attachments and mechanically tested them along their main physiological loading direction, reporting the first mechanical data on the rat USLs in isolation from surrounding organs. Finally, we used the advanced imaging techniques optical second harmonic generation microscopy and optical coherence tomography to determine how the microstructure (e.g., collagen and muscle) of the rat USLs evolves before, during, and after mechanical testing. These findings advance our understanding of the three-dimensional, nonlinear, heterogeneous, elastic, and viscoelastic deformations of the USLs. Our work may serve as a springboard for future investigations on the supportive function of the USLs by offering guidelines on testing methods that capture their complex mechanical behavior.