To do or not to do? Pelvic floor muscle training during pregnancy and after childbirth

Author(s): K. Bø - Pages: 13

Abstract

A Cochrane review concluded that women without prior urinary incontinence (UI) who were randomized to intensive antenatal pelvic floor muscle training (PFMT) were 56% less likely to report UI in late pregnancy and approximately 30% less likely to do so up to 6 months postpartum (Hay-Smith et al. 2008). Postnatal women with persistent UI 3 months after delivery were 20% less likely than those not receiving PFMT to report UI 12 months after delivery. Women receiving PFMT after delivery were also about half as likely to report faecal incontinence. To date, five RCTs have evaluated the effect of preventive antenatal PFMT. Four demonstrated favourable results. The study showing no effect included only one session with the physiotherapist. There have been two treatment studies, one demonstrating a positive effect and one reporting no effect. No negative effects have been found after antenatal PFMT. Four RCTs and one matched controlled study on prevention of UI postpartum have been published,
and all but one have shown positive results. The matched controlled study demonstrated that there were 50% less women with UI in the exercise group. The study with no effect used a very weak intervention that involved only three to four sessions with a midwife. Three RCTs showed positive results after postpartum PFMT for women diagnosed with UI. Dose-response issues are important in PFMT.

Keywords: pelvic floor muscles, pregnancy, postpartum, training, urinary incontinence.