Learning About Pelvic Floor Muscle Exercises Before and During Pregnancy: a Cross-sectional Study

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2019 Jan 7

PMID 30612181

Citations 6

Authors

Deirdre Daly

Cinny Cusack

Cecily Begley

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: All pregnant women should be given advice on the benefits of pelvic floor muscle exercises (PFMEs) in preventing urinary incontinence (UI) and know how to exercise correctly. This study explored women's knowledge and practice of PFMEs, their sources of knowledge and prevalence of UI before and during pregnancy.

Methods: We conducted a cross-sectional study with 567 women, 239 primiparous and 328 multiparous, recruited from one maternity hospital in Ireland. Logistic regression was used to examine associations.

Results: Pre-pregnancy, 41% of women (n = 232) learnt to do PFMEs, 30% (n = 172) did exercises and 28% (n = 159) experienced UI. Women more likely to report UI were aged ≥ 35 years (p = 0.03), had a BMI ≥ 30 kg/m (p = 0.01) or did PFMEs but were unsure they were exercising correctly (p = 0.03). During pregnancy, 50% of women (n = 281) received PFME information during antenatal visits and 38.6% (n = 219) attended antenatal classes. Women less likely to do PFMEs daily or weekly had no formal educational qualification (p = 0.01), did not do PFMEs pre-pregnancy (p < 0.0001) or did not attend the physiotherapist-led PFME education session (p < 0.0001). In multivariable analysis, the two factors significantly associated with UI during pregnancy were being aged 30-34 years (p = 0.05) and reporting UI pre-pregnancy (p < 0.0001).

Conclusions: This benchmarking exercise revealed considerable gaps in the totality of PFME education and services offered in the site hospital. We recommend that others do likewise to enable learning from those who have addressed service deficits.

Citing Articles

Investigation of the quality and health literacy demand of online information on pelvic floor exercises to reduce stress urinary incontinence.

Willburger B, Chen Z, Mansfield K Aust N Z J Obstet Gynaecol. 2024; 64(6):542-547.

PMID: 38686657 PMC: 11683755. DOI: 10.1111/ajo.13830.

[Home therapeutic adherence of pelvic floor muscle exercises in urinary incontinence].

Corona-Gonzalez J, Valderrama-Santillan J, Sosa-Bustamante G, Luna-Anguiano J, Paque-Bautista C, Gonzalez A Rev Med Inst Mex Seguro Soc. 2023; 61(Suppl 2):S148-S154.

PMID: 38011603 PMC: 10766441.

Knowledge, attitudes, and practice of pelvic floor dysfunction and pelvic floor ultrasound among women of childbearing age in Sichuan, China.

Wu X, Yi X, Zheng X, Chen Z, Liu J, Dai X Front Public Health. 2023; 11:1160733.

PMID: 37234767 PMC: 10206020. DOI: 10.3389/fpubh.2023.1160733.

Age at first birth and risk of urinary incontinence after delivery: a dose-response meta-analysis.

Ren Y, Hu Q, Zou H, Xue M, Tian X, Cao F Sci Rep. 2022; 12(1):16588.

PMID: 36198718 PMC: 9535015. DOI: 10.1038/s41598-022-19809-x.

Aspects of Pelvic Floor Protection in Spontaneous Delivery - a Review.

Hubner M, Rothe C, Plappert C, Baessler K Geburtshilfe Frauenheilkd. 2022; 82(4):400-409.

PMID: 35392067 PMC: 8983111. DOI: 10.1055/a-1515-2622.

References

Viktrup L, Lose G . Lower urinary tract symptoms 5 years after the first delivery. Int Urogynecol J Pelvic Floor Dysfunct. 2001; 11(6):336-40. DOI: 10.1007/s001920070002. View

Messer K, Hines S, Raghunathan T, Seng J, Diokno A, Sampselle C . Self-efficacy as a predictor to PFMT adherence in a prevention of urinary incontinence clinical trial. Health Educ Behav. 2007; 34(6):942-52. DOI: 10.1177/1090198106295399. View

OSullivan C, OConnell R, Devane D . A descriptive survey of the educational preparation and practices of antenatal educators in ireland. J Perinat Educ. 2014; 23(1):33-40. PMC: 3894593. DOI: 10.1891/1058-1243.23.1.33. View

Neels H, Wyndaele J, Tjalma W, De Wachter S, Wyndaele M, Vermandel A . Knowledge of the pelvic floor in nulliparous women. J Phys Ther Sci. 2016; 28(5):1524-33. PMC: 4905903. DOI: 10.1589/jpts.28.1524. View

Fine P, Burgio K, Borello-France D, Richter H, Whitehead W, Weber A . Teaching and practicing of pelvic floor muscle exercises in primiparous women during pregnancy and the postpartum period. Am J Obstet Gynecol. 2007; 197(1):107.e1-5. DOI: 10.1016/j.ajog.2007.02.052. View

Daly D, Clarke M, Begley C . Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors. Int Urogynecol J. 2018; 29(3):353-362. DOI: 10.1007/s00192-018-3554-1. View

Marques A, Stothers L, Macnab A . The status of pelvic floor muscle training for women. Can Urol Assoc J. 2010; 4(6):419-24. PMC: 2997838. DOI: 10.5489/cuaj.10026. View

Dumoulin C, Hay-Smith J, Frawley H, McClurg D, Alewijnse D, Bo K . 2014 consensus statement on improving pelvic floor muscle training adherence: International Continence Society 2011 State-of-the-Science Seminar. Neurourol Urodyn. 2015; 34(7):600-5. DOI: 10.1002/nau.22796. View

Frawley H, McClurg D, Mahfooza A, Hay-Smith J, Dumoulin C . Health professionals' and patients' perspectives on pelvic floor muscle training adherence-2011 ICS State-of-the-Science Seminar research paper IV of IV. Neurourol Urodyn. 2015; 34(7):632-9. DOI: 10.1002/nau.22774. View

10.

Stoll K, Hall W . Childbirth education and obstetric interventions among low-risk canadian women: is there a connection?. J Perinat Educ. 2013; 21(4):229-37. PMC: 3489119. DOI: 10.1891/1058-1243.21.4.229. View

11.

Trivino-Juarez J, Romero-Ayuso D, Nieto-Pereda B, Forjaz M, Criado-Alvarez J, Arruti-Sevilla B . Health related quality of life of women at the sixth week and sixth month postpartum by mode of birth. Women Birth. 2016; 30(1):29-39. DOI: 10.1016/j.wombi.2016.06.005. View

12.

Bo K, Haakstad L, Voldner N . Do pregnant women exercise their pelvic floor muscles?. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(7):733-6. DOI: 10.1007/s00192-006-0235-2. View

13.

Guerrero K, Owen L, Hirst G, Emery S . Antenatal pelvic floor exercises: a survey of both patients' and health professionals' beliefs and practice. J Obstet Gynaecol. 2007; 27(7):684-7. DOI: 10.1080/01443610701612284. View

14.

Haylen B, Ridder D, Freeman R, Swift S, Berghmans B, Lee J . An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2009; 21(1):5-26. DOI: 10.1007/s00192-009-0976-9. View

15.

. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20):2191-4. DOI: 10.1001/jama.2013.281053. View

16.

Chiarelli P, Murphy B, Cockburn J . Women's knowledge, practises, and intentions regarding correct pelvic floor exercises. Neurourol Urodyn. 2003; 22(3):246-9. DOI: 10.1002/nau.10119. View

17.

Hines S, Seng J, Messer K, Raghunathan T, Diokno A, Sampselle C . Adherence to a behavioral program to prevent incontinence. West J Nurs Res. 2007; 29(1):36-56. DOI: 10.1177/0193945906293793. View

18.

Fabian H, Radestad I, Waldenstrom U . Characteristics of Swedish women who do not attend childbirth and parenthood education classes during pregnancy. Midwifery. 2004; 20(3):226-35. DOI: 10.1016/j.midw.2004.01.003. View

19.

Bo K, Owe K, Nystad W . Which women do pelvic floor muscle exercises six months' postpartum?. Am J Obstet Gynecol. 2007; 197(1):49.e1-5. DOI: 10.1016/j.ajog.2007.02.014. View

20.

Bump R, Hurt W, Fantl J, Wyman J . Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol. 1991; 165(2):322-7; discussion 327-9. DOI: 10.1016/0002-9378(91)90085-6. View