Introduction and hypothesis
Urinary incontinence (UI) is prevalent during pregnancy and postpartum. UI in pregnancy strongly predicts UI postpartum and later in life. UI reduces women’s wellbeing and quality of life and presents a significant burden to healthcare resource.
A narrative review summarizing quantitative and qualitative evidence about pelvic floor muscle training (PFMT) for prevention and treatment of UI for childbearing women.
There are clinically important reductions in the risk of developing UI in pregnancy and after delivery for pregnant women who start PFMT during pregnancy, and PFMT offers additional benefits preventing prolapse and improving sexual function. If women develop UI during pregnancy or postpartum then PFMT is an appropriate first-line treatment. For novice exercisers, a programme comprising eight contractions, with 8-s holds, three times a day, 3 days a week, for at least 3 months is a reasonable minimum and ‘generic’ prescription. All women need clear accurate verbal instruction in how to do PFMT. Incontinent women, and women who cannot do a correct contraction, require referral for pelvic floor rehabilitation. Behavioural support from maternity care providers (MCPs)—increasing women’s opportunity, capability, and motivation for PFMT—is as important as the exercise prescription.
PFMT is effective to prevent and treat UI in childbearing women. All pregnant and postpartum women, at every contact with a MCP, should be asked if they are continent. Continent women need exercise prescription and behavioural support to do PFMT to prevent UI. Incontinent women require appropriate referral for diagnosis or treatment.
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Milsom I, Altman D, Cartwright R, Lapitan MC, Nelson R, Sjostrom S, Tikkinen K (2017) Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal incontinence (AI). In: Abrams P, Cardozo L, Wagg A, Wein A (eds) Incontinence: 6th International Consultation on Incontinence, Tokyo, September 2016, 6th edn. International Continence Society (ICS) and International Consultation on Urological Diseases (ICUD), Bristol United Kingdom, pp 1–142.
Chiarelli P, Campbell R. Incontinence during pregnancy. Prevalence and opportunities for continence problems. ANZJOG. 1997;37:66–73. https://doi.org/10.1111/j.1479-828X.1997.tb02220.x.
Wesnes SL, Rortveit G, Bo K, Hunskaar S. Urinary incontinence during pregnancy. Obstet Gynecol. 2007;109:922–8. https://doi.org/10.1097/01.AOG.0000257120.23260.00.
Moossdorff-Steinhauser HFA, Berghmans B, Spaanderman MEA, Bols EMJ. Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behaviour. Int Urogynecol J Advance online publication. 2020. https://doi.org/10.1007/s00192-020-04566-0.
Hage-Fransen MAH, Wiezer M, Otto A, Wieffer-Platvoet MS, Slotman MH, Nijhuis-van der Sanden MWG, et al. Pregnancy- and obstetric-related risk factors for urinary incontinence, fecal incontinence, or pelvic organ prolapse later in life: a systematic review and meta-analysis. Acta Obstet Gynecol Scand Adv Online Publ. 2020. https://doi.org/10.1111/aogs.14027.
Siahkal SF, Iravani M, Mohaghegh Z, Sharifipour F, Zahedian M. Maternal, obstetrical and neonatal risk factors’ impact on female urinary incontinence: a systematic revew. Int Urogynecol J. 2020;31:2205–24. https://doi.org/10.1007/s00192-020-04442-x.
Wang K, Xu X, Jia G, Jiang H. Risk factors for postpartum stress urinary incontinence: a systematic review and meta-analysis. Reprod Sci. 2020;27:2129–45. https://doi.org/10.1007/s43032-020-00254-y.
Diez-Itza I, Zubikarai M, Galan C, Ginto L, Saro J, Arrue M. Factors involved in the persistence of stress urinary incontinence from postpartum to 12 years after first delivery. Neurourol Urodyn. 2020;39:1849–55. https://doi.org/10.1002/nau.24442.
Wesnes SL, Seim E. Birthweight and urinary incontinence after childbirth: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol Adv Online Publ. 2020. https://doi.org/10.1016/j.eurox.2020.100115.
Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. A comparison of the long-term consequences of vaginal delivery versus caesarean section on the prevalence, severity and bothersomeness of urinary incontinence subtypes: a national cohort study in primiparous women. BJOG. 2013;120:1548–55. https://doi.org/10.1111/1471-0528.12367.
Quiboeuf E, Saurel-Cubizolles MJ, Fitexl X, Group EM-CCS. Trends in urinary incontinence in women between 2 and 24 months postpartum in the EDEN cohort. BJOG. 2016;123:1222–8. https://doi.org/10.1111/1471-0528.13545.
Dolan LM, Walsh D, Hamilton S, Marshall K, Thompson K, Ashe RG. A study of quality of life in primigravidae with urinary incontinence. Int Urogynecol J. 2004;15:160–4. https://doi.org/10.1007/s00192-004-1128-x.
Van der Woude DAA, Pijnenborg JMA, de Vries J. Health status and quality of life in postpartum women: a systematic review of associated factors. Eur J Obstet Gynecol Reprod Biol. 2015;185:45–52. https://doi.org/10.1016/j.ejogrb.2014.11.041.
Mendes A, Hoga L, Goncalves B, Silva P, Pereira P. Adult women’s experiences of urinary incontinence: a systematic review of qualitative evidence. JBI Database System Rev Implement Rep. 2017;15:1350–408. https://doi.org/10.11124/JBISRIR-2017-003389.
Toye F, Barker KL. A meta-ethnography to understand the experience of living with urinary incontinence: ‘Is it just part and parcel of life?’. BMC Urol. 2020;20:1. https://doi.org/10.1186/s12894-019-0555-4.
Wilson L, Brown JS, Shin GP, Luc KO, Subak LL. Annual direct cost of urinary incontinence. Obstet Gynecol. 2001;98:398–406. https://doi.org/10.1016/s0029-7844(01)01464-8.
Imamura M, Abrams P, Bain C, Buckley B, Cardozo L, Cody JD, et al. Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess. 2010;14:1–188. https://doi.org/10.3310/hta14400.
Von Bargen E, Patterson D. Cost utility of the treatment of stress urinary incontinence. Female Pelvic Med Reconstr Surg. 2005;21:150–3. https://doi.org/10.1097/SPV.0000000000000159.
Bø K, Frawley H, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017;28:191–213. https://doi.org/10.1002/nau.23107.
Dumoulin C, Adewuyi T, Booth J, Bradley C, Burgio B, Hagen S, Hunter KF, Imamura M, Morin M, Morkved S, Thakar R, Wallace S, Williams K (2017) Adult conservative management. In: Abrams P, Cardozo L, Wagg A, Wein A (eds) Incontinence: 6th International Consultation on Incontinence, Tokyo, September 2016, 6th edn. International Continence Society (ICS) and International Consultation on Urological Diseases (ICUD), Bristol United Kingdom, pp 1443–1628.
National Institute for Health and Care Excellence (2019) NICE guideline. Urinary incontinence and pelvic organ prolapse in women: Management. Published 2 April 2019; last updated 24 June 2019. https://www.nice.org.uk/guidance/ng123
Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5:CD007471. https://doi.org/10.1002/14651858.CD007471.pub4.
Du Y, Xu L, Ding L, Wang Y, Wang Z. The effect of antenatal pelvic floor muscle training on labor and delivery outcomes: a systematic review with meta-analysis. Int Urogynecol J. 2015;26:1415–27. https://doi.org/10.1007/s00192-015-2654-4.
Baethge C, Goldbeck-Wood S, Mertens S. SANRA-a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019;4:5. https://doi.org/10.1186/s41073-019-0064-8.
Ashton-Miller JA, DeLancey JO. Functional anatomy of the female pelvic floor. In: Bo K, Berghmans B, Morkved S, Van Kampen M, editors. Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice. 2nd ed. Edinburgh: Elsevier; 2015. p. 19–34.
DeLancey JOL, Low LK, Miller JM, Patel DA, Tumbarello JA. Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol. 2008;199:610.e611–5. https://doi.org/10.1016/j.ajog.2008.04.001.
Salvatore S, DeLancey J, Igawa Y, Koelbl H, Laterza RM, Serati M, Sultan A, Dievert KD, Lowry A (2017) Pathophysiology of urinary incontinence, faecal incontinence and pelvic organ prolapse. In: Abrams P, Cardozo L, Wagg A, Wein A (eds) Incontinence: 6th International Consultation on Incontinence, Tokyo, September 2016, 6th edn. International Continence Society (ICS) and International Consultation on Urological Diseases (ICUD), Bristol United Kingdom, pp 361–496.
Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J. 2004;15:76–84. https://doi.org/10.1007/s00192-004-1125-0.
Davenport MH, Nagpal TS, Mottola MF, Skow RJ, Riske L, Poitras VJ, et al. Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2018;52:1397–404. https://doi.org/10.1136/bjsports-2018-099780.
Pelaez M, Gonzalez-Cerron S, Montejo R, Barakat R. Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2014;33:67–71. https://doi.org/10.1002/nau.22381.
Sangswang B, Sangswang N. Is a 6-week supervised pelvic floor muscle exercise programme effective in preventing stress urinary incontinence in late pregnancy in primigravid women?: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2016;197:103–10. https://doi.org/10.1016/j.ejogrb.2015.11.039.
Borrelli SE, Walsh D, Spiby H. First-time mothers’ expectations of the unknown territory of childbirth: uncertainties, coping strategies and ‘going with the flow. Midwifery. 2018;63:39–45. https://doi.org/10.1016/j.midw.2018.04.022.
Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol. 2010;2022:135.e131. https://doi.org/10.1016/j.ajog.2009.06.008.
Olander EK, Darwin ZJ, Atkinson L, Smith DM, Gardner B. Beyond the ‘teachable moment’ - a conceptual analysis of women’s perinatal behaviour change. Women Birth. 2016;29:e67–71. https://doi.org/10.1016/j.wombi.2015.11.005.
Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42 https://www.implementationscience.com/content/6/1/42.
Glazener CM, Herbison GP, Wilson PD, MacArthur C, Lang GD, Gee H, et al. Conservative management of persistent postnatal urinary and faecal incontinence: randomised controlled trial. BMJ Open. 2001;323:593–6.
Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654. https://doi.org/10.1002/14651858.CD005654.pub4.
Wilson PD, Herbison GP. A randomized controlled trial of pelvic floor muscle exercises to treat postnatal urinary incontinence. Int Urogynecol J. 1998;9:257–64. https://doi.org/10.1007/BF01901501.
Dumoulin C, Lemieux MC, Bourbonnais D, Gravel D, Bravo G, Morin M. Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2004;104:504–10. https://doi.org/10.1097/01.AOG.0000135274.92416.62.
Hagen S, Stark D, Glazener C, Dickson S, Barry S, Elders A, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383:796–806. https://doi.org/10.1016/S0140-6736(13)61977-7.
Wilson D, Dornan J, Milsom I, Freeman R. UR-CHOICE: can we provide mothers-to-be with information about the risk of future pelvic floor dysfunction? Int Urogynecol J. 2014;25:1449–52. https://doi.org/10.1007/s00192-014-2376-z.
Jelovsek JE, Chagin K, Gyhagen M, Hagen S, Wilson D, Kattan MW, et al. Predicting risk of pelvic floor disorders 12 and 20 years after delivery. Am J Obstet Gynecol. 2018;218:222.e221–19. https://doi.org/10.1016/j.ajog.2017.10.014.
Svare JA, Hansen BB, Lose G. Prevalence of anal incontinence during pregnancy and 1 year after delivery in a cohort of primiparous women and a control group of nulliparous women. Acta Obstet Gynecol Scand. 2016;95:920–5. https://doi.org/10.1111/aogs.12896.
Johannessen HH, Mørkved S, Stordahl A, Wibe A, Falk RS. Evolution and risk factors of anal incontinence during the first 6 years after first delivery: a prospective cohort study. BJOG. 2020;127:1499–506. https://doi.org/10.1111/1471-0528.16322.
MacArthur C, Wilson D, Herbison P, Lancashire RJ, Hagen S, Toozs-Hobson P, et al. Faecal incontinence persisting after childbirth: a 12 year longitudinal study. BJOG. 2013;130:169–79. https://doi.org/10.1111/1471-0528.12039.
Johannessen HH, Wibe A, Stordahl A, Sandvik L, Mørkved S. Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial. BJOG. 2016;124:686–94. https://doi.org/10.1111/1471-0528.14145.
Sultan AH, Nugent K. Pathophysiology and nonsurgical treatment of anal incontinence. BJOG. 2004;111(Suppl 1):84–90. https://doi.org/10.1111/j.1471-058.2004.00474.x.
Garcia-Mejido JA, Idoia-Valero I, Aguilar-Galvez IM, Borrero Gonzalez C, Fernandez-Palacin A, Sainz JA. Association between sexual dysfunction and avulsion of the levator ani muscle after instrumental vaginal delivery. Acta Obstet Gynecol Scand. 2020;99:1246–52. https://doi.org/10.1111/aogs.13852.
Sobhgol SS, Priddis H, Simth CA, Dahlen HG. The effect of pelvic floor muscle exercise on female sexual function during pregnancy and postpartum: a systematic review. Sex Med Rev. 2019;7:13–28. https://doi.org/10.1016/j.sxmr.2018.08.002.
Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186:1160–6. https://doi.org/10.1067/mob.2002.123819.
Hagen S, Glazener C, McClurg D, Macarthur C, Elders A, Herbison P, et al. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial. Lancet. 2017;389:393–402. https://doi.org/10.1016/S0140-6736(16)32109-2.
Sobhgol SS, Smith CA, Dahlen HG. The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis. Int Urogynecol J. 2020;31:2189–203. https://doi.org/10.1007/s00192-020-04298-1.
DeLancey JO, Sampselle CM, Puch MR. Kegel dyspareunia: Levator ani myalgia caused by overexertion. Obstet Gynecol. 1993;82:6580659.
Thompson JA, O’Sullivan PB. Levator plate movement during voluntary pelvic floor muscle contraction in subjects with incontinence and prolapse: a cross-sectional study and review. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:84–8. https://doi.org/10.1007/s00192-003-1036-5.
Maher RM, Iberle J. Concurrent validity of noninvasive coccygeal motion palpation and transabdominal ultrasound imaging in the assessment of pelvic floor function in women. J Womens Health Phys Therap. 2020;44:176–81. https://doi.org/10.1097/JWH.0000000000000175.
Takaoka S, Kobayashi Y, Taniguchi T. Effect of pelvic floor muscle training program in reducing postpartum levator hiatus area in Japanese women: a prospective cohort study using three-dimensional ultrasonography. Jpn J Nurs Sci. 2020;17:e12346. https://doi.org/10.1111/jjns.12346.
Van Delft K, Thaka R, Sultan AH. Pelvic floor muscle contractility: digital assessment vs transperineal ulstraound. Ultrasound Obstet Gynecol. 2015;45:217–22. https://doi.org/10.1002/uog.13456.
Terry R, Jarvie R, Hay-Smith J, Salmon V, Pearson M, Boddy K, et al. “Are you doing your pelvic floor?” an ethnographic exploration of the interaction between women and midwives about pelvic floor muscle exercises (PFME) during pregnancy. Midwifery. 2020;83:102647. https://doi.org/10.1016/j.midw.2020.102647.
Faubion SS, Shuster LT, Bharucha AE. Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clin Proc. 2012;87:187–93. https://doi.org/10.1016/j.mayocp.2011.09.004.
Frawley HC, Dean SG, Slade SC, Hay-Smith EJC. Is pelvic-floor muscle training a physical therapy or a behavioral therapy? A call to name and report the physical, cognitive, and behavioral elements. Phys Ther. 2017;97:425–37. https://doi.org/10.1093/ptj/pzx006.
Bayat M, Eshraghi N, Naeiji Z, Fathi M. Evaluation of awareness, adherence, and barriers of pelvic floor muscle training in pregnant women: a cross-sectional study. Female Pelvic Med Reconstr Surg Advance online publication. 2020. https://doi.org/10.1097/SPV.0000000000000852.
Hill A-M, McPhail SM, Wilson JM, Berlach RG. Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. Int Urogynecol J. 2017;28:1557–65. https://doi.org/10.1007/s00192-017-3309-4.
O’Neill AT, Hockey J, O’Brien P, Williams A, Morris TP, Khan T, et al. Knowledge of pelvic floor problems: a study of third trimester, primiparous women. Int Urogynecol J. 2017;28:125–9. https://doi.org/10.1007/s00192-016-3087-4.
Whitford HM, Alder B, Jones M. A cross-sectional study of knowledge and practice of pelvic floor exercises during pregnancy and associated symptoms of stress urinary incontinence in north-East Scotland. Midwifery. 2007;23:204–17. https://doi.org/10.1016/j.midw.2006.06.006.
Ratamess NA, Alvar BA, Evetoch TK, Housh TJ, Kibler B, Karaemer WJ, et al. Progression models in resistance training for healthy adults [ACSM position stand]. Med Sci Sports Exerc. 2009;41:687–708.
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59. https://doi.org/10.1249/MSS.0b013e318213fefb.
Bø K, Hagen RH, Kvarstein B, Jørgensen J, Larsen S. Pelvic floor muscle exercise for treatment of female stress urinary incontinence: III. Effects of two different degrees of pelvic floor muscle exercises. Neurourol Urodyn. 1990;9:489–502.
Mørkved S, Bø K. The effect of postpartum pelvic floor muscle exercise in the prevention and treatment of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1997;8:217–22. https://doi.org/10.1007/BF02765817.
Mørkved S, Bø K, Schei B, Salvesen KA. Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial. Obstet Gynecol. 2003;101:313–9. https://doi.org/10.1016/s0029-7844(02)02711-4.
Bø K, Haakstad LA. Is pelvic floor muscle training effective when taught in a general fitness class in pregnancy? A randomised controlled trial. Physiotherapy. 2011;97:190–5. https://doi.org/10.1016/j.physio.2010.08.014.
Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med. 2014;48:299–310. https://doi.org/10.1136/bjsports-2012-091758.
Bø K, Nygaard IE. Is physical activity good or bad for the female pelvic floor? A narrative review. Sports Med. 2020;50:471–84. https://doi.org/10.1007/s40279-019-01243-1.
Hay-Smith J, Dean S, Burgio K, McClurg D, Frawley H, Dumoulin C. Pelvic-floor-muscle-training adherence “modifiers”: a review of primary qualitative stuides - 2011 ICS state-of-the-science seminar research paper III of IV. Neurourol Urodyn. 2015;34:622–31. https://doi.org/10.1002/nau.22771.
Salmon VE, Hay-Smith EJC, Jarvie R, Dean S, Terry R, Frawley H, et al. Implementing pelvic floor muscle training in women’s childbearing years: a critical interpretive synthesis of individual, professional, and service issues. Neurourol Urodyn. 2020;39:863–70. https://doi.org/10.1002/nau.24256.
Neels H, Wyndaele J-J, Tjalma WAA, De Wachter S, Wyndaele M, Vermandel A. Knowledge of the pelvic floor in nulliparous women. J Phys Ther Sci. 2016;28:1524–43. https://doi.org/10.1589/jpts.28.1524.
Geynisman-Tan JM, Taubel D, Asfaw TS. Is something missing from antental education? A survey of pregnant women’s knowledge of pelvic floor disorders. Female Pelvic Med Reconstr Surg. 2018;24:440–3. https://doi.org/10.1097/SPV.0000000000000465.
Chiarelli P, Cockburn J. The development of a physiotherapy continence promotion program using a customer focus. Aust J Physiother. 1999;45:111–9. https://doi.org/10.1016/s0004-9514(14)60343-3.
Gillard S, Shamley D. Factors motivating women to commence and adhere to pelvic floor muscle exercises following a perineal tear at delivery: the influence of experience. Journal of the Association of Chartered Physiotherapists in Women’s Health. 2010;106:5–18.
Mason L, Glenn S, Walton I, Hughes C. The instruction in pelvic floor exercises provided to women during pregnancy or following delivery. Midwifery. 2010a;17:55–64. https://doi.org/10.1054/midw.2000.0235.
Wagg AR, Kendall S, Bunn F. Women’s experiences, beliefs and knowledge of urinary symptoms in the postpartum period and the perceptions of health professionals: a grounded theory study. Prim Health Care Res Dev. 2017;18:448–62. https://doi.org/10.1017/S1463423617000366.
Grant A, Currie S. Qualitative exploration of the acceptability of a postnatal pelvic floor muscle training intervention to prevent urinary incontinence. BMC Womens Health. 2020;20:9. https://doi.org/10.1186/s12905-019-0878-z.
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;27:684–7. https://doi.org/10.1080/01443610701612284.
Chiarelli P, Murphy B, Cockburn J. Women’s knowledge, practises, and intentions regarding correct pelvic floor exercises. Neurourol Urodyn. 2003;22:246–9. https://doi.org/10.1002/nau.10119.
Temtanakitpaisan T, Bunyavejchevin S, Buppasiri P, Chongsomchai C. Knowledge, attitude, and practices (KAP) survey towards pelvic floor muscle training (PFMT) among pregnant women. Int J Women’s Health. 2020;12:295–9. https://doi.org/10.2147/IJWH.S242432.
National Health Service (2019) The NHS Long Term Plan. https://www.longtermplan.nhs.uk. Accessed 11 Jan 2021.
Li T, Wang J, Chen X, Chen L, Cai W. Obstetric nurses’ knowledge, attitudes, and professional support related to actual care practices about urinary incontinence. Female Pelvic Med Reconstr Surg Advance online publication. 2020. https://doi.org/10.1097/SPV.0000000000000941.
Webb SS, Skene ER, Manresa M, Percy EK, Freeman RM, Tincello DG. Evaluation of midwifery pelvic floor education and training across the UK and Spain. Eur J Obstet Gynecol Reprod Biol. 2020;256:140–4. https://doi.org/10.1016/j.ejogrb.2020.10.065.
O’Connell B, Hanna B, Bailey S, Walsh H, Prosser A. The nature and severity of urinary incontinence in post-natal women. Contemp Nurse. 2002;13:158–68. https://doi.org/10.5172/conu.13.2-3.158.
Yount SM, Fay RA, Kissler KJ. Prenatal and postpartum experience, knowledge and engagement with Kegels: a longitudinal, prospective, multisite study. J Womens Health (Larchmt) Advance online publication. 2020. https://doi.org/10.1089/jwh.2019.8185.
Strahle A, Stainton MC. Women’s experience of revealing perinatal bladder function -implications for midwifery care. Women Birth. 2006;19:17–21. https://doi.org/10.1016/j.wombi.2006.01.001.
Hermansen IL, O’Connell B, Gaskin CJ. Are postpartum women in Denmark being given helpful information about urinary incontinence and pelvic floor exercises? J Midwifery Womens Health. 2010;55:171–4. https://doi.org/10.1016/j.jmwh.2009.09.004.
Mason L, Glenn S, Walton I, Hughes C. Do women practise pelvic floor exercises during pregnancy or following delivery? Physiotherapy. 2010b;87:662–70. https://doi.org/10.1016/S0031-9406(05)61112-1.
Sacomori C, Zomkowski K, Dos Passos PI, Cardoso FL, Sperandio FF. Adherence and effectiveness of a single instruction of pelvic floor exercises: a randomized clinical trial. Int Urogynecol J. 2020;31:951–9. https://doi.org/10.1007/s00192-019-04032-6.
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Woodley, S.J., Hay-Smith, E.J.C. Narrative review of pelvic floor muscle training for childbearing women—why, when, what, and how. Int Urogynecol J 32, 1977–1988 (2021). https://doi.org/10.1007/s00192-021-04804-z
- Behavioural support
- Pelvic floor
- Pregnant women
- Urinary incontinence