The results indicate that home-based PFMT is effective. However, written training instructions were as efficient as home-based training with follow up visits every sixth week.

We examined symptoms of post-traumatic stress disorder (PTSD) in mothers of very low birth weight (VLBW) infants 2-3 years post-partum, compared with mothers of term, normal weight infants. Mothers were asked to report current symptoms relating specifically to the birth of their infant using The Impact of Event Scale-Revised (IES-R). Mothers of VLBW infants recorded significantly higher levels of PTSD symptoms overall (median scores: VLBW 25 [range 2-82], versus controls: 0 [range 0-5], P < 0.001), and in all sub-categories (p < 0.001). These findings suggest that mothers of VLBW infants have a relatively high prevalence of symptoms of PTSD at 2-3 years postnatal.

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Introduction and hypothesis This is a prospective cohort follow-up study based on the hypothesis that primiparous women with non-assisted vaginal deliveries and a second-degree perineal tear have more posterior compartment symptoms 1 year after delivery than those with no or first-degree tears. Methods A follow-up questionnaire, including validated questions on pelvic floor dysfunction, was completed 1 year postpartum by 410 healthy primiparas, delivered without instrumental assistance at two maternity wards in Stockholm between 2013 and 2015. Main outcome measures were posterior compartment symptoms in women with second-degree perineal tears compared with women with no or only minor tears. Results Of 410 women, 20.9% had no or only minor tears, 75.4% had a second-degree tear, and 3.7% had a more severe tear. Of women presenting with second-degree tears, 18.9% had bowel-emptying difficulties compared with 20.0% of women with minor tears. Furthermore, almost 3% of them with second-degree tears complained of faecal incontinence (FI) of formed stool, 7.2% of FI of loose stool compared with 1.2% and 3.5% respectively in women with no or only minor tears. Conclusions Symptomatic pelvic floor dysfunction is common among primiparous women within 1 year following uncomplicated vaginal delivery, and there are no significant differences between second-degree perineal tears and minor tears. These symptoms should be addressed in all women after delivery to improve pelvic floor dysfunction and quality of life.

Introduction and hypothesis Urinary incontinence (UI) is associated with pregnancy and parity and can cause health problems for women. Our objective was to explore risk factors for UI and its effect on women's daily activities, psychological health and wellbeing 9-12 months postpartum in a low-risk primiparous population. Methods In this prospective cohort study, first-time mothers in a low-risk population with a spontaneous vaginal birth reported the occurrence of UI and its effect on daily activities and on their psychological health and wellbeing in a questionnaire completed 1 year after birth. Descriptive and comparative statistics were employed for the analysis. Results A total of 410 women (75.7%) completed the questionnaire. The self-reported rates of stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were 45.4%, 38.0% and 27.0% respectively. Neither the duration of the second stage of labour, the baby's head circumference or its birth weight were associated with the incidence of UI. There was an association between reported negative impact on daily activities and more negative psychological wellbeing (p < 0.001). Conclusions Urinary incontinence was common among primiparous women at 9-12 months postpartum. Women whose symptoms had a negative impact on their daily activities reported more psychological suffering. KeywordsUrinary incontinence . Postpartum . Primiparous . Vaginal . Birth Abbreviations UI Urinary incontinence SUI Stress urinary incontinence UUI Urge urinary incontinence MUI Mixed urinary incontinence

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Background and AimNeonatal intensive care units (NICUs) are high stress environments for parents and staff. A high prevalence of post-traumatic stress in parents exists, often persisting for years. Maternal anxiety affects infant cognitive and socio-emotional development assessed at 24 months corrected age. The authors aimed to assess current psychological and social support available for parents in UK tertiary-level NICUs.MethodsTelephone survey in August 2009 of all 50 tertiary-level NICUs in the UK. The authors asked the senior nurse/nurse manager what formal psychological support, if any, was provided to parents on their NICU, and whether their unit had dedicated social work input.ResultsThe authors obtained information from all 50 (100%) units. Two units (4%) had dedicated clinical psychologists for their NICU who provided comprehensive support for parents and offered regular meetings and counselling sessions; a further 15 units (30%) had the support of an available clinical psychologist who provided input to both the NICU and maternity unit as required; 13 units (26%) offered some psychological support, though not from a trained psychologist (eg, offered by a trained counsellor nurse/family care nurse, a parental support group, bereavement counsellor or hospital chaplain); in 20 (40%) units no psychological support was available for parents. Regarding social work support for the NICU, 20 (40%) units had regular input from a social worker, either in terms of them joining the clinical ward round or attending a weekly psychosocial meeting. Time allocated for the dedicated social worker support ranged from a few hours per week to a full time social worker based in the unit. Five (10%) units held a weekly social ward round. The majority of NICUs (30/50; 60%) did not have either a dedicated social worker, or any regular meeting between nurses/doctors and social worker to discuss the social needs of parents/families.ConclusionSome NICUs offer parents excellent psychological support, while many other NICUs offer parents no formal psychological support whatsoever. The psychological and social needs of many parents with babies on UK neonatal units are presently not being addressed, and this may have adverse long-term consequences for infants and their families.