“There was no real importance put on them”. Experiences of multiparous women and pelvic floor muscle exercise (PFME) prescription. A qualitative study

Abstract

Background Pregnancy is the main risk factor for the development of Stress Urinary Incontinence (SUI) which is known to have detrimental effects on quality of life in approximately 54.3% of women. The recommended treatment for SUI is to increase pelvic floor muscle strength, however, it is not clear why long-term adherence to pelvic floor muscle exercise (PFME) is poor. Objectives To understand multiparous women's experience of incontinence and the prescription of pelvic floor muscle exercise (PFME) in the ante and post-natal period on their first pregnancy, and the differences, if any, that they experienced on subsequent pregnancies. Methods Purposive sampling was used to recruit women who had two or more children. The 1:1 semistructured interviews were recorded, transcribed verbatim and anonymised. Thematic analysis was undertaken by both researchers, independently, and the codes and themes were agreed by consensus. Results Women were not aware that PFME could prevent incontinence, and the education provided was not sufficient to enable adherence to a PFME program. PFME were prescribed by health professionals, but there was a lack of detail, and the importance of PFME was not emphasised on first or subsequent pregnancies. On subsequent pregnancies, women were more aware of PFME and incontinence, however, this education came from informal sources, not the health care professionals providing the ante or post-natal care. Conclusions Health care professionals should include more information, and better guidance regarding PFMEs. Most of the information about PFMEs came from informal sources, especially on the second and subsequent pregnancies.

Maintaining A Long‐Term Practice of Daily Pelvic Floor Muscle Exercises: What Do Childbearing Women Think?

“…The lack of PFMT use to prevent and treat UI is perplexing, given that this intervention is effective, simple, and woman‐controlled. Existing research shows that a lack of awareness of the need to practice PFMT long‐term contributes to low engagement 23,24 . Limited evidence exists on the effectiveness of long‐term PFMT.…”

“…Existing research shows that a lack of awareness of the need to practice PFMT long-term contributes to low engagement. 23,24 Limited evidence exists on the effectiveness of long-term PFMT. Concurrently, there is no evidence to suggest that daily long-term PFMT is detrimental to pelvic floor health outside of women with overactive pelvic floor muscles.…”