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Why is education for pelvic floor muscle exercises a neglected public health issue?

02 November 2017
12 min read
Volume 25 · Issue 11

Abstract

Background

Pelvic floor muscle exercises positively impact on urinary stress incontinence and quality of life for women.

Aim

To try and understand more about pelvic floor exercises.

Methods

A search was performed on Cochrane, CINAHL and Discover More. Delimiting the search provided 28 papers, which then informed this literature review. Differing methodology and small sample size of individual studies, variation in trainer and the design of pelvic floor muscle exercises education limited the evidence base.

Findings

Many barriers existed and women were found to be disinterested with pelvic floor exercises or unaware of the reasons for performing them. Those who were young, in their first pregnancy and from deprived areas were less likely to perform pelvic floor muscle exercises, as they had no access to information or believed they were not necessary. Midwives lacked confidence in their knowledge and suggested that other health professionals could perform promotion better.

Conclusions

It is important to investigate how midwives can influence education about pelvic floor muscle exercises and women's perceptions. New and creative methods of health promotion are needed to engage women with pelvic floor muscle exercises more effectively.

Pelvic floor muscle exercises are suggested as a method to improve pelvic muscle control in the antenatal and postnatal period (Dinc et al, 2009; Bo and Haakstad, 2011; Langeland-Wesnes and Lose, 2013), and are defined as the repetitive contraction of the pelvic muscles performed with an intent to strengthen, increase endurance and coordinate muscle activity, in order to prevent urinary incontinence (Hay-Smith et al, 2008). During pregnancy, pelvic floor exercises may help to counteract the pressure caused by the fetus, and the increased laxity of ligaments in the pelvic area (Hay-Smith et al, 2008). It is recognised that this information is provided by midwives at booking as part of their role in public health. The National Institute for Health and Care Excellence (NICE) (2008) recommends that pregnant women are advised about pelvic floor exercises at their first booking appointment; however, there is no data collected that would indicate if this advice takes place in a standardised way locally, nationally or internationally.

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