Abstract
Background
Pelvic floor muscle exercises (PFME) are recommended for treatment of urinary incontinence
with less evidence available about the effect on female sexual function (FSF) and
childbirth.
Aim
To investigate the effect of antenatal PFME on FSF during pregnancy and the first
three months following birth as a primary outcome, and on labour and birth outcomes
as a secondary outcome.
Method
200 nulliparous women were randomised to control (n = 100) and intervention (n = 100)
groups. The women in the intervention group (IG) undertook PFME from 20 weeks gestation
until birth and had routine antenatal care, while those in the control group (CG)
received routine antenatal care only. The Female Sexual Function Index (FSFI) was
used to measure FSF at 36 weeks gestation and three months postnatal. Baseline characteristics
and childbirth data were also collected and analysed using SPSS.
Results
There were no statistically significant differences between the two groups in terms
of FSF scores during pregnancy and on childbirth outcomes. Sexual satisfaction was
slightly higher in the CG [Mean ± SD, CG: 4.35 ± 1.45 vs. IG: 3.70 ± 1.50, (P = 0.03)]
at three months after birth. However, 50% of women adhered to the PFME, and 40% of
women did not resume sex by three months after the birth.
Conclusion
Though some trends were observed, the results showed no effect of PFME on sexual function
or labour and birth outcomes. This needs to be interpreted considering the 50% adherence
to PFME. More research is recommended.
Abbreviations:
FSF (Female Sexual Function), FSFI (Female Sexual Function Index), RCT (Randomised controlled trial), PFME (pelvic floor muscle exercises), WSLHD (Western Sydney Local Health District)Keywords
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References
- Exercise during pregnancy. A narrative review asking: what do we know?.Br. J. Sports Med. 2015; 49: 1377-1381
- The effect of pelvic floor muscle exercises program on sexual self-efficacy in primiparous women after delivery.Iran. J. Nurs. Mid. Res. 2015; 20: 347
- Effects of prenatal perineal massage and Kegel exercises on the integrity of postnatal perine.Health. 2015; 7: 495
- Related factors of urge, stress, mixed urinary incontinence and overactive bladder in reproductive age women: a cross-sectional study.Int. Urogynecol. J. 2008; 19: 367-373
- Rate and related factors of dyspareunia in reproductive age women: a cross-sectional study.IJIR. 2007; 19: 88-94
- Effects of pregnancy on pelvic floor dysfunction and body image; a prospective study.Int. Urogynecol. J. 2008; 19: 1495-1501
- Childbirth and sexuality.Routledge International Handbook of Women’s Sexual and Reproductive Health. Routledge, 2019: 332-345
- REVIEWS: pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review.J. Sex. Med. 2007; 4: 4-13
- Effects of pregnancy on female sexual function and body image: a prospective study.J. Sex. Med. 2008; 5: 1915-1922
- The impact of pregnancy and childbirth on sexual behaviors: a systematic review.J. Sex Res. 2017; 54
- Does pelvic floor muscle training improve female sexual function? A systematic review.Int. Urogynecol. J. 2015; 26: 1735-1750
- Effect of postpartum pelvic floor muscle training on vaginal symptoms and sexual dysfunction-secondary analysis of a randomised trial.BJOG. 2016; 123: 634-642
- 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
- Postpartum sexual function of women and the effects of early pelvic floor muscle exercises.Acta Obstet. Gynecol. Scand. 2010; 89: 817-822
- Effect of pelvic floor muscle training on postpartum sexual function and quality of life: a systematic review and meta-analysis of clinical trials.Taiwanese J. Obstet. Gynecol. 2019; 58: 737-747
- Effect of pelvic floor muscle training on female sexual function during pregnancy and postpartum: a randomized controlled trial.Iran. Red Cres. Med. J. 2017; 19: 10-15
- Randomised controlled trial of pelvic floor muscle training during pregnancy.BMJ. 2004; 329: 378-380
- Effect of antenatal pelvic floor muscle exercise on mode of delivery: a randomized controlled trial.Integ. Med. Int. 2017; 4: 187-197
- Does antenatal pelvic floor muscle training affect the outcome of labour? A randomised controlled trial.Int. Urogynecol. J. 2008; 19: 85-88
- Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial.Braz. J. Phys. Ther. 2011; 15: 487-493
- The effect of antenatal pelvic floor muscle training on labor and delivery outcomes: a systematic review with meta-analysis.Int. Urogynecol. J. 2015; 26: 1415-1427
- The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis.Int. Urogynecol. J. 2020; : 1-15
- Process evaluation of the midwifery initiated oral health-dental service program: perceptions of pregnant women.Aust. Dent. J. 2019; 64: 55-65
- Evaluation of the effect of an antenatal pelvic floor muscle exercise programme on female sexual function during pregnancy and the first 3 months following birth: study protocol for a pragmatic randomised controlled trial.Trials. 2019; 20: 1-11
- SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials.BMJ. 2013; 346
- Randomisation and Online Databases for Clinical Trials.(URL: https://www.sealedenvelope.com/ [accessed 2019-03-08][WebCite Cache ID 76iYrkrIW])2019
- 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
- Factors influencing long-term adherence to pelvic floor exercises in women with urinary incontinence.Neurourol. Urodynam. 2018; 37: 1120-1127
- Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence.Int. Urogynecol. J. 2008; 19: 773-782
- A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI.J. Am. Geriat. Soc. 1998; 46: 870-874
- The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.J. Sex Mar. Ther. 2000; 26: 191-208
- The REDCap consortium: building an international community of software platform partners.J. Biomed. Info. 2019; 95: 103208
- Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale.Br. J. Psych. 1987; 150: 782-786
- The relationship assessment scale.J. Social Personal Rel. 1998; 15: 137-142
- Does pelvic floor muscle training improve female sexual function? A systematic review.Int. Urogynecol. J. 2015; 26: 1735-1750
- Effect of supervised exercise training during pregnancy on neonatal and maternal outcomes among overweight and obese women. Secondary analyses of the ETIP trial: a randomised controlled trial.PLoS One. 2017; 12e0173937
- Performance of self-reported and unsupervised antenatal pelvic floor muscle training and its effects on postpartum stress urinary incontinence among Chinese women: a cohort study.J. Int. Med. Res. 2020; 480300060520914226
- Pelvic-floor-muscle training adherence: tools, measurements and strategies—2011 ICS State-of-the-Science Seminar Research Paper II of IV.Neurourol. Urodyn. 2015; 34: 615-621
- Perineal trauma and postpartum perineal morbidity in Asian and non-Asian primiparous women giving birth in Australia.J. Obst. Gynecol. Neonatal Nurs. 2008; 37: 455-463
- Pregnancy, childbirth, and sexual function: perceptions and facts.Int. Urogynecol. J. 2014; 25: 5-14
- A cross-sectional study of female sexual function and dysfunction during pregnancy.J. Sex. Med. 2007; 4: 1381-1387
- Failed labor induction in nulliparous women at term: the role of pelvic floor muscle strength.Int. Urogynecol. J. 2012; 23: 1105-1110
- Effect of persistent guidance of pelvic floor muscle training on the delivery outcome and pelvic muscle strength.Chin. J. Nurs. 2013; 4
- Trainability of the pelvic floor a prospective study during pregnancy and after delivery.Acta Obstet. Gynecol. Scand. 1988; 67: 437-440
Article info
Publication history
Published online: March 08, 2022
Accepted:
February 20,
2022
Received in revised form:
February 17,
2022
Received:
October 4,
2021
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.