A longitudinal follow up of women in their practice of perinatal pelvic floor exercises and stress urinary incontinence in North-East Scotland

Objectives to establish the reported practice of pelvic floor exercises and stress urinary incontinence after delivery. Design a longitudinal study using a postnatal postal questionnaire. Participants 257 women in the North-East of Scotland were sent questionnaires between June and December 2000, 6–12 months after delivery (previously recruited and interviewed during the last trimester of pregnancy). One hundred and sixty-three women responded (63.4%). Findings more women reported the practice of pelvic floor exercises after delivery than during pregnancy: 134 (83.2%) compared with 123 (76.4%). Six to 12 months after delivery, 96 (60%) women said that they were still doing the exercises. A third of respondents (n=54, 33.1%) reported stress incontinence at some time since having the baby. Of those reporting incontinence at the time of questionnaire completion, six (19.3%) said the incontinence was moderate or severe, whereas eight (34.7%) reported incontinence once a week or more. Women who had an operative vaginal delivery (forceps or ventouse delivery) were more likely to report the practice of pelvic floor exercises than those having a spontaneous vaginal delivery. No significant difference was found in reported rates of stress incontinence between women who had different modes of delivery. The practice of pelvic floor exercises daily or more often during pregnancy was associated with less reported postnatal incontinence compared with less frequent practice. Key conclusions self-reported rates of practice of pelvic floor exercises increased from pregnancy to the immediate postnatal period and subsequently declined. A third of women reported the symptoms of stress incontinence after delivery. Daily or more frequent practice of the exercises during pregnancy may be required in order to prevent postnatal incontinence (although further research is required to confirm this finding). Implications for practice midwives should continue to encourage regular and frequent practice of pelvic floor exercises in the postnatal period and beyond. They also need to ask about symptoms of stress incontinence and refer as necessary.