Pelvic floor exercises, incontinence and pregnancy

: knowledge, motivation and behaviour

Abstract

Childbirth and obstetric factors have been linked to the subsequent development of urinary incontinence. It has been suggested that the practice of pelvic floor exercises during pregnancy may reduce the prevalence of postpartum incontinence. However little is known about current information provision about pelvic floor exercises to pregnant women and rates of practice of the exercises. Motivation of pregnant women to practise the exercises has not been examined. This study was designed to address these deficiencies and to find out if the Revised Theory of Planned Behaviour (RTPB) was applicable to the practice of pelvic floor exercises during pregnancy. A cohort of women (n = 289) attending antenatal clinics in Dundee were interviewed in the third trimester of pregnancy regarding information and practice, as well as beliefs and attitudes about pelvic floor exercises using the RTPB as a framework. A follow-up postal questionnaire was sent between 6 – 12 months after delivery (63.4% response rate). 77.9% of women reported receiving information in the current pregnancy: younger women, first-time mothers and those from more deprived backgrounds were less likely to report receiving information. Just over half the women (54.0%) reported the practice of pelvic floor exercises during pregnancy, and 83.2% of responders to the follow-up reported practising the exercises in the first month after delivery. Non-practice of the exercises in pregnancy was associated with younger age, more deprived area of residence and lower educational level, but not parity. The RTPB variables (‘attitude to the new behaviour’, ‘subjective norm’ and ‘self-efficacy’) explained 53.1% of variance in intention to practise pelvic floor exercises during pregnancy. Perceived vulnerability to incontinence (‘attitude to current behaviour’) had no relationship with intention, but this relationship may have been moderated by current behaviour. Generally women did not think postnatal incontinence was likely. Measures of past behaviour significantly improved the percentage of explained variance in intention. Confidence in ability to correctly perform the exercises (‘self-efficacy’) was significant in predicting subsequent practice. These findings will help to inform future interventions in order to encourage more women to practise pelvic floor exercises.

Date of Award	2002
Original language	English
Supervisor	Martyn Jones (Supervisor) & Beth Alder (Supervisor)