Effect of Pelvic Muscle Exercise on Transient Incontinence During Pregnancy and After Birth
Research with nonpregnant incontinent women has shown us that pelvic muscle exercise can increase muscle strength and decrease urine loss. This interdisciplinary team of researchers, led by a nurse, sought to determine if a similar exercise intervention would affect antepartum or postpartum urinary incontinence and pelvic muscle strength. A prospective trial randomized primigravidas at 20 weeks gestation into either a treatment or control group. The treatment group received instruction that included muscle identification exercises followed by strength-building exercises, and the control group received routine care with no systematic teaching. Urinary incontinence symptoms were measured by a questionnaire, and pelvic muscle strength was measured using a speculum with attached strain gauges that measured the force of a pelvic muscle contraction.
Results demonstrated that women in the pelvic muscle exercise group had fewer urinary incontinence symptoms than their control counterparts at 35 weeks gestation, 6 weeks postpartum, and 6 months postpartum. Although no statistical difference in muscle strength was found between the two groups, the researchers did note a pattern of greater postpartum strength in the treatment group. Another interesting finding was that women who started out with greater muscle strength at 20 weeks had greater muscle strength at 12 months postpartum.
On the basis of these findings, the researchers recommend that pelvic muscle exercise be taught to women in the antepartum and postpartum periods, and that pelvic muscle exercise be prescribed to nulligravid women anticipating eventual pregnancy who demonstrate pelvic muscle weakness. The intriguing question the researchers leave with us is whether pelvic muscle exercise during the childbearing period has a protective effect on future continence.