What women do and don’t know about childbirth and their pelvic floor muscles

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By Stephanie Prendergast

 

Recently, a number of studies were published on what women do and don’t know about their pelvic floor muscles, childbirth, and longer-term pelvic health.

 

How much do you actually know? Take our quiz and find out! If you do not know the answers, don’t fret. You are amongst 93% of women who felt like they were insufficiently informed about their pelvic health and requested more information about pelvic floor function and childbirth. The 7% that are sufficiently informed are all pelvic floor physical therapists in the United States and all employees of PHRC. Joking aside, numerous studies are concluding better peripartum education is needed and we at PHRC want to help provide it. Let’s get to it.

 

PHRC Pelvic Health Quiz

 

  1. What do your pelvic floor muscles do?
  2. What do your pelvic floor muscles go around?
  3. Should your pelvic floor muscles and abdominal muscles work together?
  4. Why might women leak urine when they are pregnant?
  5. If you leak urine when you are pregnant, what can you do about it?
  6. How often should you exercise your pelvic floor muscles?
  7. What is Pelvic Organ Prolapse and how does it occur?
  8. True or False: Once a person has pelvic organ prolapse not much can be done to help.
  9. True or False: Leakage of stool only occurs in older women.
  10. True or False: If stool leakage happens related to pregnancy or birth, it is short-term in duration.
  11. True or False: Surgery is the only treatment for stool leakage.
  12. Do pelvic floor muscles play a role in orgasm?
  13. Do the pelvic floor muscles play a role in painful sex?

 

As a pelvic floor physical therapist, I understand how underserved postpartum women are and believe they can benefit from postpartum physical therapy. Because postpartum physical therapy is not currently included as a standard of care for women they often find us on their own. In order to find us women need to know that pelvic floor physical therapy addresses urinary, bowel, and sexual problems, and here in 2017, most women don’t know this.

 

In one cross-sectional study1, 633 Australian 1st-time pregnant women completed a survey. The survey showed:

 

  • 17.4% of the women survey had never heard of pelvic floor muscles.  
  • 41% of women thought it was normal to leak urine while pregnant.
  • 63% of women did not know pelvic floor muscle exercises can prevent fecal incontinence.
  • 89% of the women were not doing pelvic floor exercises.

 

In another cross-sectional-study conducted in 3 antenatal clinics in London2, 249 1st-time pregnant women in their third trimester completed a survey. The survey showed:

 

  • The average pelvic health knowledge score was 45%.
  • Women knew the least about pregnancy as a risk factor for pelvic organ prolapse, answering only 35% of the questions correctly.
  • Women also knew very little about fecal incontinence, answering only 36% of the questions about fecal incontinence correctly.

 

Finally, 212 1st-time pregnant women in Belgium were surveyed.3 Women were asked whether an episiotomy or perineal rupture would cause more damage and worse outcomes. 86% of the women believed a rupture had a more negative outcome, which is in clear contrast to current research on the topic.4 Additionally, this survey showed:

 

  • 76% of the women in this study thought that childbirth would negatively affect their sexuality.
  • The majority of women thought stress urinary incontinence and dyspareunia following childbirth was normal.
  • 93% of women felt insufficiently informed about pelvic floor muscles and childbirth.

 

Astounding, right? The message to take home is that pregnancy and childbirth are risk factors for stress urinary incontinence, fecal incontinence, pelvic organ prolapse, painful intercourse, and aorgasmia. The reason we need better education is because pelvic floor physical therapy significantly reduces these risk factors and all postpartum women can benefit from pelvic floor physical therapy. Leaking urine or stool, painful sex, aorgasmia and pelvic pain are common and treatable but never normal!

 

PHRC is committed to raising everyone’s pelvic health IQ. We want women to feel empowered and prepared for labor and delivery, we want women armed with the information they need for an efficient postpartum recovery, and we want women  informed on what they need to do to optimize their pelvic health for eternity. Stay tuned, next week we are going to provide the quiz answers and talk about what women can do at home to prepare themselves for labor and delivery. The subsequent posts in this series will address labor and delivery, postpartum sex, postpartum depression, and aftercare for C-section and perineal scars.

 

We hope you find this series helpful and please feel free to share our posts!

 

 

 

References:

 

  1. Hill AM et al. Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. Int Urogynecol J. 2017; March, DOI 10.1007/s00192-017-3309-4.
  2. O’neill AT et al. Int Urogynecol J. (2017) 28: 125-129. DOI 10.1007/s00192-016-3087-4.
  3. Neels H et al. Knowledge of the pelvic floor in nulliparous women. J. Phys Ther Sci. 28: 1524 – 1533, 2016.
  4. Andrews V. Evaluation of postpartum women perineal pain and dyspareunia- a prospective study. Eur J Obstet Gyn Reprod Bio, 2008, 137: 152-156.

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