Pregnancy and Role of Pelvis Exercise

Approximately 3% of pregnant women facing urinary incontinence during their gestational period. The negative impact of urinary incontinence is significant in their quality of life with respect to inconsistent physical activity, travel, social relationships, and emotional health. Pelvic floor muscle exercise is an effective treatment during pregnancy and has no significant adverse effects. Continence can be improved when incontinent pregnant women adequately perform pelvic floor muscle exercise.

Studies from developed countries such as Turkey and New Zealand demonstrated that pelvic floor muscle exercise performed for at least 6 weeks reduced the risk of the urinary incontinence in the postpartum period. In addition, the study report also showed that symptomatic Pelvic organ prolapse can cause substantial discomfort, reduce the quality of life and limit activities of daily living.

The aim of pelvic floor muscle exercise is to strengthen the peri-vaginal and peri-anal musculature to increase a woman’s control of urine leakage. A number of studies have shown that pelvic floor muscle exercise is effective for women of all ages experiencing urinary incontinence.

Pelvic floor muscle exercise can improve pelvic floor muscle strength which plays an important role in controlling the urethral sphincter. This will result in cure or relieve stress urinary incontinence in a pregnant woman. Following are some recommendation of pelvic floor muscle exercise

• The daily recommended number of contractions was 30 at maximum or near maximum intensity for strength building.
• Pregnant women need to perform pelvic floor muscle exercise with both slow and fast contractions. The slow contraction is performed by contracting or squeezing the peri-vaginal and peri-anal muscles by holding a strong contraction for 10 seconds while continuing to breathe naturally, then slowly relaxing the muscle for 10 seconds. These exercises were followed by fast contractions which were performed by briefly contracting and relaxing the muscles rapidly for a total of 10 times wherein holding the initial contraction and relaxation of the pelvic floor muscle followed by rapid contraction and relaxation of these muscles equaled one set. The women were instructed to repeat 20 sets of these exercises twice a day for a total of 40 sets per day at least 5 days per week for an overall period of 6 weeks and exercise frequency was recorded in a training diary.
• Experts suggested that The strength of the pelvic floor muscles corrected the mobility of the bladder neck and the urethra, leading to increased urethral sphincter competence and increased urethral resistance, thus resulting in decreased frequency and amount of urinary leakage further leading to improvement of the quality of life among the pregnant women.
• The proper learning technique and adherence of the pelvic floor muscle exercise regimen are essential to obtain an effective result. Therefore, this exercise needs proper training protocol and instruction must be given by physiotherapist for correct conduction of effective pelvic floor muscle training.
• Usually, pelvic floor muscle training sessions are conducted as an outpatient basis and started between 18 and 20 weeks of gestation and lasted 12 consecutive weeks. Taking instructions from experts helps to understand the causes and treatment for stress urinary incontinence during pregnancy. While enhancing the understanding of the benefits of pelvic floor muscle exercise also minimize stress urinary incontinence severity.
• The women with anal sphincter tears have a higher risk to develop fecal incontinence after delivery. Effective pelvic floor muscle exercise has the potential for reducing the occurrence or severity of fecal incontinence in the postpartum period.