Hypothesis / aims of study
Pregnancy and delivery are intense experiences in a woman's life and can result in pelvic floor dysfunction symptoms. Pelvic floor muscle training (PFMT) is effective in the prevention and treatment of these bothersome symptoms. No previous research assessed how and if women want to enroll in early PFMT after childbirth. Patient-Reported Experience Measures (PREMs) are developed to assess the patients’ experiences within the healthcare process. PREMs are influenced by patient preferences, expectations, and previous experiences. This research aims to evaluate the PREMs about pelvic floor rehabilitation in a postnatal population.
Study design, materials and methods
A prospective observational study design was used. After informed consent, a pelvic floor rehabilitation consult was given during the new mother’s stay at the maternity unit (1-5 days after delivery) by a specialized pelvic floor physiotherapist. The therapist gave a short education regarding the pelvic floor. This informational session consisted of information about pelvic floor anatomy, the influence of pregnancy and delivery on the functionality of the pelvic floor, postnatal pelvic floor complications and how to prevent and treat pelvic floor disorders (pelvic floor exercises, lifestyle interventions and adherence strategies included). All women were taught how to contract their pelvic floor correctly. The pelvic floor therapist used visual control to make sure the contractions were performed correctly and provided verbal feedback to correct mistakes . At the end of the personalized session, the therapist handed over a brochure with general tips and tricks regarding the pelvic floor. This informational leaflet repeated the given information and supplementary pelvic floor related topics were added, such as ‘Drinking and eating habits’, ‘Lifting techniques’, ‘Toilet posture’, ‘Tips on making stool’ and ‘Tips regarding urination’ Six to eight weeks later, these women were phoned by a blinded researcher to conduct a PREMs survey, based on a validated PREMs questionnaire. Descriptive statistics were analyzed using SPSS, version 25.0.
Interpretation of results
The majority of new mothers were satisfied with the pelvic floor related care and education they received during the first days after delivery. A personalized approach regarding early PFMT and education was found very useful (8.3/10). Most women would recommend their peers to undergo the same postnatal physiotherapy consult as they received. Most new mothers felt empowered to perform pelvic floor exercises and were motivated to proceed with postnatal physiotherapy. Information leaflets, on the contrary, were less successful; one-third of all participants declared that they didn’t read them, while the remaining part expressed moderate interest and recall about the topics described. These results support our hypothesis that real-time in-person education goes above information leaflets, probably because an individualized approach provides opportunities to convince women about the importance of this topic.