Although pregnancy and childbirth are physiological processes, they may be associated with potential physical problems, including problems like urinary-, faecal incontinence and a change of sexual function. Many of these postpartum problems originate from pelvic floor disorders. The aim of this study was to evaluate the influence of pelvic floor muscle training on postpartum pelvic floor function and the sexual function of primiparous women.

This is a randomized, prospective study including 300 primiparous women, who delivered between 2018 – 2019 in our hospital. Inclusion criteria were the delivery of the first, singleton baby, the ability to speak and understand German fluently. The participants were evaluated by clinical examinations and questionnaires after 6 and 12 months postpartum. The examination included a speculum examination in order to evaluate the degree of the prolapse and an evaluation of pelvic floor contraction using the modified Oxford Score. The questionnaires included the Female Sexual Function Index and the “Pelvic floor questionnaire for pregnant women and women after childbirth”. After 6 months the women were randomized in two groups. Compared to the control group the intervention groups participated in pelvic floor muscle training under supervision of a certified physiotherapist once a week over 6 weeks. Lost to follow up was 100 women after 6 month, 136 women after 12 months. 
This study was approved by the ethics committee and informed consent was obtained from all participants.

The results of the questionnaires showed no significant differences between the groups after 12 months (total scores FSFI p = 0.465; Pelvic floor questionnaire p = 0.766). A significant stronger pelvic floor muscle strength was found for the intervention group after 12 months (p = 0.001; control group p = 0.111). The development of the pelvic floor and sexual function over the time showed a significant improvement in both groups in almost all domains (Figure 1; total scores FSFI intervention groups p = 0.001, control group p = 0.000; pelvic floor questionnaire intervention/control group p = 0.000).

Supervised pelvic floor muscle training improved the pelvic floor muscle strength but did not improve both the pelvic floor function and the female sexual function in comparison to the control group. After 12 months the pelvic floor and the sexual function improved significant in all woman.

It can be assumed that all participants were highly motivated and did their regular pelvic floor muscle training independently. Therefore, no clear statement can be made regarding additional pelvic floor muscle training. Still, after 12 months the pelvic floor and the sexual function improved significant in all woman highlighting the importance of time in pelvic floor recovery. An open communication about this development already before childbirth could probably prevent many problems for the affected women.