The puerperal period is the most crucial period in a women’s life.  The entire body is susceptible to changes in regard to any changes in the physical, psychological as well as social surroundings. Small changes contribute to major effects on the mother. Any increase in the intra-abdominal pressure may lead to immediate postnatal complications or even urogynaecological complications in the later life. Throughout the globe, the postpartum period is considered religious and many traditions are present pertaining to this period. The cultures followed by western countries are technocentric whereas non-western countries follow ethnokinship cultures. These cultures have a huge impact on new mothers. Though postnatal physical therapy has been proven beneficial in the immediate postpartum period it is not being practiced routinely in many countries. Facilitators and barriers for postnatal physical therapy in India have been identified by a pre pilot study on 172 post delivery women. Of these results, one of the major barrier was time restraint due to breastfeeding and baby care as well as the cultural practices in the puerperal period like complete bed rest with no exercise, belief that excess movement/use of any particular part of the body leads to potential harm or complications related to that body part in the future. Hence our aim was to use culturally suitable exercises as functional training while performing daily activities and acceptable to the customs and postpartum traditions followed by the new mother.

We included 235 primiparous women irrespective of the mode of delivery to participate in our study. We excluded women who underwent any abdominal/urogynaecological surgery other than C- Section and episiotomy. The mother was first assessed and educated regarding the importance of exercise, detrimental effects of increased intra-abdominal pressure, Do’s and Don’t’s in the puerperal period as well as “knack” and manual splinting. She was then taught pelvic floor muscle training in sitting and supine positions along with breathing exercises, lumbopelvic stability exercises. The therapist ensured whether the woman was performing the correct method of pelvic floor muscle training (PFMT). After breastfeeding was established successfully, the mother was encouraged to perform PFMT during breastfeeding. She was taught to perform PFMT during sitting, during hot fomentation given to the perineum, during massage given to herself, and other activities according to her routine. The women were called for follow up at 6 weeks and 3 months postpartum. PFM strength was measured at 6 weeks postpartum and 3 months postpartum. At 3 months, the assessment proforma included questions including her compliance to PFMT, and the best possible time she could give to exercise. The results were then analysed.

Out of 235 women only 174 complied with the program. Out of 174 women 131 (75.28%) sought breastfeeding as the best functional training of PFMT. 32 (18.39%) were more comfortable while having hot fermentation to the perineum, whereas 11 (6.32) found that other activities of daily living were better as functional training of the PFM

Majority of the women were comfortable while breastfeeding, and found more time for repetitions. Some women said that once they had practiced, it became habitual for them for PFMT while breastfeeding and were performing it subconsciously. 
The study shows that the compliance to postpartum exercises is better if they are administered in the form of functional training as per individual need based as well as keeping in mind the cultural acceptance. The necessity for functional training of PFM in the postpartum period has thus become essential. Culturally suitable functional training of PFMT is feasible and makes it practically possible for a new mother to perform PFMT considering the limited time available as compared to taking out a special time for herself to exercise.

Culturally suitable pelvic floor functional training in the puerperal period proved to be feasible to administer, well accepted by mothers and better compliance was observed.