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Pelvic Exercises May Ease Second-Stage Labor


 

Pelvic floor training during pregnancy appears to facilitate delivery and was associated with a decreased incidence of prolonged second-stage labor, Kjell Salvesen, M.D., and colleagues reported.

The results were observed in a secondary analysis of a randomized, controlled study that compared the rate of postpartum incontinence in women who had done the pelvic floor muscle training during pregnancy with that of women who had not.

The original analysis found less urinary incontinence among patients in the treatment group.

Dr. Salvesen of Trondheim (Norway) University and his associates randomized 301 nulliparous pregnant women to either no training or 1 hour of intensive pelvic floor exercises with a physiotherapist each week for 12 weeks (BMJ 2004;329:378–80).

The training occurred between weeks 20 and 36 of pregnancy. The women were also encouraged to perform 8–10 intense pelvic floor contractions at home twice a day. Women in the control group were not discouraged from doing pelvic floor exercises, but received no specific instructions on how to do so.

Only those who entered spontaneous labor after 37 weeks with a singleton fetus in cephalic position were included in the final analysis: There were 111 women in the control group and 113 women in the treatment group.

Treatment-group women had a lower rate of prolonged (longer than 60 minutes) second stage of labor than women in the control group (21% vs. 34%).

Fewer women in the treatment group had episiotomies (51% vs. 64%), but the rates of operative delivery were not significantly different between the two groups.

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