Women can prevent or treat urinary or fecal incontinence due to childbirth by pelvic floor muscle training, a new review of current scientific evidence shows.
"With good one-to-one teaching and supervision, these exercises are safe and will benefit many women," Jean Hay-Smith of the University of Otago in Wellington, New Zealand, who participated in the research review, said in a press release.
The muscle training, also called Kegel exercises, after the gynaecologist who first popularised it the late 1940s, increase the strength and endurance of the muscles of the pelvic floor.
They are often recommended during pregnancy and after childbirth to prevent urinary incontinence, which affects roughly one in three women after childbirth, Hay-Smith her colleagues note in The Cochrane Library, a publication of The Cochrane Collaboration.
To investigate the latest scientific evidence on the effectiveness of Kegel exercises for treating urinary and fecal incontinence after childbirth, the researchers looked at 15 studies that included 6,181 women. All of the studies compared the pelvic floor exercise program to standard care.
Five trials included women, with their first full-term pregnancy, who were randomly assigned to begin pelvic floor exercises at 20 weeks. Women who did the exercises were 56-percent less likely to develop urinary incontinence in late pregnancy, and they had a 50-percent lower risk of incontinence within the first 12 weeks of delivery and at 30 percent lower risk three to six months after giving birth. The more intensive the program, Hay-Smith and her team found, the greater were the preventive effects.
Three trials included women who already had urinary incontinence. They did the exercises after giving birth and were 21-percent less likely to have urine leakage six months to one year after delivery compared with the women who received conventional care only. The exercise group was also 46-percent less likely to have fecal incontinence.
One of the studies, in which women met with a health professional every eight weeks and also received electrical muscle stimulation weekly, showed "much greater" effects than did the other two studies, which were less intensive, the researchers note.
Studies in which all women were offered postnatal instruction on pelvic floor exercises whether or not they had incontinence did not show a clear benefit.
"Based on the trials to date, the most beneficial population approach for postnatal pelvic floor muscle training appeared to be to offer an individually taught strengthening pelvic floor muscle training program (with the addition of a number of adherence strategies) to women potentially at greater risk of postnatal incontinence, such as after a forceps delivery or vaginal delivery of a large baby," the researchers conclude.