Acceptability of a urinary continence promotion programme to women in postpartum

OBJECTIVE: To assess the acceptability to postpartum women of a physiotherapist-delivered urinary continence promotion programme. DESIGN: A survey of women participating in a randomised controlled trial where women received the intervention (which involved training in pelvic floor exercises and incorporated adherence-enhancing strategies) or usual postpartum care. SETTING: Postpartum wards of three tertiary teaching hospitals in the Hunter Region, NSW, Australia. SAMPLE: Women were eligible to participate in the trial if they had a forceps/ventouse assisted delivery and/or delivered a higher birthweight baby (> or =4000 g). This study is based primarily on data obtained for 348 women in the intervention group. METHODS: Baseline hospital-based interview; eight-week follow up appointment with physiotherapist; three-month follow up telephone interview. MAIN OUTCOME MEASURES: Comparative dropout rates for intervention and control groups; reasons for non-participation; attendance at hospital follow up; self-reported acceptability of and embarrassment about per vaginum examination; utilisation and perceived usefulness of intervention components; self-reported adherence with recommended pelvic floor exercise regime. RESULTS: There was no significant difference in dropouts between intervention (5.9%) and control groups (6.3%). Only 14% of women gave not wanting the per vaginum assessments as their main reason for not participating in the study. Eighty-eight percent of women participated in the eight-week postpartum follow up visit with the physiotherapist, with two-thirds of these women attending the hospital for this; 72.2% of women reported no embarrassment, and 22.5% just a little embarrassment about per vaginum assessment. The information components of the intervention were well received. At the eight-week follow up visit, 83.9% reported performing pelvic floor exercises at adequate frequency. CONCLUSIONS: The postpartum period provides an ideal opportunity for pelvic floor muscle testing and the delivery of continence promotion advice.