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 ( greater than or equal to 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.