Changes in perineal musculature following childbirth: postpartum use of a perineal exercise

The purpose of the present study was to investigate the status of perineal musculature prior to delivery by use of the perineometer and to note changes brought about by vaginal delivery. The study was conducted in the prenatal clinic and inpatient maternity division of a 277 bed general teaching hospital and extended over a period of eight months. The sample included 20 women beyond 34 weeks gestation with vaginal delivery anticipated (17 multigravidas and 3 primigravidas). Measurements of perineal muscular contractions were obtained prior to delivery, at the time of discharge from the hospital following delivery and at the final postpartum examination. Ten women were instructed to exercise by contracting the pubococcygeus muscle as if trying to stop the flow of urine and ten were not instructed to exercise. The data indicated a decrease in strength of contractions of the pubococcygeus following vaginal delivery. The use of a postpartum exercise did not significantly effect the return of strength. Women who delivered relatively heavier babies yielded higher postpartum strength measures. The time that the exercise group was able to sustain a contraction went up across tests in contrast to a downward trend in the time measure for the non-exercise group. Women who had previously been instructed in the exercise yielded lower time scores than those not previously instructed.