Midwives’ knowledge, skills and attitudes related to pelvic floor exercises to postpartum mothers

Abstract

Pregnancy and vaginal birth are considered contributors to pelvic floor dysfunction and pelvic floor trauma. Pelvic floor exercises (PFMEs) during the postnatal period could strengthen and rehabilitate the pelvic floor muscles whilst improving women’s health and quality of life. The study explored the midwives’ knowledge, skills, and attitudes related to pelvic floor exercises for postpartum mothers. This was achieved through the following objectives; explore midwives’ knowledge of pelvic floor exercises for postpartum mothers, identify the midwives’ skills in teaching pelvic floor exercises to postpartum mothers, and explore the midwives’ attitudes towards the advantages of pelvic floor exercises for postpartum mothers. Ethical approval was granted by FREC. A qualitative approach was selected for this dissertation. Seven midwives who worked at the local hospital as Discharge Liaison Midwives were recruited for this study. Semi-structured, face-to-face interviews were carried out with the participants. Data was transcribed verbatim and analysed using Burns and Grove’s (2017) approach to content analysis. The findings revealed how midwives working in the community were knowledgeable on pelvic floor exercises. Midwives highlighted the relevance that postnatal mothers perform PFMEs to minimise pelvic floor dysfunctions. Additionally, midwives emphasised their vital role in providing advice related to pelvic floor exercises. Findings exposed how midwives were concerned about the lack of policies and guidelines on PFMEs within the local hospital's maternal services. Midwives also discussed how by collaborating in a multidisciplinary team, midwifery postnatal care and advice could positively contribute to a better quality of life for women. Findings of the study were discussed with relevant literature, which indicated that Maltese midwives working in the community seemed competent on the significance of pelvic floor exercises and how to educate the mothers in the community. The discussion highlighted how the midwives’ concerns on the lack of policies and guidelines on PFMEs were disregarded throughout the years, yet they could help postnatal mothers from pelvic floor dysfunction. Recommendations for education, practice and research were proposed for this dissertation. This included the provision of regular sessions and courses on PFMEs for postpartum women and midwives. The importance of adhering to the latest research, development of policies and guidelines on PFMEs, along with the giving importance of future research concerning the possibility of combining PFMEs with other exercises, were also mentioned.