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Randomised controlled trial of pelvic floor muscle training during pregnancy

BMJ 2004; 329 doi: (Published 12 August 2004) Cite this as: BMJ 2004;329:378
  1. Kjell Å Salvesen (pepes{at}, professor in obstetrics and gynaecology1,
  2. Siv Mørkved, physiotherapist2
  1. 1 Department of Obstetrics and Gynaecology, Trondheim University Hospital St. Olav, N-7006 Trondheim, Norway
  2. 2 Department of Community Medicine and General Practice, Norwegian University of Science and Technology, N-7489 Trondheim, Norway
  1. Correspondence to: K Å Salvesen
  • Accepted 25 May 2004


Objectives To examine a possible effect on labour of training the muscles of the pelvic floor during pregnancy.

Design Randomised controlled trial.

Setting Trondheim University Hospital and three outpatient physiotherapy clinics in a primary care setting.

Participants 301 healthy nulliparous women randomly allocated to a training group (148) or a control group (153).

Intervention A structured training programme with exercises for the pelvic floor muscles between the 20th and 36th week of pregnancy.

Main outcome measures Duration of the second stage of labour and number of deliveries lasting longer than 60 minutes of active pushing among women with spontaneous start of labour after 37 weeks of pregnancy with a singleton fetus in cephalic position.

Results Women randomised to pelvic floor muscle training had a lower rate of prolonged second stage labour (24%, 95% confidence interval 16% to 33%; 22 out of 105 women were at risk (undelivered) at 60 minutes in the survival analysis) than women allocated to no training (38% (37/109), 28% to 47%). The duration of the second stage was not significantly shorter (40 minutes v 45 minutes, P = 0. 06).

Conclusions A structured training programme for the pelvic floor muscles is associated with fewer cases of active pushing in the second stage of labour lasting longer than 60 minutes.


  • This article was posted on on 14 July 2004:

  • Contributors KÅS and SM were involved in designing and conducting the study, analysing the data, and writing the report. Kari Bø contributed to the design of the study. The physiotherapists Hildegunn Børsting, Trude Hoff Leirvik, Bente Olsen, Monica U Tøndel, and Bjørg Vada led the group training sessions. Pål Romundstad gave statistical advice. KÅS is the guarantor.

  • Funding Norwegian Fund for Postgraduate Training in Physiotherapy and Norwegian Women's Public Health Association.

  • Competing interests None declared.

  • Ethical approval Regional medical ethics committee.

  • Accepted 25 May 2004
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