Perceived Impact of Regular Pelvic Floor Exercises on the Health of Pregnant Women Attending Selected Health Care Centres in Owo Metropolis
Chapter One
OBJECTIVES OF THE STUDY
The following are the objectives of this study:
- To examine the perception of pregnant women in owo local government area of Ondo State on the benefits of pelvic floor muscle exercise during pregnancy.
- To examine the importance and benefits of pelvic floor muscle exercise among pregnant women.
- To identify the outcome of pelvic floor muscle exercise among pregnant women.
CHAPTER TWO
LITERATURE REVIEW
The Level of Knowledge of the Importance of pelvic floor muscle exercise among Pregnant Mothers Knowledge has been variously defined. Hornby (2006) describes knowledge as information, understanding and skills that one gains through education or experience. Knowledge is critical to man’s quality of life because everything that is done depends on knowledge. Knowledge is the sum of conceptions, views and propositions which have been established and tested. In the context of this study, knowledge refers to the act of having adequate information and understanding of the concept of focused antenatal care services. This knowledge can be obtained through health education, electronic media, prints and health education programmes. It could be in realization of the above assertion that Magadu, Maduse & Rodignes (2006) maintained that knowledge of pregnant mothers is a major factor in determining the extent of utilization of benefits of pelvic floor muscle exercise. According to them, the educational status of pregnant mothers is an influencing determinant in the effective utilization of maternal and child health (MCH) services. Igbokwe (2008) indicated that urban and rural locations have great impact on the utilization of the benefit of pelvic floor muscle exercise. Expectant mothers in the urban area utilize antenatal services better than their counterparts in the rural area who have the problems of accessibility to MCH services; some pregnant mothers in the rural area may have basic knowledge of the importance of antenatal services but due to problems of accessibility to health facilities will hinder them from such services (Igbokwe, 2008). Also inadequate knowledge concerning health related matters usually lead to negative attitude towards the health issue. It is positive when a person develops a strong attraction of likeness for the situation, objectives or other persons or groups while it is negative when the person develops dislike for such situations, objectives, group or any other identifiable aspects of our environment (Igbokwe, 2012).
Pregnant Mothers’ Perception of the Benefits of pelvic floor muscle exercise During Pregnancy
Pregnant women generally experiences physical, psychological and physiological changes during pregnancy which often results in decreased in physical activity and thereby place them at a risk of several chronic diseases and a times, it can lead to mortality. Prenatal pelvic floor muscle exercise is of great benefit to both the mother and the foetus in order to reduce risks of disorders associated with pregnancy on them (Clap & Rizzle, 2016). pelvic floor muscle exercise refers to structured form of physical activity usually for reasons of gaining or maintaining fitness and it produces a versatile range of physical, physiological, biochemical and psychological changes, and the nature and magnitude of these changes depend on the type, frequency of the pelvic floor muscle exercise, pelvic floor muscle exercise intensity, duration of pelvic floor muscle exercise performed especially during the prenatal period (Udoh, 2001). Exercise has been scientifically known for promoting the circulation of blood to both the pregnant women and the vital organs of the foetus. Exercise improves muscle tone, thus enhancing safe and normal delivery (Fraser & Cooper, 2014).
Pre-natal exercise is described as physical activity performed by pregnant women in order to improve their health before delivery (Schuurmans, Senikas, & Lalonde, 2014). It has many benefits such as improvement of cardiovascular fitness, easier and less complicated birth (Clapp, 2000). Simkin, Whalley, & Keppler (2015) emphasized that the best amount and type of exercise for pregnant women is dependent on overall health, the risk level of the pregnancy, the level of her fitness and her activity level before becoming pregnant. Physical changes accompanied with pregnancy directly affect the pregnant women’s tolerance for exercise. Hormonal changes cause the ligament to relax and the joints to become more mobile. The center of gravity shifts because of the enlargement of the abdomen. When pregnant women engages in frequent physical exercise, it will helps to maintain and tones the muscle of the body, makes the pregnant woman to be strong, agile and give the woman the endurance needed during labour. Samselle (2012) listed some conditioning exercises that are introduced to take care of the muscles that pregnancy affects most by pregnancy. These exercises are meant to help the pregnant women make good use of all their muscles during birth, and to increase the speed of post-partum recovery. The conditioning exercise includes pelvic floor exercise (kegel or super kegel exercise) which aim at maintaining the tone of the muscles especially the pelvic muscles, improve circulation, and provide a good support for the uterus and other organs. Another exercise is pelvic tilting which strengthen the abdominal muscles, improve posture and relieves backache.
Simkin, Whalley & Keppler (2015) stated that pre-natal exercise programme for pregnant women should include at least five minutes of warm up (slow, smooth movements and stretching); a period of sustained, vigorous aerobic exercise lasting approximately fifteen minutes; and at least five minutes of cool-down consisting of mild activity until the heart rate returns to normal. The kind of aerobic exercise that is best for pregnant mothers is a low impact exercise which includes brisk walking, swimming, and cycling. In this study prenatal exercise is described as physical effort performed by the pregnant mothers in order to improve their health before delivery.
Perception refers to how a person sees a situation or the feeling an individual has about a thing. However, according to Wehmeier (2011) perception is defined as an idea, or an image one has as a result of how one sees or understands a thing or situation. In this study, perception could be used to mean the view of pregnant women on the benefits of pre-natal exercise. Benefit in this study is the ability of prenatal exercise to produce good health results for the pregnant women and the foetus. A Pregnant woman is a woman that is carrying a developing embryo or foetus in her womb. The age range of child bearing women according to WHO/UNFPA/UNICEF/World Bank Statement (2002) is 15-49 years. When a woman is pregnant she is exposed to so many health risks, not only the pregnant women, the child in her womb is also exposed to so many health risks. Because of this, it is necessary for all the pregnant women to be monitored by gynecologists at the antenatal clinic. Antenatal clinic is any branch of health services that takes care of pregnant women. Any clinic that takes proper care to the pregnant women prior to delivery is known as antenatal clinic (Pearsall, 2015). In this study antenatal clinic monitors the health of a woman during pregnancy, as well as the health and development of the baby.
CHAPTER THREE
RESEARCH METHOD
Research design
The research design adopted for this study was the descriptive design which enabled the researcher to assess the perceived benefits of pelvic floor muscle exercise among pregnant mothers in owo local government area of Ondo State, Nigeria.
Research population Target population
The target population of the study consisted of all registered pregnant women who booked in the owo local government area of Ondo State. This summed up to 531 registered pregnant women.
Accessible population
The accessible population was 150 registered pregnant women from all the wards in the LGA, in Ondo. This covered pregnant women who were in the wards as at the time this study was carried out in owo local government area of Ondo State.
CHAPTER FOUR
RESULTS AND DISCUSSION
Socio-demographic data
The socio-demographic data of respondents is presented as shown in Table 2.
Table 2: Socio-demographic data of respondents
CHAPTER FIVE
CONCLUSIONS AND RECOMMENDATION
CONCLUSION
The study revealed that the respondents’ knowledge of benefits of pelvic floor muscle exercise was good. However despite the above, minority of the respondents still demonstrated poor knowledge and unfavorable attitude which may be due to those factors identified as hindrance to the benefit of pelvic floor muscle exercise. Effort should be made to address those falls to improve their knowledge.
Recommendations
Considering the result of findings, it was recommended among others that:
- Women should be careful when planning to engage in these activities (pelvic floor muscle exercise), mainly when starting only during pregnancy.
- Attention should also be paid in avoiding pelvic floor muscle exercise in supine position during the second half of pregnancy in order to prevent hypotension and avoid the Valsalva maneuver throughout the pregnancy.
- Women should start with 15 min of pelvic floor muscle exercise three times a week and gradually increase to 30 min four times a week at low-to moderate intensity.
- Active women at the owo local government area may keep their routine pelvic floor muscle exercise or perform at least moderate-to vigorous pelvic floor muscle exercise four times a week in sessions of 30 min or more.
- Nurses in the area should also include benefits of pelvic floor muscle exercise in their health talks during antenatal clinic to prevent the negative perception about pregnant mothers’.
Implications for nursing practice
The overall finding obtained from the result revealed pregnant women knowledge based on the benefits of pelvic floor muscle exercise. However, there still exist poor knowledge. This calls for intensive awareness creation on the benefits of pelvic floor muscle exercises among pregnant mothers’ for these women during ANC visit. Also workshop and retraining on component of pelvic floor muscle exercises should be conducted for nurses in owo local government area to update their knowledge and careful monitoring and supervision in order to improve on those observed weaknesses which posed as barriers to utilization of pelvic floor muscle exercise among pregnant women.
REFERENCES
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