2019 Volume 33 Issue 1 Pages 14-26
Purpose
The purpose of this study was to evaluate the feasibility of midwives implementing postpartum pelvic floor muscle training using vaginal palpation. This occurred through developing a manual and a process of midwifery training by which midwives learned teaching techniques of vaginal palpation using the manual.
Methods
The first step was to develop a vaginal palpation pelvic floor training manual. Eight medical professionals (midwives, nurses & physicians) specializing in the treatment of the urogenital area considered the suitability of content. Next, using the resulting modified manual, researchers gave a 30-minute lecture for seven midwives. Then the midwives practiced their pelvic floor muscle training by vaginal palpation with consenting women on their fourth postpartum day. Following the pelvic floor muscle training by vaginal palpation, midwives did a guided reflection on their experience. The qualitative contents were thematically analyzed.
Results
During the first step, the contents of the procedure manual were modified according the condition of women with weakened pelvic floor muscles after vaginal delivery. Modification concerned the place and timing of implementation, the time required, and lubricants. In the second step, there were questions about the method of vaginal palpation and the use of the Oxford scale to evaluate pelvic floor muscle strength: the Oxford scale was easy to implement. Three categories were extracted from the results of reflection: (1) Learning of techniques, (2) Actual experience of vaginal palpation, and (3) Awareness of the practice. Based on interviews and a questionnaire survey the postpartum women had no negative reactions and comments and experiences were positive. There were no problems occurring in the implementation.
Conclusion
Midwives who participated in this study were able to master the teaching techniques of pelvic floor muscle training by vaginal palpation without difficulty using the prepared manual and found that there were no problems in implementation. It was suggested that postpartum pelvic floor muscle training by vaginal palpation could be practiced clinically as part of midwifery care.
