A STRUCTURED pelvic floor muscle training (PFMT) programme during pregnancy may significantly reduce severe perineal trauma during childbirth, according to an early-release clinical study.
Perineal trauma, particularly obstetric anal sphincter injury (OASI), is a major concern in vaginal births and can lead to long-term complications such as incontinence and chronic pain. While PFMT is already widely recommended to prevent urinary incontinence, its role in reducing birth-related trauma has remained unclear.
In this prospective, patient-preference controlled trial, researchers enrolled 300 low-risk first-time mothers across two tertiary centres between December 2024 and September 2025. Participants at or beyond 28 weeks’ gestation either opted into a structured PFMT programme (n=150) or received standard antenatal care (n=150). The intervention included twice-weekly supervised sessions alongside daily home exercises consisting of repeated maximal pelvic floor contractions.
Antenatal Pelvic Floor Training Linked to Lower Rates of Severe Perineal Injury
The primary outcome, severe perineal trauma, occurred significantly less frequently in the PFMT group compared with controls (4.0% vs. 14.7%). This represents a substantial reduction in risk, with an odds ratio of 0.24. In addition, women in the PFMT group experienced a shorter second stage of labour, averaging approximately 50 minutes compared with nearly 59 minutes in the control group.
Importantly, the programme did not appear to adversely affect other maternal or neonatal outcomes. Rates of episiotomy, minor perineal tears, postpartum urinary incontinence, and low Apgar scores at five minutes were similar between groups.
Larger Randomised Trials Needed to Confirm Findings
The authors suggest that improved pelvic floor muscle strength and coordination may help better control of pushing and tissue stretching during delivery, thereby reducing the likelihood of severe injury. However, they caution that the study’s non-randomised design and reliance on patient preference may introduce selection bias.
Despite these limitations, the findings provide encouraging evidence that antenatal PFMT could offer benefits beyond continence, potentially improving childbirth outcomes without added risk. The researchers call for larger, randomised controlled trials with longer follow-up to confirm these results and assess long-term maternal health impacts.
If validated, integrating structured PFMT into routine antenatal care could represent a simple, low-cost strategy to reduce serious birth-related complications.
Reference
İncebıyık M et al. The effect of a pelvic floor training program on perineal trauma during birth: a patient-preference controlled clinical trial. Sci Rep. 2026; DOI: 10.1038/s41598-026-47603-6.
Featured image: ATRPhoto
