Abstract
Pelvic floor muscle training (PFMT) is widely recommended for the prevention and management of pelvic floor dysfunction, including urinary incontinence, during pregnancy and postpartum. This integrative review, guided by the five-step process proposed by Lubbe et al. (2020), synthesised current evidence on supervised antenatal PFMT in relation to pelvic floor dysfunction and maternal wellbeing. Six electronic databases and selected professional organisation websites were searched for studies involving pregnant people undertaking supervised PFMT, with quantitative and/or qualitative outcomes related to pelvic floor dysfunction or wellbeing. Twenty-six articles were included (24 primary studies and two grey literature sources), encompassing randomised controlled trials, cohort studies, and mixed-methods designs. Overall, supervised PFMT was associated with improvements in pelvic floor outcomes, including reduced incidence and severity of urinary incontinence during pregnancy and early postpartum. Several studies also reported improvements in pelvic floor muscle function and symptom-related quality of life. Supervision may enhance exercise technique, adherence, and progression compared to unsupervised training. Limited evidence indicated potential benefits for psychological wellbeing. While some studies implemented programmes of 12 weeks or longer, the optimal duration and intensity of supervised PFMT remain unclear. Barriers to implementation included limited awareness among pregnant people and constraints related to time, training, and resources among healthcare providers. Evidence regarding cost-effectiveness and long-term outcomes remains limited. These findings suggest that supervised PFMT may be a valuable component of antenatal care. Further research is needed to determine optimal delivery approaches, evaluate long-term outcomes, and explore implementation within the Aotearoa New Zealand context.