Pelvic floor workout may Reduce Postpartum Stress Urinary Incontinence: JAMA

A new multicenter randomized clinical trial published in the Journal of the American Medical Association found that pelvic floor workout significantly reduced the incidence of stress urinary incontinence (SUI) at 6 weeks postpartum, which indicates its effectiveness as a preventive intervention during pregnancy.

Stress urinary incontinence, which is defined as involuntary urine leakage during activities that increase abdominal pressure like coughing or lifting, is a common postpartum complication. Studies have increasingly emphasized that rehabilitation training for SUI should extend beyond isolated pelvic floor exercises, instead incorporating whole-body approaches that strengthen core muscles, stabilize posture, and improve pelvic-spinal balance.

Thus, this research developed the Pelvic Floor Workout (PEFLOW) program, which was a targeted prenatal exercise regimen designed to enhance pelvic floor strength while integrating global postural training. The program was evaluated in a multicenter randomized clinical trial involving 764 first-time pregnant women aged 20 to 40.

The participants, all within their first 16 weeks of a singleton pregnancy, were recruited from 9 hospitals from August 2020 to June 2022. They were randomly assigned to either an exercise group, which followed the PEFLOW program starting at 28 weeks of gestation, or a control group which received standard prenatal care. The exercise group attended guided sessions every 2 weeks until delivery.

The primary outcome measured was the incidence of SUI at 6 weeks postpartum. The results showed a statistically significant reduction in SUI cases (8.7%) among women in the exercise group when compared to the control group (13.9%). 

In addition to lower incontinence rates, women who participated in the PEFLOW program demonstrated stronger pelvic floor muscle function. Nearly 18% of women in the exercise group achieved higher scores on the Modified Oxford Scale (MOS) which measured pelvic muscle strength, when compared to just under 8% in the control group.

This research followed participants for up to one year postpartum, which reinforced the reliability of the findings through intention-to-treat analysis. Women with pre-existing pelvic conditions or pregnancy complications were excluded to ensure accurate assessment of the program’s preventive potential.

Overall, this study suggest that incorporating structured, posture-focused pelvic floor training into routine prenatal care could play a key role in reducing postpartum SUI and improving maternal health.

Source:

Gao, L., Zhu, H., Sun, X., Wang, S., Xie, B., Liu, H., Ren, W., Liang, J., Tang, X., Zhen, M., Wu, G., Qin, B., Hu, Y., Kong, L., Chen, W., Sun, X., & Wang, J. (2026). Pelvic floor workout for preventing stress urinary incontinence in primiparous women: A randomized clinical trial: A randomized clinical trial. JAMA Network Open, 9(4), e267132. https://doi.org/10.1001/jamanetworkopen.2026.7132