Invited review: Maternity exercises 75 years on: What has changed and what does experimental evidence tell us?

Abstract

Seventy-five years ago, in the first issue of the New Zealand Journal of Physiotherapy, Mrs DuFaur summarised Margaret Morris’s ‘Maternity Exercises’ which included antenatal and postnatal exercises and relaxation. This paper looks briefly through a contemporary ‘evidence-based’ lens at the effectiveness of exercise and relaxation for childbearing women and considers priorities for present-day obstetric physiotherapy. Cochrane systematic review findings suggest the strongest evidence is for pelvic floor muscle training to prevent and treat urinary incontinence. There is limited, yet promising, evidence that pregnant women with low back or pelvic pain may benefit from individually tailored pregnancy-specific advice and that relaxation training (progressive muscle relaxation and breathing techniques) might offer benefits for labour and delivery. The context and delivery of New Zealand maternity care has changed substantively since the ‘Maternity Exercises’ were introduced. Organisational and professional influences on current maternity service delivery provide fewer opportunities for direct contact between childbearing women and obstetric physiotherapists. Working collaboratively with midwifery and other colleagues is necessary to maximise the potential benefits of physiotherapy interventions for the health of childbearing women; teaching and supporting intensive pelvic floor muscle training in pregnancy and postpartum is a priority for contemporary obstetric physiotherapy.