What are women’s views and perception of the effects of pelvic floor exercise son their maternal health in Benue State?

What are women’s views and perception of the effects of pelvic floor exercise son their maternal health in Benue State?

Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

Exercise has become a vital part of many women’s lives. Although many women still prefer to engage in exercise during pregnancy, they are concerned about the possible adverse effects.

The concerns about exercising during pregnancy relate to the dual stresses of pregnancy and exercise that might create conflicting physiological demands on the mother-to-be (Wiswell, 1996; Sternfeld, 1997). In contrast to the adaptations that occur during pregnancy, which are intended to nurture and protect the foetus, those that occur during exercise serve to maintain maternal homeostasis. Excessive physical activity during pregnancy may thus create conflicting maternal and foetal needs and may pose potential risks for the outcome of the pregnancy. On the other hand, the adaptations may complement each other and offer potential benefits (Sternfeld, 1997).Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

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The physiological changes that occur during exercise include: redistribution of cardiac output away from the visceral circulation to the exercising muscles and skin, depletion of energy stores and an increase in body temperature (Clapp, 1996). In addition, several other potential risks have been described, including teratogenic effects as a result of exercise-induced hyperthermia, decreased carbohydrate availability for the foetus, redistribution of uterine blood flow with subsequent foetal hypoxia, increaseduterine contractility with a possible increase in the risk for preterm labour, infertility, abortion, congenitalmalformation,cordentanglement,placental separation, premature membrane rupture, growth restriction, foetal trauma, foetal bradycardia, difficultlabour, as well as maternal musculoskeletal injury (Clapp, 1996; Sternfeld, 1997; Stevenson, 1997; Clapp, 2000; Borg-Stein, Dugan & Gruber, 2005).Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

Exercise recommendations during pregnancy have evolved over the last several decades (Borg-Stein et al., 2005). Until the 20th century physical activity during pregnancy had been discouraged primarily because of theoretical concerns of exercise-induced injury and adverse foetal and maternal outcomes (Dempsey, Butler & Williams, 2005). Consequently many saw pregnancy as a state of confinement in which women were not encouraged to engage in recreational physical activity (Dempsey et al., 2005). Results from animal studies published before the 1970’s clearly supported these concerns, which led to a variety of restrictive regulations regarding exercise(Clapp, 1996; Dempsey et al., 2005). Women were instructed to limit their involvement in exercise and non-exercisers were told not to initiate exercise when pregnant (Borg-Stein et al., 2005). In contrast, research findings published since the 1970’s do not support these concerns (Clapp, 2000; Dempsey et al., 2005). In fact, findings of studies completed since 1985 have demonstrated no adverse maternal or foetal effects in healthy women engaged in mild and moderate exercise activities (Clapp, 1996; Henriksson-Larsen, 1999; Riemann &Kanstrup-Hansen, 2000; Dempsey et al., 2005;), but rather, showed somewhatfavourable effects (Wiswell, 1996; Sternfeld, 1997; Clapp, 2000; Frey, 2002). The influence of the past 30 years of research can clearly be seen in the significant changes of the American College ofObstetriciansandGynaecologists (ACOG) guidelines, published in 2003 (Committee on patient education of the ACOG, 2003). These guidelines recommend moderate exercise, 30 minutes or more per day, on most, if not all days of the week for women with low risk pregnancies.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

1.2 Statement of Problem

Pregnancy and delivery are normal physiological processes. During pregnancy and after pregnancy so many physiological and psychological changes occur and sometime mothers are worried and stress regarding these. But exercise does wonder during pregnancy. It helps prepare the mother for child birth by strengthening the muscles and building endurance, and makes getting her body back in shape once the baby’s born much easier. Body releases a hormone called relaxing during pregnancy which loosens the joints in preparation of delivery , so mother need to take care with the choice of exercises and pay attention to technique . It’s important to find exercises that won’t injure her or harm the baby. Ideal exercise gets her heart pumping, keeps her supply, manages weight gain and prepares her muscles for the hand work of labour and delivery without causing undue physical stress for her or her baby.

Postnatal period demands a lot a physical and psychological adaptation. While some exercise is very good for a new mother, doing too much too soon can be harmful also. Current medical practice recommends that pregnant women should most assuredly engage in some sort of exercise regimen while pregnant. Exercising during pregnancy is good for the mother. Pregnant women who exercise tend to have reduced risk of obesity, gestational diabetes, and hypertension.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

One study was conducted on effect of selected antenatal exercise on the nature and outcome of labour in 39 primipara mothers during antenatal period in a selected hospital .An experimental method was used. The study concluded that antenatal exercise taught were effective in terms of outcome of labour in both mother and baby.

Another study was conducted, to investigate the effect of an exercise programme, including specific stabilizing exercises, on pain intensity and functional ability in women with pregnancy related low back pain. Randomized method is used. The study concluded that a specific exercise program decreased back pain intensity and increased functional ability during pregnancy.

The researcher from taking knowledge from experts realized that the knowledge regarding antenatal and postnatal exercise is very important for antenatal mothers and their health. So, the need for this study to evaluate knowledge of the effect of regular pelvic floor exercises on maternal health among women of reproductive age.

1.3 Research Objectives

The general objective of this study is to evaluate the knowledge of the effect of regular pelvic floor exercises on maternal health among women of reproductive age. The following specific objectives were formulated for the study;Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

1. To investigate the level of women’s knowledge on the effect of pelvic floor exercises on maternal healthof women of reproductive age in Benue State

2. To analyse women’s views and perception of the effects of pelvic floor exerciseson their maternal health in Benue State

3. To assess the positive and negative effects of pelvic floor exercises on women’s maternal health in Benue State

4. To assess the practice level of exercises by women of reproductive age in Benue State in a bid to increase maternal health.

1.4 Research Questions

The following research questions were formed from the objectives of the study.

1. What is the level of women’s knowledge on the effect of pelvic floor exercises on maternal healthamong women of reproductive age in Benue State?

2. What are women’s views and perception of the effects of pelvic floor exerciseson their maternal health in Benue State?

3. What are the positive and negative effects of pelvic floor exercises on women’s maternal health in Benue State?Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

4. Are the women of reproductive age improving maternal health using exercises (pelvic floor exercises) in Benue State?

1.5 Significance of the Study

The outcome of this study would be significant to women of child-bearing age in Benue State and Nigeria in general in the following ways:

1. The findings of this study would provide information on the care of maternal health of women of reproductive age through regular exercises (pelvic floor exercises in this case).

2. The findings of this study would help policy makers and the health sector to understand problems militating against maternal health among women of child-bearing age in Benue State and provide a way forward via regular exercises.

3. It would provide a basis for further research to other interested researchers. Also, the findings of this study would contribute to existing knowledge on the effect of regular pelvic floor exercises on maternal health of women of reproductive age; knowledge and awareness level.

1.6 Basic Assumptions

This study was based on the following assumptions:

1. Adequate and regular exercises are necessary to protect and promote the maternal health of women of reproductive health.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

2. Place of residence can constitute a strong barrier to practice of exercises and related activities among women of reproductive age.

3. Level of education and knowledge can constitute a strong predictor of exercise practice for maternal health among women of reproductive age.

4. The attitude and perceptions of women of reproductive age in Benue State can affect their practice and proper information on exercise for maternal health.

1.7 Scope of Study

The study was focused on the knowledge of the effect of regular pelvic floor exercises on maternal health among women of reproductive age in Nigeria using Benue State as a case study.

1.8 Delimitation and Limitation of the Study

Delimitation

This study was delimited to the knowledge of the effect of regular pelvic floor exercises on maternal health among women of reproductive age (15-49 years) in six Local Government Areas selected from the three Senatorial Zones in Benue State. They include Katsina-Ala, Vandeikya (Zone A); Gboko, Makurdi (Zone B), and Ogbadibo, Otukpo (Zone C). Specifically, only women of reproductive age attending antenatal and postnatal clinic at the General Hospitals in the selected Local Government Areas were involved in the study.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

Limitation

Uncooperative attitude of some of the respondents constituted a limitation in this study as some of the women of reproductive age did not return their questionnaire. The researcher only made do with responses of the respondents whose questionnaire were correctly completed and returned.

1.9 Definition of Terms

Maternal Health:Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and even death.

Pelvic Floor Exercises:Pelvic floor exercises strengthen the muscles around the bladder, sexual organs, and back passage.Strengthening the pelvic floor muscles can help stop incontinence, treat prolapse, and make sexual activities better.Both men and women can benefit from doing pelvic floor exercises.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

There are numerous potential health benefits for women who exercise during pregnancy, including better weight control, improved mood and maintenance of fitness levels. Regular exercise during pregnancy can also decrease the risk of pregnancy-related complications such as pregnancy-induced hypertension and pre-eclampsia.Before exercising when pregnant, consult your doctor, physiotherapist or healthcare professional. You may need to modify your existing exercise program or choose a suitable new one if you were exercising very little before getting pregnant.
Benefits of exercise during pregnancy
Exercise during pregnancy offers many physical and emotional benefits. Physical activity may also help manage some symptoms of pregnancy and make you feel better, knowing you’re doing something good for yourself and your baby.

Some of the benefits of regular exercise throughout your pregnancy include:

enjoyment
increased energy
improved fitness
reduced back and pelvic pain
decreased risk of pregnancy complications such as pre-eclampsia and pregnancy-induced hypertension
preparation for the physical demands of labour
fewer complications in delivery
faster recuperation after labour
prevention and management of urinary incontinence
improved posture
improved circulation
weight control
stress relief
reduced risk of anxiety and depression
improved sleep and management of insomnia Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay
increased ability to cope with the physical demands of motherhood.
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Exercising and changes associated with pregnancy
Your body will undergo many changes during pregnancy. Some will affect your ability to exercise, or require you to modify your exercise routine, including:

Hormones such as relaxin loosen ligaments, which could increase your risk of joint injuries (such as sprains).
As pregnancy progresses, your weight will increase and you will experience changes in weight distribution and body shape. This results in the body’s centre of gravity moving forward, which can alter your balance and coordination.
Pregnancy increases your resting heart rate, so don’t use your target heart rate to work out the intensity of your exercise. In healthy pregnant women, exercise intensity can be monitored using a method known as Borg’s Rating of Perceived Exertion (RPE) scale. This measures how hard you feel (perceive) your body is working.
Your blood pressure drops in the second trimester, so it is important to avoid rapid changes of position – from lying to standing and vice versa – so as not to experience dizzy spells. Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay
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Exercise suggestions during pregnancy
Pre-exercise screening is used to identify people with medical conditions that may put them at a higher risk of experiencing a health problem during physical activity. It is a filter or ‘safety net’ to help decide if the potential benefits of exercise outweigh the risks for you.

Read through the pre-exercise self-screening tool before embarking on a new physical activity or exercise program.

If you have been cleared to exercise, and you participated in physical activity before you were pregnant, it is recommended that you:

Do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week.
Let your body be your guide. You know you’re at a good exercise intensity when you can talk normally (but cannot sing) and do not become exhausted too quickly.
If you are healthy and you are not experiencing complications in your pregnancy, continue this level of activity throughout pregnancy, or until it becomes uncomfortable for you to do so.
Be guided by your doctor, physiotherapist or healthcare professional.
If you have been cleared to exercise, but you were inactive before your pregnancy:Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

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Start with low-intensity exercises such as walking or swimming, and build up to moderate intensity activity.
Aim to do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week. You can start with separate sessions of 15 minutes each, and build up to longer durations.
Let your body be your guide. You know you’re at a good exercise intensity when you can talk normally (but cannot sing) and do not become exhausted too quickly.
If you are healthy and you are not experiencing complications in your pregnancy, continue this level of activity throughout pregnancy, or until it becomes uncomfortable for you to do so.
Be guided by your doctor, physiotherapist or healthcare professional.

Physical Changes During Pregnancy
Pregnancy begins when the developing embryo implants in the endometrial lining of a woman’s uterus. Most pregnant women do not have any specific signs or symptoms after implantation, although it is not uncommon to experience minimal bleeding.

After implantation, the uterine endometrium is called the decidua. The placenta, which is partly formed from the decidua and partly from outer layers of the embryo, connects the developing embryo to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother’s blood supply.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

The umbilical cord connects the embryo or fetus to the placenta. The developing embryo undergoes tremendous growth and changes during the process of fetal development.

Most pregnant women experience a number of symptoms that can signify pregnancy. The symptoms include nausea and vomiting, excessive tiredness and fatigue, cravings for certain foods that are not normally sought out, and frequent urination, particularly during the night.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

A number of early medical signs are associated with pregnancy. These signs typically appear, if at all, within the first few weeks after conception. Not all of these signs are universally present, nor are all of them diagnostic by themselves; taken together, however, they may make a presumptive diagnosis of pregnancy.

These signs include:

The presence of human chorionic gonadotropin (hCG) in the blood and urine.
Missed menstrual period.
Implantation bleeding (occurs at implantation of the embryo in the uterus during the third or fourth week after last menstrual period).
Increased basal body temperature sustained for over 2 weeks after ovulation.
Chadwick’s sign (darkening of the cervix, vagina, and vulva).
Goodell’s sign (softening of the vaginal portion of the cervix).
Hegar’s sign (softening of the uterus isthmus).
Pigmentation of the linea alba (called linea nigra), which is darkening of the skin in a midline of the abdomen. This darkening is caused by hyperpigmentation resulting from hormonal changes, usually appearing around the middle of pregnancy.
Breast tenderness is common during the first trimester. Shortly after conception, the nipples and areolas begin to darken due to a temporary increase in hormones. This process continues throughout the pregnancy.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

Despite all the signs, some women may not realize they are pregnant until they are far along in pregnancy. In some cases, a few have not been aware of their pregnancy until they begin labor. This can be caused by many factors, including irregular periods (quite common in teenagers), certain medications (not related to conceiving children), and obese women who disregard the pregnancy-related weight gain. Others may be in denial of their situation.

The First Trimester
The first 12 weeks of pregnancy are known as the first trimester. During this trimester, fetal development can be divided into different stages.

At the beginning of the fetal stage, the risk of miscarriage decreases sharply. All major structures, including the head, brain, hands, feet, and other organs have been formed by the fetal stage. Once pregnancy moves into the second trimester, the risks of miscarriage and birth defects drops drastically.

The Second Trimester
Weeks 13 to 28 of the pregnancy are called the second trimester. Most women feel more energized in this period. They put on weight as the symptoms of morning sickness subside and eventually fade away.

By the end of the second trimester, the expanding uterus has created a visible baby bump. Although the breasts have been developing internally since the beginning of the pregnancy, most of the visible changes appear after this point.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

The uterus can expand up to 20 times its normal size during pregnancy. Although the fetus begins to move and takes a recognizable human shape during the first trimester, it is not until the second trimester that movement of the fetus, often referred to as quickening, can be felt by the woman.

The Third Trimester
Final weight gain takes place during the third trimester, and it is the most weight gain throughout the pregnancy. The fetus will be growing most rapidly during this stage, gaining up to 28g per day.

This is a photograph of a pregnant woman’s abdomen that has dropped. The abdomen drops due to the fetus turning in a downward position ready for birth.
A pregnant woman: A pregnant woman’s abdomen drops due to the fetus turning in a downward position ready for birth.

The woman’s abdomen will transform in shape as the abdomen drops due to the fetus turning in a downward position ready for birth, and the woman will be able to lift her belly up and down. The woman’s navel will sometimes become convex—popping out—due to her expanding abdomen. This period of her pregnancy can be uncomfortable and cause symptoms like weak bladder control and backache.

The body’s posture changes as the pregnancy progresses. The pelvis tilts and the back arches to help keep balance. Poor posture occurs naturally from the stretching of the woman’s abdominal muscles as the fetus grows. These muscles are less able to contract and keep the lower back in proper alignment.Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

The pregnant woman has a different gait. The step lengthens as the pregnancy progresses due to weight gain and changes in posture. In addition, the increased body weight of pregnancy, fluid retention, and weight gain lowers the arches of the foot, further adding to the foot’s length and width.

The influences of increased hormones such as estrogen and relaxin initiate the remodeling of soft tissues, cartilage, and ligaments. Certain skeletal joints (e.g., the pubic symphysis and sacroiliac) widen or have increased laxity. Regular Pelvic Floor Exercise On Maternal Health Among Women of Reproductive AGE Essay

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