The RECOVER Study - Postpartum Recovery of Pelvic Floor Structures and the Impact of Early Rehabilitation

Summary

The goal of this observational study with an embedded pilot clinical trial is to learn how the pelvic floor recovers after vaginal childbirth and whether early individualized pelvic floor muscle training can improve recovery in people who experience pelvic floor symptoms after vaginal delivery. The main questions it aims to answer are:

* How do pelvic floor muscles and surrounding tissues change and recover during the first year after vaginal childbirth?
* How are these structural changes and their recovery related to urinary, bowel, and vaginal symptoms?
* In participants with pelvic floor symptoms after vaginal childbirth, does early individualized pelvic floor muscle training improve symptoms and support structural recovery compared with usual care?

Researchers will compare participants who receive the early pelvic floor muscle training to those receiving standard postpartum care to see if the training helps improve pelvic floor function and reduce symptoms.

Participants will:

Attend clinic visits at six weeks, and six months after childbirth

Complete questionnaires about urinary, bowel, and vaginal symptoms, as well as physical activity and quality of life at six weeks, and four, six months, and twelve months after childbirth

Undergo clinical pelvic floor assessments, including vaginal palpation of muscle strength, tone, and perineal body stability

Have ultrasound examinations of the pelvic floor to assess muscle structure, tissue integrity, and perineal body morphology

For those in the pilot trial, participate in an early, individualized pelvic floor muscle training program

This study will provide important information about how the pelvic floor heals after childbirth, how structural changes are linked to symptoms, and whether early personalized training can help prevent long-term problems.

Conditions

• Urinary Incontinence
• Pelvic Organ Prolapse (POP)
• Bowel Symptoms
• Postpartum
• Physiotherapy and Rehabilitation
• Pelvic Floor Muscle Training
• Pelvic Floor
• Recovery

Interventions

BEHAVIORAL

Early individualized pelvic floor muscle training (PFMT)

Participants receive individualized pelvic floor muscle training (PFMT) delivered by a physiotherapist starting 2-3 weeks postpartum. The program must include pelvic floor exercises at least three times per week, with three sets of 8-10 contractions per session, progressing from light to stronger and endurance-focused contractions. Physiotherapists may also include relaxation techniques, hip, back, and abdominal exercises, breathing exercises, and advice on general physical activity according to each participant's needs. Treatment is adapted based on ultrasound images and a video of pelvic floor contractions, allowing physiotherapists to tailor exercises to any detected tears or weaknesses. All interventions are documented in a checklist to record which components were delivered. Ultrasound files and videos are provided for physiotherapists to guide treatment, but the assessor remains blinded to group allocation.

Sponsors & Collaborators

• Vastra Gotaland Region

  lead OTHER_GOV

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-04-07

Primary Completion

2028-12-31

Completion

2029-12-31

Countries

• Sweden

Study Locations