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 from 2-3 weeks postpartum. The program is individually progressed according to recovery and aims to gradually achieve the recommended training dose of 8-10 maximal contractions held for 6-8 seconds, performed in three sets, 2-3 times daily, for at least 12 weeks. Participants receive an information booklet covering pelvic floor recovery, pain management, bowel and bladder function, relaxation, physical activity, scar healing, ergonomics, sleep, and sexual health. An exercise diary is used to monitor adherence. Follow-ups are conducted every second week during the first 3 months and thereafter every fourth week. Participants requiring additional guidance in performing pelvic floor contractions are offered in-person physiotherapy visits. All interventions are documented in a checklist to record delivered components. Ultrasound files and videos are provided to guide treatment.

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