Pelvic Floor Muscle Training After Childbirth and Twelve Years On: What Two Randomized Trials Found

Physical therapists and physical therapist assistants who see postpartum women or women with stress urinary incontinence, along with clinicians in orthopaedic, women’s health and general outpatient settings who field questions about whether pelvic floor and abdominal training holds up over time.

Physical therapists and physical therapist assistants; other licensed rehabilitation clinicians working with postpartum and pelvic health populations.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Moreira SE, Debs AL, de Oliveira EH, da Silva MCN, Pinto RMC, Pereira-Baldon VS. Hypopressive exercises for diastasis recti and pelvic floor symptoms in postpartum women: A randomized trial. Braz J Phys Ther. 2026;30(3):101584. doi:10.1016/j.bjpt.2026.101584

van Oorschot HFC, Tijsseling D, Labrie J, van der Vaart CH. Twelve-Year Follow-Up of a Randomised Controlled Trial Comparing the Effectiveness of Pelvic Floor Muscle Training Versus Mid-Urethral Sling Surgery for Female Moderate to Severe Urinary Incontinence. BJOG. 2025;132(6):826–833. doi:10.1111/1471-0528.18092

After completing this course, you will be able to:

1. State what a twelve-week hypopressive training program did and did not change in postpartum women with diastasis recti, as reported in the Brazilian randomized trial.
2. Describe what the twelve-year follow-up of the PORTRET trial reported about pelvic floor muscle training compared with midurethral sling surgery, including the cross-over pattern the authors found.
3. Distinguish what a short postpartum trial and a long-term incontinence follow-up each support when a clinician is asked how long the effects of pelvic floor and abdominal training are likely to last.

1. Start Here: Course Overview, the Clinical Question and the Audio Briefing
2. Part One: Hypopressive Exercise for Diastasis Recti and Pelvic Floor Symptoms After Childbirth
3. Who Took Part: Postpartum Women With a Two-Centimetre Abdominal Separation
4. Inside the Protocol: Twelve Weeks of Supervised Hypopressive Training
5. What Changed and What Did Not: Separation, Endurance, Symptoms and Body Image
6. Adherence, Blind Spots and How Far the Postpartum Findings Reach
7. Part Two: Pelvic Floor Muscle Training Versus Sling Surgery, Twelve Years Later
8. Who Was Followed: Women With Moderate to Severe Stress Urinary Incontinence
9. How the Long-Term Follow-Up Was Done: Questionnaires, Cross-Over and Two Analyses
10. What Remained After Twelve Years: Improvement, Cure and the Move to Surgery
11. Response Rate, Missing Adherence Data and What Stays Uncertain
12. Bringing It Together: What a Short Trial and a Long Follow-Up Each Support
13. Where the Two Studies Point the Same Direction
14. Where They Diverge, and Which Paper Found What
15. Framing the Conversation: What Can Honestly Be Promised a Patient
16. What These Two Studies Leave Open
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Moreira SE, Debs AL, de Oliveira EH, da Silva MCN, Pinto RMC, Pereira-Baldon VS. Hypopressive exercises for diastasis recti and pelvic floor symptoms in postpartum women: A randomized trial. Braz J Phys Ther. 2026;30(3):101584. doi:10.1016/j.bjpt.2026.101584
2. van Oorschot HFC, Tijsseling D, Labrie J, van der Vaart CH. Twelve-Year Follow-Up of a Randomised Controlled Trial Comparing the Effectiveness of Pelvic Floor Muscle Training Versus Mid-Urethral Sling Surgery for Female Moderate to Severe Urinary Incontinence. BJOG. 2025;132(6):826-833. doi:10.1111/1471-0528.18092