Pelvic floor dysfunction (PFD) is a prevalent yet under-recognised condition among obstetric women, often presenting as urinary incontinence and pelvic organ prolapse. Despite evidence supporting pelvic floor muscle training as an effective first-line management strategy, awareness and service utilisation remain suboptimal. This quality improvement project, conducted at Singapore General Hospital, aimed to enhance PFD awareness among obstetric patients and nursing staff and to increase physiotherapy uptake from a baseline of 0% to 50% within 6 months. The comprehensive root cause analysis identified three critical barriers to physiotherapy utilisation within our department—inadequate screening procedures, insufficient staff and patient education and poorly defined referral processes. A pre–post intervention design was implemented across outpatient, inpatient and postnatal care settings. Interventions included structured patient education through pamphlets, digital media and discharge materials, systematic PFD screening and strengthened referral pathways. Nursing staff received targeted training and physician engagement was integrated in later cycles to improve patient receptivity. Outcomes were assessed through referral rates, completed physiotherapy appointments and pre/post education surveys with nursing staff. Baseline data revealed inconsistent referrals and low health literacy as key barriers. During the first cycle, many antenatal patients deferred physiotherapy until postpartum, highlighting the need for stronger physician involvement. Adjustments in the second cycle, particularly routine counselling by obstetrics doctors, improved patient acceptance and referral compliance. As a result, physiotherapy uptake increased significantly, reaching the target of 50% within 2 months. Nursing staff also demonstrated improved confidence and knowledge in PFD education. This initiative successfully embedded pelvic floor health into standard maternal care, underscoring the importance of education, multidisciplinary collaboration and physician advocacy in overcoming stigma and systemic gaps. It also establishes a sustainable framework for integrating pelvic floor health into maternity care and improving long-term outcomes for women.
Chun et al. (Wed,) studied this question.