BACKGROUND/OBJECTIVES: Pelvic floor muscle (PFM) training is widely recommended during pregnancy and postpartum as both a preventive and therapeutic intervention. The addition of electromyography (EMG) biofeedback may further enhance training effectiveness. This study aimed to evaluate the effectiveness of a 6-week BeBo PFM training program (BeBo, derived from the German Beckenboden, pelvic floor) and to compare it with BeBo training combined with EMG biofeedback in women after vaginal delivery (VD) and cesarean section (CS), relative to control groups. METHODS: A total of 120 primiparous women (mean age 29.0 +/- 1.9 years), 6 to 8 weeks postpartum after VD (n = 60) or CS (n = 60), were randomly assigned to BeBo training, BeBo+EMG-biofeedback, or control group. Neuromuscular PFM activity was assessed before and after intervention using surface electromyography (sEMG; Noraxon G2 TeleMyo 2400) with a vaginal probe. RESULTS: Women performing BeBo training with EMG-biofeedback demonstrated significantly greater improvements in PFM endurance (p < 0.001, eta2 0.423) in both VD and CS groups compared with controls and BeBo training alone. Regarding maximal fast contraction, significant improvements (p = 0.042, eta2 0.097) were observed in both delivery groups within the EMG-biofeedback group, whereas BeBo training alone was effective only in the VD group. CONCLUSIONS: PFM training based on the BeBo concept, particularly when supported by EMG-biofeedback, effectively enhances neuromuscular function, with the greatest benefits observed in women after VD. EMG-biofeedback should be considered as an adjunct in standard postpartum preventive care, with training protocols tailored to delivery mode: relaxation-focused for CS and strengthening-focused for VD.

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