NOW CLOSED: Post-natal pelvic floor and bladder problems - the last great taboo? Talk and you could win £100 voucher

[AnnMumsnet]

There is a Pelvic Floor Toner that is on GP prescription but it is not being offered to new mothers as a matter of course - how would you sell it? How would you get it 'out there'? Share your ideas and you could win a £100 High Street voucher.

We've been asked by the team behind the PelvicToner to find out what Mums think about their product and to ask how they would market it if they were in charge of the product.

The team say "The PelvicToner is the only clinically-proven pelvic floor exercise device that is available on GP prescription and therefore free of charge to any women holding a Maternity Exemption Certificate. The incidence of Urinary Stress Incontinence (USI) in women outweighs practically all other health conditions (put together) yet the reaction of women at large, lobby groups and many in the medical profession, is just to accept it as a tribulation to bear - something to get used to or one that can't be resolved. This is just not true, and over 80% of cases can be quickly and simply cured with an effective exercise programme."

"The scale of the problem is enormous. There are approximately 15,000 births each week and clinical estimates are that 5,000 of these mothers each week will go on to develop USI. The problem typically starts with childbirth but just gets worst after the menopause. Since January 2011 GPs have been able to prescribe the PelvicToner which in clinical trials proved to be at least as effective as supervised pelvic floor training with a physiotherapist, but to offer significant advantages in that it 'enabled the confident identification of the correct muscles and provided effective exercise using a mild resistance'. It was also recognised that the PelvicToner improved compliance with the exercise programme not least because the patient noted significant improvements within a matter of days, unlike the physiotherapy programme where improvement was not expected within three months."

So - the team behind the product know it's good (they have sold over 100,000) and have loads of evidence to prove it can help with this widespread condition, but face issues from GP's not prescribing it and women not knowing it is either available or effective.

As a way of getting folks talking about this topic we wanted to ask Mumsnetters - if you were in charge of marketing this product what would you do?

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
~ Where else do you think it can be advertised?
~ What kind of message would be most persuasive to you?
~ How much do you think it would cost to buy?
~ What information would you like to know about the product?
~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
~ How do you think they could persuade more GPs to prescribe the PelvicToner?

Any other comments on this issue welcome - PelvicToner very much want to get folks talking about this issue.

Everyone who adds their thoughts to this thread will be entered into a prize draw where one winner will get £100 in High Street vouchers.

thanks
MNHQ

I am 48 and tbh, pelvic floor has only started being an issue within the last 2 or 3 years, resulting in what my GP has diagnosed as 'urge incontinence'.
Have had a referral to the physiotherapist who prescribed pelvic floor exercises together with medication from the GP. According to the physio, 70% of people see an improvement with this approach.

I find it hard to believe, as (like many others it seems), I am not sure I am using the 'right' muscles. Odd as it may sound (!) I had hoped that the specialist physio would be able to do an internal exam to help check that I was clenching and releasing the right bits!

I would definitely by this product, £30 seems a good price for regaining control of my bladder in the privacy of my own home. I might make the odd joke with friends about 'weak bladder' but I am too embarrassed to talk about it openly with others.

I think it would be good for it to be available on prescription for mothers/ women at any stage and not just immediately after the birth (Holding a "maternity exemption certificate" as at present) Problems aren't always immediately apparent especially when busy looking after a newborn and adjusting to your new life, and can develop or get worse later on.

I had to laugh when I saw this in the speel ... ''click here to read three excellent articles from the Daily Mail, Daily Mirror and Woman's Own that all confirm the benefits that the PelvicToner can bring to a flagging sex life!''

I think anything recommended by the readers of the DM would put me off buying it instantly

Having said that I do think its a good idea, and the price is reasonable.

Mumsnet and other sites are good places. i am in my 40s so haven't been to a toddler group or read a mother and baby magazine for years. I would aim the marketing at middle aged women approaching the menopause. Add a few frightening words like prolapse and I think you have caught a lot of womens attention. Having said that I do think its could be targeted at young mothers too. I was lucky and didn't even think of these issues until after birth no 3.

I probably wouldn't see my GP about this. I feel my problems are minor and if a reasonably priced gadget could help, well I'd try that first.

I guess if you want more GPs to prescribe then you'd have to push the marketing with them directly, but I'm not sure that would be economical if you can sell directly to the public for £30 and a prescription is £7.50 then why not ?

Could it be a different colour ? looks a bit clinical in white... maybe a bit of bling

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
I think Mumsnet would be an ideal place to make awareness for this product. Not just a discount but send some samples out to people willing to test and let their reviews do the proof.
~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
If I had known this was available under the GP I most definitely would have approached them about it.
~ Where else do you think it can be advertised?
I think leaflets in Maternity Packs given out just after birth, perhaps at the doctors surgery or in the Clinics where you visit midwife.
~ What kind of message would be most persuasive to you?
Real mums saying how it has really helped them.
~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
Not with the mums I have met at from baby groups but my sister-in-laws have spoken about it regularly with me since my pregnancy/birth.
~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
If embarrassment is the big factor then online, it gives the best anonymity but ability to do enough research, have questions answered etc.
~ How do you think they could persuade more GPs to prescribe the PelvicToner?
Let them know how embarrassing this could be for a woman to broach, especially with male doctors. Just because it is not being spoken about does not mean it is not happening to new mothers.

I was surprised by Cardomumginger's comment. I've been studying the website because I have decided that this looks like a great product to sell through my therapist business. There is a link on the site to research published in the BMJ (Clinical research published in the British Medical Journal recommended that pelvic floor exercise should be the first choice of treatment for genuine stress incontinence because simple exercises proved to be far more effective than electro-stimulation or vaginal cones. www.bmj.com/content/318/7182/487.abstract)

I have been speaking to a doctor friend and she says you will never see a claim that one thing is superior to another. The test is always to prove that it is not inferior. The thing is that in all published clinical trials weights and electricl devices have proved to be inferior to physio exercises so, in my book, that means this thing is superior to them.

I've spoken to another therapist and she is selling between 50 and 100 every month just by raising the subject of bladder weakness during her consultations. I fancy some of that!!!

Brendaf

I read the abstract of the BUJI paper linked to on the website here:

www.bjui.org/ContentFullItem.aspx?id=427&LinkTypeID=1&SectionType=4

which says:
"Both groups showed statistically significant symptom improvement post treatment. There was no significant difference between groups regarding improvement in SUI. Some women reported easier use and favoured the confidence derived from the biofeedback with the PTD.
Conclusions: The PTD is not inferior to standard PFME. It is a safe and well tolerated adjunct to PFME, which increases patient choice and may promote subsequent compliance and efficacy."

This is a very different conclusion from the one the manufacturers state, which is that their device is superior to NICE Gold Standard pfes - although this statement appears to no longer be on the manufacturer's website.... [hmmm]

As for the superiority of pfes over electronic stimulators - this is simply not true for all women. Women with extreme weakness may require electronic stimulation to help get the muscles working again before pfes can be done. In my case I had a pf score of almost 0 out of 5. With NeuroTrac I would get up to 2 out of 5 and could then start doing pfes. Without this initial help the muscle would not work - I could try as much as I liked (and I had been for the best part of 9 months!) and nothing was happening.

I'm not saying that the PelvicToner has no place. I think it has. But the suggestion was that it should be prescribed by GPs. I think that pfes are a superior way for possibly even most women to improve tone and continence. And, as I said, I think asking women to do pfes and seeing what happens is a useful way to screen out those who need specialist help. And by specialist I mean referral to gynae or physio services with the expertise to accurately assess, diagnose and and prescribe. Those women who will benefit from PelvicToner can be prescribed that. Those who need cones can have those. And those who need electronic stimulators can be given those. In all cases women should be shown how to use them, and their progress needs to be assessed at follow up. I don't think that GPs are best placed to do this, and this is my concern. I think GPs should be prescribing pfes and then refering promptly if these don't work.

Marketing: there are lots of websites in which people talk about this sort of thing (birthtrauma.uk and so on) and companies who sell braces, prosthetics and so on (Winn health is one of them). You could look into advertising with them. Or possibly on/with products required by those of us with problems in this area (Tena Lady, anyone?).

If you have a real and chronic problem, like myself, you will try just about anything to improve matters IF you know where to get hold of it. What about in public or department store loos (the sort of ads you see on the inside of doors in motorway service stations)? These are the places in which you will be thinking about and wishing you didn't have a problem, so you might be more receptive ....
It's not something most of us relish talking about.

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?

Yes - but more than that, this is something I would have wanted to know about in advance of experiencing anyy questions (see below)

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?

Definitely, if I knew about it.

~ Where else do you think it can be advertised?

I would like to have known about this before experiencing any issues...so what about in all the Govt sponsored ante-natal handbooks, some leaflets (or discount vouchers) in teh Bounty packs they give out in the hospitals and at the HV centres, getting NCTn to hand out leaflets about the products; get HVs to stock/hand out leaflets and recommend the product?

~ What kind of message would be most persuasive to you?

That it works!

~ How much do you think it would cost to buy?

No idea.

~ What information would you like to know about the product?

How much it costs, how long it takes before it works, how much time does it take each day, how big is it.....

~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?

Not really.

~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?

I would far rather talk to my GP than a random toddler-group mum!!

~ How do you think they could persuade more GPs to prescribe the PelvicToner?

More information - I'm not convinced my GP even knows about this - and maybe some pressure from various parenting organisations to raise awareness.

I think at the moment the main problem is that we just aren't given a lot if any medical followup after birth, concerning urine leakage.
After continuning problems, finally went to GP and just says pelvic floor exercises, didnt evenen reccomend any.

If this is something that could be perscribed by GPs or recommended by health visitors ect, they us as mums need to know about it to ask for it........ive never heard of people that will freely reccomend specific things unless i ask for the. ......so if i knew about the product i would deffo ask my GP about it.

But firstly i would deffo want to know if it actually works, what evidence have
you got that proves this

Does the product help with minor problems and stress incontinence - as in leaking if Ii move quicky and unexpecdly or when i sneeze and cough and currently i have to having to tense when sneezing and coughing .

I would also want to know how long you would have to use it, where and when and how many times in day, is it portable?
Does it work on people of all sizesI have d

Could this be given discounts for the products, and advertised need to get word out there, childcare magazines, mumsnet, netmums,

It could be advertises of the long term cost and health effectivness...eg preventing prolapse and long term required use of tenna lady

I deffo wouldnt buy it at a todler group, but from a chemist fine or online......some baby clinics maybe though
In the finacial crisis i wouldnt be able to afford anything over £30

i have deffo talked to it with people normally people i know and they are normally other mums......but it sometimes comes up in a joke....eg i sneeze and i pee my pant a little ....

I agree that mumsnet is a good place to start alot of mums use this site as a valuable source of information and advice about things they would be embarrassed to discuss in real life.
I had no idea that this was available to buy or from the GP. I was prescribed one by the incontinence nurse and was horrified when the pharmacist explained that it was an unusual it and had to be ordered in specially, this was extremely embarrassing.
I think leaflets available in Dr surgeries and pharmacies about the product would help alot.
The message that would have helped me is to know how common bladder problems actually are and how there is this simple device available which can make such a difference.
I do not like discussing bladder issues in real life at all.
I would like to see a raised awareness of bladder and pelvic floor troubles in mums a more focused approach by health professionals to uncover these issues with access to help and guidance.
I would have been happy to buy this from Drs or a large pharmacy or other pregnancy/baby retailer.
I would like to see more GPs prescribing the pelvic toner it makes such a difference to how we woman feel and helps to stay in control of our pelvic floor with less embarrassing issues.

I wanted to have SlackBladder as my mumsnet name but it had already been taken.

I have had bladder problems all my life, and they only got worse after two very long and difficult deliveries. After much badgering and insistence I finally managed to work my way through GP, physio, GP, gynae, GP and finally properly specialised bladder consultant to have a posterior repair and a TVT (basically a little hammock to hoick up your urine tube). The whole process took two years. The TVT made a huge difference but my pelvic floor is still very weak.

The physio didn't help at all, nor did the electronic gadget that I was lent by the hospital, not the Aquaflex that I bought. So an alternative, proven product would certainly be of interest to me.

I have no problems talking to health professionals about this, nor to other women. As I said, I really had to insist on being referred up the medical hierarchy before a proper flow test was done and I had my operations. If I had been less vocal I would still be sitting in a puddle.

So: I think these kinds of problem often do not manifest themselves until some time after a birth, so aiming marketing at pregnant women is probably not very productive ("It won't happen to me").

Advertising on sites like mumsnet would help. I don't read women's magazines so cannot comment on them. Some editorial in Sunday paper magazines (e.g. Sunday Times Style) would be better than advertising, I would have thought.

Perhaps GP practice nurses could be targeted as they are the ones who do the contraceptive check-ups. They could routinely ask women about their pelvic floor and bladder health, and offer advice including devices.

I personally think this is a fabulous idea and I would defo try it as I have had a weak bladder for awhile but it has got a lot worse since having my son. I think that there should be more advertising stating that the doctors can prescribe these because a lot of woman are too embarrassed to talk openly about bladder problems and that's why so many go untreated. If these were affordable for the working family on a budget that would be fab because at the moment the way things are people don't have much spare cash if any. I also think that making them more widely available in shops and the playgroups etc would help a lot more too.x

I have been suffering from mild urinary incontinence since having dd who is now 13 weeks. I would definitely have asked my GP for one of these at my 8 week check if I had known about them.

I am currently seeing a physio for the incontinence so perhaps it would be useful if the pelvic floor exerciser was available through physio's as well as gp's.

I agree that advertising through MN and offering a discount is a good idea, also how about advertising them in the bounty packs given out on the post natal ward with a discount voucher?

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?

Yes!

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?

I?d be inclined to buy it, but would like it prescribed either by my GP (unlikely he is still in the stone age ? I had to have children before he?d fit the coil!! ), my midwife, post natal or the incontinence physio who I have been referred to this pregnancy (and should have been referred to after DS was born!); I don?t think it should solely be down to GPs to prescribe these.

~ Where else do you think it can be advertised?

Pregnancy magazines, women?s lifestyle magazines, in Mama Packs/ Bounty Packs / Emma?s Diary Packs, the back of service station toilet doors.

~ What kind of message would be most persuasive to you?

That is works both preventatively (more inclined to buy) and as an effective cure for incontinence/way to improve pelvic floor strength.

~ How much do you think it would cost to buy?

Around £30, which having looked at the site is what I would pay for it anyway . It is considerably cheaper than other products on the market that purport to do the same thing, without as much evidentiary back up as this product.

~ What information would you like to know about the product?

How effective it is and the kind of time frame within which you would expect to see a noticeable effect (references to studies would be great, but then I like stats/claims to be backed up ) and how it works.

~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?

I wouldn?t say taboo, but not a usual topic of conversation, usually only in reference to pregnancy/delivery issues with close mum friends!

~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?

I?m not embarrassed to talk to my GP, like I said above my biggest issue would probably be getting them take any problem I had seriously. Other practitioners (midwives, practise nurses, physiotherapists) would probably be easier to approach and more amenable to listening to the issues I had. I?d rather have it prescribed, but if that were not possible/likely I would rather buy through the website, definitely not friends or toddler groups; although if I found it effective I wouldn?t hesitate to recommend it in toddler groups/to friends if the topic of conversation came up.

~ How do you think they could persuade more GPs to prescribe the PelvicToner?

Give them an overview of the Mumsnet feedback , actually educate them that this IS a problem that for a minimal cost can be rectified and should automatically be asked about at/included in 6 week post natal checks beat them around the head with free samples.

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?

Discounts are always good!

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?

I think I'd be more likely to buy it than ask a doctor for it, tbh. I've never suffered from USI, but I doubt I'd bother a Dr about it unless it was severe.

~ Where else do you think it can be advertised?

Bounty packs, parenting magazines, that sort of thing

~ What kind of message would be most persuasive to you?

I'd want to know that it was a common problem, that the product is very effective, and maybe a money back guarantee

~ How much do you think it would cost to buy?

No idea. 50 pounds?

~ What information would you like to know about the product?

How much time it would take, how quickly I'd see a difference.

~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?

I have had these sort of jokey discussions before. Never discussed it seriously.

~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?

I'd rather buy in a (nice, anonymous) pharmacy or supermarket or online. No way would I buy at a toddler group.

~ How do you think they could persuade more GPs to prescribe the PelvicToner?

You know what GPs are like. Bribe them with pens.

Mumsnet is one of the best places to start and offering a discount would be good. Ante natal should have samples to show prospective mums with free literature and be encouraged to discuss the pelvic floor issues. Competitions are an excellent way of promoting products. Free trials also stimulate alot of feedback, blogs and word of mouth advertising. The product would also be invaluable for ladies who have experienced a hysterectomy and are advised to do daily pelvic floor exercises to prevent further organ prolapse. It could also be sold as increasing pleasurable sex. Get one in featured in 50 Shades Of Grey! Posters should be provided for GP,s, gyne hospital departments, ladies changing rooms at swimming baths,spas,gym,s etc. Gp,s should be given incentives & lots of stats by the company to promote prescribing them as they work to strict budgets. Ladies need to be made aware they can request them on prescription & most read magazines such as Woman, or The Lady & they need to be real women type adverts. Prevention is always cheaper than cure! I would want to purchase on line and not pay more than about £30, with a money back guarantee if no improvements.

I didn't know there was anything like this available - and I speak as somebody waiting on a referral to the hospital for a vaginal prolapse, and related incontinence. The GP asked me about whether I'd tried pelvic floor exercises (yes - & I've also tried the Aquaflex weights, which I probably read about on MN), but nothing like this was mentioned. I couldn't be sure if this is through ignorance, or lack of interest on behalf of the GP, to be honest.

I guess this product might be aimed at me. I have appalling pelvic floor muscles as the result of a 3rd degree tear after dc1 and have gone on to have 2 more children subsequently so I really really need to do something about this. Am all too aware of the statistics looming for me post menopause. The effect it has now is inhibiting as I am worried about having sex with a new partner as am not sure how satisfactory it will be for either of us.

I've been referred to Women's Health twice, shown how to do pelvic floor exercises, used cones (they fall out) and electrical stim (to no avail) and Women's Health just shrugged when I asked, 'what next?'

My only option as far as I can see is to ask my GP for a recommendation for vaginoplasty, which won't be available on the NHS as my insides aren't hanging out, and start saving the 4k for the operation.

I am sorry but I don't believe a piece of plastic like this is going to get the results that it promises. I'd be happy to try one out and report back to MN. If it did work for me, it would work for anyone with a vagina!

I would want to know how quickly the product starts to work/help, how often it needs to be used, if it's discreet, how long it needs to be used for and also if it helps major problems as well as miner proplems.

It would be good to see it advertised in magazines, especially magazines aimed towards women, also adverts in public toilets would be good, as well as toilets in doctor surgerys, bounty packs you get durning and after pregnancy.
If I was to by this I would expect to pay around £20-£25.00 but no more, I think it would be good if it was avalible to buy from chemists, local family planing clinics, health visitors and midwifes.

If I could get it on prescription I would ask my doctor, but think I would prefer to ask a female doctor as they would be more understanding, I think it would be good to get a website up about this subject and get women and men to join and show that this can be a really bad problem and effect women in various ways, Maybe some of us who blog should do a post on our blogs about the problem and what can be done to help and mention the product and what it does, how it works etc.

I would also talk to friends about it as I know that a lot of people can feel embrassed having this proplem but it is properly more common than we all think

We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?

Yes, why not?

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?

Probably.

~ Where else do you think it can be advertised?

Magazines/parenting sites

~ What kind of message would be most persuasive to you?

The research evidence that it is effective

~ How much do you think it would cost to buy

£40

~ What information would you like to know about the product?

As above re:research evidence

~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?

Occasionally.

~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?

Not way. Pharmacy or HV.

~ How do you think they could persuade more GPs to prescribe the PelvicToner?

Don't know, I'm not a Dr!

It's a really tough product to market! My initial thoughts were that it looks like a speculum that they use when they do your smear. My smear experiences have been particularly painful so it didn't leave with any excitement for your product at all! Sorry! I think if your GP prescribed it you might be inclined to use it. I have to say recommendations from friends or other mums might make you interested but the picture was a real put off for me. Maybe think about how you present it visually as a product?

A discount is always good, and it gets people looking and talking particularly if it's a flash type one. I think I would be unlikely to ask the GP for it and I don't think my GP would prescribe it unless you really pushed for it and how many people are prepared to do that? I do however think GP's should be prescribing this as there are lots of people with this issues. I know my mother in law has problems and wears pad and she is not prepared to do much about it and has almost accepted that that is life!

Advertising on mums sites with good reviews will help, in big branded parents magazines to raise profile and also I think a big target audience will be older women who think that's life so maybe some of the glossy magazines aimed for that age group. A competition which sounds a bit cringe worthy but it gets people looked at it and thinking about it even if they don't enter and you might be very surprised by the response it generates.

In the blurb the most persuasive thing for me was the quick improvement within such a short period of time for 5 minutes a day. Testimonies are very powerful when branded right too.

I think around £12 is a good price but I know it's marketed for a lot more. It is a very taboo subject amongst younger women and I have never heard any of my friends mention it, however I have heard menopausal aged women talking about it. I think I would be embarrassed to sell my friend one but I would talk to them about it if needed.

In order to get GPs to prescribe it has to be cost effective for them and I really don't know how you get through to them. Maybe you should consider using a study or something that's in GP jargon.

I agree that this is a big problem for lots of new moms, my suggestion would be to have your health visitor/ midwife make them available.

I didnt know that a product such as this was available and TBH most of us do not do our pelvic floor exercises simply because there is so much else to do with a new baby.

I was referred to a 'programmer' following the forceps birth of my first child. It was full of incontinent old ladies......and me. The assessment was that my muscles weren't great but weren't a disaster either i.e. I didn't leak when I coughed! so I wasn't too embarrassed to go to my GP but the results weren't particularly satisfying - the problem still remains.

I wouldn't buy through a friend. Online works best for me. More than anything I'd need to be convinced it actually works, and understand how often I'd need to use it to see a result. If a friend recommended it having had fab results then that would be most convincing, but not one who's on commission!

I would have really welcomed this opportunity and the problem has got even worse following the birth of my second child. I'd like to know how much your product costs and how easy it is to use. I'd find something time consuming difficult to accommodate into my busy life.

Wouldn't buy one from a friend and certainly not through a toddler group. A pharmacy maybe though, or a reputable online seller (boots?) If MN were to offer a discount, that would feel like a safe way to buy.

When focussing marketting consider that the women who are most likely to decide its worth spending money on this will not want anything down there for a good few months post-birth. So look at places mums go with babies/toddlers and adverts in the loo seem like a good plan.

Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?

It wouldnt have occurred to me to go to the GP for it, I would only buy it if I could afford it (which at present I cannot afford a coffee!). I dont ever think of my GP as responsible for anything other than referrals to hospitals or prescription medication, even though I know they are responsible for more.

Where else do you think it can be advertised?

Typically called 'women's' magazines, glossy, chat, parenting and pregnancy magazines, maybe go on womens' hour and talk about the evidence based part of it? GP surgery posters, ladies bathrooms, discount with incontinence products (Im thinking the pelvic floor people pay tena lady a bit to put a discount voucher with their products - tena lady dont lose out too much, they dont really want their customers to be incontinent forever do they ;) and customers buying tena lady or similar will remember that and may use them again for another reason or recommend them to others who pelvic floor is not applicable to)

Since it seems to focus on sex on the website, I suppose it could also discretely advertise in Ann Summers or other sex shops, but this may not reach women who do not shop in these places for whatever reason.

Health visitors, midwives, other health professionals you come into contact with could have information on it.

What kind of message would be most persuasive to you?

Not getting a prolapse when Im older? I do have stress incontinence and I would want to know it works and that witth use I would eventually need no support from it and manage to not have stress incontinence.

How much do you think it would cost to buy?

I imagine it costs a lot. Then I checked the link - £29.99 - great!

Just for anyone not clicking the link - heres something important:

It is the only pelvic toning device to be available on NHS Prescription, which means it is free of charge to new mothers who have a Maternity Exemption Certificate huzzah!

What information would you like to know about the product?

That it works, that I can use it at home discretely and its not obvious if I choose to use it with other people present and they are wondering if I look rather uncomfortable. I want to know if Ill still need incontinence products while using it or during the process and some real life feedback.

Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?

I have a friend who I can talk about it with because her situation is unusual (I wont share here) but it is a prominent part of her life so I feel more comfortable opening up to her. My other mum friends who are very glamarous and stylish, lost baby weight and are just perfect all over dont even look like they fart like scruffy old me so as much as I respect, trust and value their friendship - its not taboo but I dont really want others to sit their imagining Ive wet myself everytime we have a joke. I also think people may unconsciously look at my pants and see if I have been incontinent if they knew? Paranoia perhaps...

If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?

Considering the quote on the website that the link above takes us to:

?You do see a lot of British women with vaginas you could drive a bus up,? one woman obstetrician remarked graphically.

I feel so much more comfortable talking to a clinician now!!!

My GP is pretty good I would speak to her. If my friend recommended it that would be fine but I dont want to buy one from a friend like Avon. That might suit others however.

How do you think they could persuade more GPs to prescribe the PelvicToner?

Show them the cost effectiveness from areas which have done clinical trials and prescribing costs for related treatment or other have reduced. I imagine it may impact on indirect prescribing and treatment costs for other conditions which stress incontinence may contribute to.

I think a more professional looking website may help people feel more confident. It does make me think of those adverts at the back of magazines that you have no idea if you can trust.

As I am not a GP I cannot comment on whether they enjoy training sessions and what not, but perhaps the pelvic toner people can give some testers/freebies to clinics, GPs can hand them out to anyone who comes in to ask and then get feedback for themselves?

Could it be part of some NICE guidelines or best practice chart to state what to prescribe or refer in the process of seeking support for stress incontinence etc?