Most of us can recall friends and family describe their pregnancy journeys and the experience of giving birth. I’ve heard the highs, and the not-so-highs. From morning sickness and sleepless nights, to baby giggles and first steps, mothers love to share. Mothers glow with pride even while exhausted as they share their baby’s “firsts”. So, the “first” time I heard a mother discuss her experience with postpartum urinary leakage, I was pretty surprised.
As a trained Pelvic Physical Therapist, I wasn’t surprised to learn a new mother can have urinary incontinence. Rather, I was shocked when I realized this has been a taboo topic, in dire need of discussion. The trauma a woman’s body experiences giving birth does not seem to be a topic of regular conversation. After all, there is a beautiful newborn addition to the family drawing everyone’s time and attention. However, the topic of postpartum urinary incontinence is certainly an important subject deserving of discussion, and should not be taboo! If you are leaking urine following pregnancy, you are not alone. It is a common occurrence but it is not a normal one. It is a sign of pelvic floor dysfunction. And yes, there is help.
Postpartum incontinence: Bladder control after baby
A typical, healthy bladder will eliminate 5-9 times each day, or every 2-4 hours. After giving birth, the most common forms of urinary incontinence are Urge Incontinence and Stress Urinary Incontinence. Urge urinary incontinence refers to the sudden urge to urinate followed by an involuntary loss of urine. It can be the result of nerve damage sustained from pregnancy or childbirth.
Stress Urinary Incontinence can be described as the involuntary loss of urine with exertions (lifting the baby, exercise, sneezing, coughing, or laughing). It can be the result of weakened pelvic floor (muscles that span the bottom of the pelvis). Your doctor may have said some incontinence is normal during the 6-8 week healing period after giving birth. If your symptoms persist beyond that time, what then? Back to the doctor, who will likely prescribe Kegel exercises.
What are Kegels?
Kegels seem to be the one size fits all exercise recommended when a woman experiences leakage. A Kegel consists of squeezing and lifting your pelvic floor muscles upward and inward. Unfortunately, kegels are not appropriate for everyone. If you are experiencing leakage due to overused pelvic floor muscles, kegels will not help and may make things worse.
When kegels are indicated, it is best to seek instruction from a pelvic physical therapist to learn the correct way to perform this exercise. A pelvic PT will also provide you with an in depth assessment and provide an individualized treatment plan. Your treatment may include diet analysis, bladder re-training and core strengthening (the pelvic floor is part of our core!). A recent study found 60% of the women tested were unable to perform pelvic muscle exercises correctly, despite expressing prior knowledge of being able to do so (Kandadai et al, 2015).
Here’s what can you do today to help with your incontinence symptoms:
Limit common bladder irritants such as caffeinated and alcoholic beverages, and acidic foods. Be sure to get enough hydration! Do not limit your water intake for fear of leakage. This will “confuse” your bladder and may cause an exacerbation of symptoms. Final tip: contact a trained Pelvic Physical Therapist to discuss your concerns. There is help!