During your pregnancy you will hear a lot of advice, from a wide range
of sources. One thing that a lot of people tend to shy away from talking about
openly however is the experience of incontinence during pregnancy, and after
giving birth.
Incontinence is the involuntary loss of urine (meaning you might pee a
little even though you don’t want to!). Many women will experience some degree
of incontinence at some stage during their pregnancy and shortly after giving
birth – and this is completely normal! Reading up about incontinence, and
knowing what to expect, how best to handle incontinence and what you can do
help your body heal to prevent ongoing incontinence is really important.
Why will I experience
incontinence during pregnancy?
The most common form of incontinence during pregnancy is stress incontinence. This type of
incontinence is caused by increased pressure on the bladder, caused by your baby’s
growth – so you might experience this more as your pregnancy progresses.
Because of the increased pressure, your bladder sphincter (the valve that stops
you peeing) struggles to function properly, resulting in involuntary
incontinence.
Incontinence can also be the result of an overactive bladder. Some women who have an overactive bladder need
to urinate more often, as their bladders have uncontrollable spasms, which
again can affect the ability of the bladder sphincter to function properly.
You may be more likely to
experience incontinence if:
·
This is your first pregnancy
·
You have a long labour
·
You have weak pelvic muscles
·
You experienced bowel or bladder incontinence
prior to falling pregnant
How do I know if I have weak
pelvic muscles?
There are some signs that could indicate you had weak pelvic floor
muscles prior to falling pregnant, and if you have developed weaker pelvic
floor muscles after giving birth. These signs can include:
- Accidently leaking urine when you laugh, cough
or sneeze (this is very common during the later stages of pregnancy, and for
new mums)
- Needing to go the toilet frequently
- Leaking urine before you make it to the toilet
in time
- Finding it difficult to empty your bladder
- Accidently losing control of your bladder or accidently
passing wind
- Pain in the pelvic area or pain during sex
Will it get worse after giving
birth?
This really varies from woman to woman. Most women find that after
giving birth, with the reduction of pressure on their bladder, they experience
incontinence less and this continues to improve as their body heals. For some
women this process can take a matter of weeks, for some women it takes months,
and in some cases it can become a longer term condition.
During your pregnancy your body sends out hormones to the tissues and
muscles that make up your pelvic floor,
and these hormones make it ‘stretchier’ than normal. This is to support the
growth of your baby in the uterus, and prepare your uterus for giving birth.
During the birth, these pelvis floor muscles are stretched even more,
and they can weaken. If you have weak pelvic floor muscles to begin with, it
can take longer for the body to recover from this stretching, and you may find
you experience incontinence for longer, even after giving birth.
What if I have a caesarean
birth?
Stress incontinence usually passes a few weeks or months after giving
birth, but it can be on going for some women. For this reason, women sometimes
may consider an elective caesarean. Some women may have already been advised by
their doctor and midwife to opt for a caesarean over a natural birth for
various medical reasons.
While having a caesarean birth may
prevent stress incontinence continuing after the birth, there are no guarantees. Medical professionals
have advised that a caesarean may only reduce the risk of severe stress incontinence
by 5%, and the more caesarean births you have, the less impact this has on
whether you experience incontinence after the birth.
What can I do to help my body
heal and improve incontinence?
The best way to help improve incontinence, and help your body heal
after giving birth is to strengthen the pelvic floor muscles. Even if you have
a weak pelvic floor to begin with, some simple exercises can help your body
during your pregnancy and during healing:
- Before you cough or sneeze, cross your legs tightly
and squeeze them together
- Avoid any heavy lifting
- Avoid any bouncing exercises, as these relax the
pelvic muscles
- Avoid becoming constipated by eating plenty of
fibre and drinking plenty of water
- Avoid straining when you go to the toilet, this
can cause a ‘pushing down’ on the muscles which can weaker them further
- Practice doing pelvic floor exercises, sometimes referred to as kegel exercises
How do I do pelvic floor
exercises?
Pelvic floor muscles help to strengthen the pelvic floor muscles, which
can help to improve incontinence. They can be done just about anywhere, anytime
– even sitting at your work desk, or laying down in bed!
To start:
Find the
right muscles: the muscles you want to strengthen are the muscles that
control you urinating. To find them, try stopping your pee mid-flow when you’re
on the toilet. If you succeed you’ve found the right muscles!
Practice
the technique: to start with contract (tighten) these muscles for 5 seconds
and then relax for 5 seconds. Keep doing this over time and work your way to
contracting the muscles for 10 seconds at a time.
Remember
to breathe: keep your breathing steady and relaxed as you do these
exercises as this will help blood flow to your muscles.
Repeat
the exercise: for the exercises to be really effective, you need to
practice and repeat these exercises regularly – aim to do this exercise for 10
repetitions, up to three times a day.
You can do these gentle but effective exercises any time during
pregnancy, and almost immediately after giving birth. If you have been doing
the exercises and are not seeing any improvement, try speaking to your midwife or
doctor who can advise on other exercise that may help.
To learn more on why does the pelvic floor gets affected during pregnancy, how to prevent it from being affected and more on the pelvic floor exercises to do during pregnancy, read here.
You should also speak to your doctor or midwife if during your
pregnancy or after giving birth you experience:
- No control over the flow of your urine
- Pain when you urinate
- Cloudy or very discoloured urine
- Unpleasant smelling urine
These symptoms could be a sign of urinary tract infection, and may require anti-biotics to help fight the infection.
It is always important to know your body and what feels ‘normal’ for
you. Speak to your doctor or midwife if you experience any changes so they can
provide support and medical care when appropriate.