Having a baby is a miraculous thing! However your body goes through a LOT to grow your little bundle and birth them, whichever birth route you took. Therefore there is no surprise that our bodies can feel different afterwards. One of the symptoms that I hear a lot from my clients is stress incontinence after birth. Stress incontinence is the technical term for a leakage of urine when putting the pelvic floor under stress so for example sneezing, running, jumping, standing up from sitting down etc. Depending on the level of reduced control of the pelvic floor will depend on what types of activity that will cause leakage. It's a topic that many women feel embarrassed to talk about and can really affect quality of life.
So is it normal after child birth to have stress incontinence?
Yes, during pregnancy our pelvic floor is constantly put under strain from the increasing weight of our unborn baby, especially in the last 6 weeks when we increase our fluid levels extraordinarily! So regardless of how your baby is delivered, that pelvic floor has had to work very hard over the last 9 months. Once your baby is born the pelvic floor doesn't get a break! It now has to work hard whilst you do much more squatting, lifting, carrying your new baby, prams etc. If the control around the pelvic floor isn't up to the task then a bit of leakage can occur.
Is it just a side effect of becoming a mum that I have to live with?
Nooooo! I find it heart breaking how stress incontinence along with other pelvic issues are so shrugged off as just 'a part of being a mother'. For the majority of women this problem can be solved! Yes...COMPLETELY GONE! No more big pads for running, standing on the side lines whilst your kids play on a trampoline or anxiously awaiting a sneeze at work in case of an embarrassing moment.
What can I do about it?
There is no 'one size fits all' solutions to this and it completely depends on the type of pregnancy and births you have had. However these are the most common treatments for it listed below:
Get checked out by a physiotherapist.
Seeing a specialist pelvic health physiotherapist that is trained to work with post natal women (like myself) would be a great starting point! We complete a thorough assessment of your body (including internal assessments of your pelvic floor if indicated) and create a programme for you to get back to whatever activity it is! They can also help with discomfort during intimacy, increased urgency, scar work, prolapse concerns and more! Have a look at my antenatal and postnatal services for more information. If you're not sure what you need then the Mummy MOT is a great place to start!
If you are unsure which service would be best or how to go about finding a women's health physiotherapist in your area please get in touch with me and I will happily point you in the right direction.
2. Pelvic floor control exercises
Now I say control and not 'strengthening' as there are some conditions that are caused from an overactive pelvic floor that is unable to fully relax. There has to be a balance between working the muscle and allowing it to relax, recover and rebuild. If you have been assessed by a physiotherapist and they are happy with you starting some pelvic floor work then pilates or yoga by a post natal specialist is a great place to start! You're looking for small groups with more time for the instructor to ensure you are doing the exercises correctly and at your own pace. Or if classes aren't your thing the NHS Squeezy app is fantastic!
3. Don't run before you can walk
It is so common after having a baby to want to 'get rid of the baby weight', get back to exercises you couldn't do during pregnancy (more about that in a future blog post) or start new mumma-baby exercise activities during the day whilst on maternity leave. Just because a class is suitable 'from 6 weeks' doesn't mean it's suitable for you yet. Everybody's pregnancy and birth is different, as is our post natal recovery...so why would everyone automatically be at the same point in their recovery at 6 weeks? Speak to your physio and work out what exercise classes would be best for you and when.
4. Low impact classes first, high impact classes later
Low impact classes such as yoga, pilates, tai chi are a great place to start! Progressing upwards to customised circuits, weights work (with guidance and supervision) and eventually running, aerobics, jumping exercises (usually around 12 weeks post partum). If you start a class that is too hard for your pelvic floor you'll do more harm than good so make sure you pick an activity that is right for you! Again, just because a class is made for mothers and babies, it still may not be appropriate for you yet, depending upon your own rehab journey.
5. The 'knack'
The knack technique is a great tool to reduce those embarrassing moments! Simply tighten up your pelvic floor when you are about to sneeze or do anything strenuous will help to reduce the leakage! The more you do it the more effective it will be and eventually an automatic response.
I had a baby 20 years ago...is there any chance I can regain my pelvic floor control?
ABSOLUTELY! Muscles are amazing things and will continue to adapt and build for the whole of our lives! Speak to a specialist physiotherapist for more information of how to do this successfully.
If you would like to learn more about your pelvic floor and how to improve your symptoms why not get in touch!