If you are anything like me, you will forget to do your pelvic floor exercises during and after pregnancy, resulting in never being able to jump on the trampoline with the kids in fear of a little…accident.
More than 50% of first time pregnant women and up to 85% of second time mothers can develop bladder weakness after giving birth. This can range from very mild, to quite severe depending on a number of factors after having a baby.
When you are pregnant, your body produces hormones such as progesterone and oxytocin that increase during pregnancy and can relax not only the muscles in the uterus, but other smooth muscles in the body like the muscles of the bladder, bowels and oesophagus; this helps the muscles relax in order to give birth, but also contributes to bladder weakness after birth as the muscles are stretchier than normal.
The weakened and stretched tissues and muscles make up your pelvic floor making it harder for you to squeeze the muscles (sphincters) at the bottom of your bladder to stop wee escaping. When you give birth to your baby, your pelvic floor muscles are stretched even more.
Bladder weakness may begin in the first trimester but it's more common in the third trimester when your baby gets larger and your muscles start getting softer in preparation for birth.
Woman who have had more than two vaginal childbirths are at a higher risk of developing bladder weakness as the stress of an enlarged uterus applies pressure to the bladder and also the pelvic floor. Sometimes having an episiotomy can also cause bladder weakness as the muscles have been cut during delivery of the baby.
The good news is, bladder weakness after birth is usually only short lived and once your body starts recovering after having a baby, your muscles will start to get stronger and repair. There are a few ways in which you can try to eliminate bladder weakness whilst pregnant.
Pelvic floor exercises
Pelvic floor exercises strengthen the muscles used after giving birth and can also help to stop incontinence, and make sex better too. Luckily you can do this exercise anywhere, at the supermarket, standing, sitting on the bus, even watching television. Some woman like to have a routine where they do it at certain times during the day, so they know they have done it, for example, every time you sit and feed your baby, or whilst you are sitting eating. The best thing about it is, you can be doing pelvic floor exercises and no one knows!
-Squeeze and draw in your back passage at the same time. Close up and draw your vagina (front passage) upwards.
-Do it quickly, tightening and releasing the muscles immediately.
-Then do it slowly, holding the contractions for as long as you can (but not more than 10 seconds) before you relax.
-Repeat each exercise 10 times, four to six times a day.
Sometimes it helps to imagine you’re stopping a bowel movement, holding in a tampon or stopping starting (or slowing down) the flow of urine while you’re on the toilet. Remember not to actually stop the flow of urine whilst on the toilet as this can be very dangerous.
After you have given birth, health professionals advise woman to wait 6 weeks before starting any kind of exercise. However, you can start doing your pelvic floor exercises straight away. In fact, starting your pelvic floor exercises as soon as you can after giving birth can help your perineum and vagina to heal more quickly, improving and help bring down swelling and bruising caused by delivery. Lastly, (and importantly) it can help strengthen the pelvic floor to avoid any wee accidents however big or small.
When you feel ready to start exercising again, stomach firming can also help strengthen your weakened muscles and pelvic floor. If you have had a caesarean section, you must consult your GP or midwife on when it is safe to start doing stomach exercises again.
Deep stomach exercises
This exercise will help to firm your stomach:
-Lie on your side with your knees slightly bent.
-Let your tummy sag and breathe in gently.
-As you breathe out, gently draw in the lower part of your stomach like a corset, narrowing your waistline.
-Squeeze your pelvic floor at the same time.
-Hold for a count of 10 then gently release.
-Repeat 10 times.
You may want to consult with your GP ifyou are still leaking wee, can’t tighten your muscles, or have any pain. If after your post natal check (around 6 weeks) you are still experiencing any of these symptoms, you may be referred to a woman’s health physiotherapist, especially if your pelvic floor may have been over stretched by having a big baby, severe tear, or forceps birth.
Look at our gurgle guide to post natal fitness for advice on how to start exercising after bith.
Hopefully whilst you are sitting here reading this, you have done a few pelvic floors...
The advice included in the article is for information purposes only. If you have any questions or concerns please discuss these with your midwife, GP, or other medical professional.