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July 28, 2016

Bladder weakness isn't usually something that new mums love talking about but it is common after pregnancy and birth, and if it's affecting you then it does need to be addressed. A survey by Physiotherapy New Zealand revealed that one in three women who have had a baby will experience some form of incontinence. This is because the pelvic floor muscles get seriously stretched during pregnancy and don't always bounce back It can be anything from a mild annoyance that makes you feel the need to cross your legs when you sneeze to a debilitating problem that stops you wanting to leave the house.

What’s my pelvic floor?

If your pelvis is a bowl, the pelvic floor muscles are the base of the bowl. The pelvic floor muscles are like a hammock which supports and controls organs including the bladder, urethra, rectum and vagina. Your pelvic floor keeps your internal organs inside, stops your bladder and bowel from leaking, and helps you orgasm more easily. The pelvic floor muscles start out strong and springy, but over-stretching can cause them to lose their elasticity and strength. A weak pelvic floor can cause problems ranging from a lack of sexual satisfaction to a leaking bladder or even a prolapse where one or more of your organs sags down into your vagina.

Why does it happen, and who is at risk?

While most women experience some slight incontinence in late pregnancy, it should resolve itself shortly after birth. But for many mums, it continues as long-term bladder incontinence – you leak a tiny bit when you sneeze, wear a pad when you go running, or avoid jumping on a trampoline. Most new mums will experience one or two of the symptoms of pelvic floor weakness during or immediately after pregnancy, but the the following continue, they point to a weak pelvic floor:

  • A little bit of pee escaping unexpectedly, such as when you sneeze, cough or during exercise
  • Lack of feeling during sex or genital numbness
  • Flatulence escaping unexpectedly, such as when lifting your baby
  • Needing to urinate very often, not being able to hold it in for long and needing to run to the toilet

While any woman who has had a baby is at risk, these additional factors can work against you:

  • A traumatic birth
  • A family history of incontinence
  • Being over 35 at the time of your first baby's birth
  • Obesity
  • Smoking
  • A chronic cough
  • Many years of heavy lifting
  • Ongoing constipation

The good news is that exercising these muscles can make a huge difference - studies show physiotherapy in the form of pelvic floor muscle training can have up to an 8- percent cure rate of stress incontinence! The bad news is that according to the research New Zealanders have never exercised their pelvic floor muscles and only nine percent do daily exercises.

What can I do?

Advice for strengthening your pelvic floor muscles from physiotherapist Jane Le Fevre:

  • Find your pelvic floor

The pelvic floor runs from your pubic bone at the front of your pelvis to the coccyx at the back. Imagine the doors closing together and then lifting towards your head. The rest of your body stays still.

  • Practise gentle lifts throughout the day

Practise lifting during the day, at the sink while washing your hands, at your desk, not just lying down at the end of the day. Work on connecting with it and then seeing if you can hold it for fie seconds. As it's an internal exercise, no one will know you are working out.

  • Combat coughs and sneezes

Strong contractions are needed to resist high loads on your pelvic floor, such as coughs or sneezes. So if you feel a cough or sneeze on it's way, lift your pelvic floor as strongly as you can and try and keep it lifted while you sneeze. If at first this is a bit difficult, scrunching your toes in your shoes can help you to get a little bit more oomph.

  • Practise, practise, practise

If you don't use it, you will lose it! Imagine a hose flowing with water lying on a trampoline. If the trampoline is floppy, when a foot comes and steps on the flowing hose, the flow will continue as there is no resistance from the trampoline. Now imagine the trampoline is strong, a food stepping down on the flowing hose will be met with some resistance so the hose will be bent and the flow will stop.


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