Urinary incontinence after birth

How are we treating our pelvic floor?

Guest writer Carolyn Sultana*

Are you thinking that your urinary leakage after pregnancy is so minor it is not worth mentioning? If you’re still experiencing leaks 6-8 weeks after the birth of your baby, tell the midwife or the doctor at you postnatal check. Any urinary leakage whether a small amount with a cough or sneeze or during exercise to larger amounts should be dealt with immediately.  Get referred to a Women’s Health Physiotherapist to start the process of getting your pelvic floor back in shape. 

Your pelvic floor health matters as most leakages happen because of weak pelvic floor muscles.  The pelvic floor is a layer of muscle that spans from the front part of your pelvis right back to your tailbone and its role is to support the pelvic organs, stabilize and control the spine, control continence and ensure sexual sensation and arousal.  The pelvic floor also plays a role in supporting a growing fetus during pregnancy and assist in the birth process.

The pelvic floor can become weak due to a variety of reasons, the most common being pregnancy and childbirth.  Being overweight, constipated, having persistent coughs and practicing high impact sports also predispose to muscle weakness.  Changes in hormones with menopause and older age tend to also weaken the pelvic floor.

A women’s health physiotherapist would ask a series of questions related to the cause, symptoms and precipitating factors of incontinence followed by a vaginal examination to assess the current strength of the muscles.  During the examination, the physiotherapist is able to teach a proper pelvic floor contraction which is described as an inward lift and squeeze around the urethra, vagina and rectum.  There are women who have difficulty performing such a contraction or who are not able to sustain the contraction over a number of seconds.  For such circumstances the physiotherapist can recommend a program of biofeedback training together with electrotherapy that is done under the supervision of the physiotherapist.  The physiotherapist will also recommend what exercise training needs to be continued at home together with providing advice on any home equipment that might speed up the process for your training.

Urinary leakage, however small can have significant effect on the quality of life of the person involved.  Some women would tend to avoid physical activities and social encounters and personal relationships due to fear of leakage and embarrassment causing a decrease in general health of the person.

No one should have to live with the fear of leakage and embarrassment due to leaks and smells.  It is not acceptable that a person has to run to the toilet as she fears leakages or has to change pads or underwear several times daily.  Strengthening the pelvic floor can be achieved if a woman seeks proper supervision and advice.

*Carolyn Sultana is a Women’s Health Physiotherapist and can be contacted on 79962109 and www.facebook.com/WomensHealthPhysiotherapyMalta

Category: Guest posts, Resources for Malta Mums