Urinary incontinence after childbirth

By Fit Right

The birth of a new baby is a wonderful life event, and the beginning of many happy times ahead. However there are many challenges that are faced by a new mother, including the well-known challenges of sleepless nights, breastfeeding difficulties and losing the extra ‘baby weight’. A less widely discussed, but equally challenging issue, is that of stress urinary incontinence.

About one third of women will experience leakage of urine after having a baby. This most commonly occurs with coughing, sneezing or other exertion, which is referred to as stress urinary incontinence. Many women assume that if they have had a caesarean delivery that they would not be at risk of urinary incontinence, however unfortunately simply being pregnant is just as much of a risk factor as the mode of delivery. Other risk factors such as constipation, high impact exercise, heavy lifting in your job, at home or at the gym, and chronic coughing and sneezing can also increase the chance of it developing.

There is good news though! There is now a wealth of evidence that this common and possibly embarrassing condition can be effectively treated with correct pelvic floor muscle exercises and lifestyle advice. Pelvic floor muscle exercises should be done regularly during pregnancy and after childbirth. It is essential, however, that these exercises are done correctly, as incorrect muscle activation may be detrimental. Studies have shown that a large percentage of people were incorrectly activating these muscles when they were only verbally taught pelvic floor muscle exercises.

General lifestyle advice to combat urinary incontinence that all new mothers can follow is to avoid constipation by maintaining a healthy fibre and fluid intake (2.5-3L per day if breastfeeding, otherwise 1.5-2L), minimize heavy lifting, treat coughs and colds early, and return to high impact exercise only after having a pelvic floor assessment done by a specially qualified Physiotherapist. 

A large study was done at the University of South Australia on women with mild to moderate stress urinary incontinence. This study showed that physiotherapy proved effective for 84% of those who received pelvic floor muscle training and lifestyle advice from a qualified Continence and Women’s Health Physiotherapist. The 'cure' rate was still approximately 80% after 1 year, which is comparable to, or even better than, the 'cure' rate reported with surgery (but without the risks of a general anaesthetic and the long recovery period where lifting children is generally prohibited).

It’s easy to make an appointment to be assessed, have an individualized exercise program put in place and be given advice on lifestyle modifications that you can make. Unlike seeing a specialist doctor, seeking help from a specially qualified physiotherapist does not require a referral. To ensure that you are booked in with an appropriate practitioner, make sure that the receptionist is aware that your appointment is for incontinence, or pelvic floor muscle training.

Even if you already have a referral to see a specialist doctor about these issues, getting on the right track with a physiotherapy program while you await your specialist appointment will be invaluable to your long-term outcome. If you do require surgery, it is best practice to optimise your pelvic floor muscle function beforehand.

Urinary incontinence is not just a normal part of having a baby, it can be helped!

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Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.

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