A WEE PROBLEM
Light bladder leakage is an issue for many expectant women and new mums. Here’s how to manage it
All about light bladder leakage and how to manage it
Pregnancy and early motherhood attract all kinds of advice from relatives, friends and even strangers, but not many discuss the fact that you might wee yourself.
Incontinence, or light bladder leakage (LBL), affects one in three women who have given birth. Both stress incontinence (where sneezing, laughing or coughing can make you wee a bit) and urge incontinence (where you need the toilet urgently and can leak a little or a lot) are very common around pregnancy and childbirth.
Women’s incontinence physiotherapist Liz Lush from www.mummyandco.com.au says numerous factors contribute to poor bladder control during pregnancy.
“All the connective tissue in your body softens during pregnancy in preparation for childbirth, including your pelvic floor – the muscles and ligaments supporting your bladder, uterus and bowel,” she explains.
“Sudden changes in muscle co-ordination, such as when your baby has a growth spurt, means your natural bracing ability may not be as sharp as usual. And when you add the increased weight from baby, placenta and extra fluid, the pressure on your pelvic floor can also lead to LBL.”
It’s never normal to leak urine, but the good news is LBL is fixable, Liz says. It can also be preventable.
HERE ARE SOME TIPS ON HOW TO PREVENT AND MANAGE POOR BLADDER CONTROL
CONSULT AN EXPERT
A women’s health physio can assess your individual technique. This is important, says Liz, because some women have weakened pelvic floor muscles, while others are ‘clenchers’ with an overactive pelvic floor that tires from tension.
PELVIC FLOOR EXERCISES
Studies show about one-third of women do the wrong thing when they try to contract the pelvic floor muscles, which should involve a squeeze and lift focused on the urethra and vagina. If you sit on a rolled towel, your perineum (that bit between your vagina and anus) should feel like it lifts up from the towel when you draw in your pelvic floor.
“It should hold while you continue relaxed breathing, and relax properly when you let go,” Liz says. “Clues you aren’t doing it correctly are tight ribs, thighs, buttocks or entire stomach, holding your breath or tucking your bottom under.” Aim for three sets of 8-10 pelvic floor contractions daily, holding for 8-10 seconds.
USE THE RIGHT PADS
Many new mums find buying incontinence pads embarrassing, but wearing one is definitely better than staying home all day or being unable to exercise – and a period pad or panty liner won’t do the job, Liz says. “It’s a bit like the difference between a cheap nappy and a good one,” she adds. “Incontinence pads are designed specifically to absorb urine and draw moisture away from your skin, so it’s worth getting the right product.”
ADJUST YOUR EXERCISE PROGRAM
If you’re used to exercising, you can continue throughout your pregnancy in most cases, although you may have to adapt your regimen as your body changes, Liz advises.
Women who are deciding to take up exercise for the first time during pregnancy should discuss this with their GP or obstetrician. As a general rule, choose low-impact activities such as swimming, walking or pregnancy Pilates over skipping, jumping, sit-ups or planks.
After your baby arrives, trying to whip your body back into shape too soon can make a wee problem a lot bigger.
“Some women take their obstetric follow-up six weeks after giving birth as their clearance to start high-impact exercise to get back in shape,” says Liz.
“But the nerve that supplies the pelvic floor is stretched during childbirth and takes about four months to repair, so to avoid further damage, slow and steady is the best approach until then.”
CHECK YOUR TOILET HABITS
Samantha Cattach, a pelvic health physiotherapist and restorative exercise specialist, says having a quick wee just because you have the opportunity or you’re awake anyway for night feeds is only asking for trouble. “You might need to urinate more with all the extra fluid but most people can go all night without having to use the toilet,” says Samantha.
Squatting is the most natural and efficient way to empty your bladder and bowels, she says. And since the invention of the flushing toilet, most of us have been doing it wrong and putting added pressure on our pelvic floors. To fix this, put a footstool or box in front of the toilet and use it to raise your knees above hip level, she advises.
Finally, avoid constipation at all costs, because straining on the toilet can damage your pelvic floor. Drinking plenty of water and upping your fibre intake may help, but if you are frequently constipated, see your doctor.
DON’T SUCK IT IN
Many of us are experts at sucking in our tummies, but if you do it too much it can interfere with digestion and even weaken your pelvic floor, Samantha says. You might think that squeezing and holding is a good way to strengthen and tone those tummy muscles, but practising how to release tension in your abdomen and pelvis is just as important, she adds.