A WEE PROB­LEM

Light blad­der leak­age is an is­sue for many ex­pec­tant women and new mums. Here’s how to man­age it

Mother & Baby (Australia) - - Contents -

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.

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