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Postpartum Incontinence

Dec 3, 2019

Urinary incontinence stands for involuntary urination or leaking urine.There are 6 different types of incontinence: stress, urge, mixed, overflow, functional and reflex incontinence. The first three could be caused by pregnancy and / or childbirth.The first one is most common - stress incontinence. Many women experience it during the final stages of pregnancy or after giving birth. Urine leaks during activities such as: laughing, coughing, sneezing, lifting, jumping, etc. (physical stress). Urge is when a person has a sudden need to urinate with large volume of urine loss. If she’s not on the toilet on time, she cannot hold it in. And the third one is mixed, which means it is the combination of urge and stress incontinence. 


Why does it happen?


There are many factors that contribute to incontinence. Many women experience it during pregnancy, especially if the fetus has slightly dropped down towards the birth canal.during the final weeks of pregnancy, or simply if the fetus is big and / or very active, thus putting pressure on the bladder. Many women continue experiencing these problems after childbirth because sometimes during delivery the pelvic floor muscles can be practically injured (during long and complicated vaginal deliveries, procedures such as forceps or manual revision of uterine cavity, pushing too hard, big baby, sometimes even C section…) 


What to do if I have it? Can I cure it myself?


It is always a good idea to talk to a licensed physiotherapist that specialises in pelvic floor disorders, or if there is no such person to be found in your living area, you may talk to a gynecologist and a urologist. Good news is that stress incontinence is in 90% of cases completely curable without any surgery. In most cases it is caused by pelvic floor weakness and the only thing you need to do are pelvic floor exercises, also called Kegals. Research shows patients are able to see changes within 6 weeks, but might need to continue doing them for a few more months. It is important however to see a doctor because a patient might be suffering from other problems as well, such as pelvic organ prolapse or diastasis recti.


Is it normal to have incontinence?


Many doctors would say that having incontinence up to 6 months postpartum is normal. However, it is NOT. We need to stop normalizing incontinence. Even though it is very common and oftentimes goes away quickly, it is certainly not normal and it needs to be addressed. 


How often should I do Kegals?


As often as you can. Ideally, you would do 10 reps (squeeze and hold for a count to 10, relax for at least 10 seconds and repeat), 3 times a day. Also, whenever you need to cough, sneeze, lift, laugh, etc, you should first squeeze and tighten those muscles. These exercises are not only good for relieving incontinence, but when those muscles become stronger and more functional,  sex may become more enjoyable, and a person should be able to achieve more powerful orgasms.

 


How can I know if I’m doing Kegals correctly?


When you first start doing pelvic floor exercises, they might feel odd or off, but after some time you’ll get used to them. Also if they are very weak or damaged, you might not even find / feel them at first, but after a few tries, you’ll get there. Be patient and give yourself time to heal. When you perform these exercises, you can activate full length of the  muscle, or you may want to separate it into three parts. First one, in the front. You squeeze and lift the muscles, as if you were about to stop the flow of urine. Next, in the middle, like you want to pick up a tampon with your vagina and pull it up. And finally, behind, as if you were about to stop wind. You may mix them up as you like. Remember, 10 reps 3 times a day. At first it will be difficult to hold the muscles tight for a long time, and you might only be able to do it for 1-2 seconds. That’s OK, take your time. There is no rush in recovery.

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