How to Conquer Incontinence and Pregnancy

How to Conquer Incontinence and Pregnancy

Unfortunately, 1 in 3 women has urinary leakage postpartum. There are a few reasons why this happens.

Symptoms of nausea shake off your exercise routine in the first trimester. So does uncertainty about what’s safe. Then, muscles that support your deep core and pelvic floor become deconditioned. Your body’s center of gravity shifts forward. You gain 20-50 pounds. The internal pressure of your abdominal region increases. Then when your baby arrives, it’s hard to find the time to help everything heal. Voila- incontinence.

It is so widely accepted as something that happens with pregnancy, that it’s not often discussed. But just because it’s common, doesn’t mean it’s normal!

There are 4 Kinds of Urinary Incontinence

1. Urge Incontinence

This is when you have to go RIGHT then and can’t hold it. Sometimes this is triggered by a specific environment. Like when you hear the sound of water.

2.Frequency Incontinence

This is when you find yourself going to the bathroom all the time. We want to aim to void every 4 waking hours. While pregnant, you may experience more frequency and that’s OK. This is because of increased blood flow to that area of your body, hormonal changes, and increased bladder pressure.

3.Stress Incontinence

This is leakage with coughing, sneezing, or laughing. It's anything that stresses your deep core from a pressure stand-point. This is the most common form of incontinence, but often, one of the simpler fixes!

4. Mixed Incontinence

There can be a mixture of any of the above. 

If you think you might have any of the above forms of incontinence, there’s good news! There’s a lot that can be done to prevent, treat, or alleviate incontinence.

Performing pelvic floor exercises throughout your pregnancy will help. So will practicing pelvic floor exercises immediately postpartum. These habits may reduce both symptoms and duration of incontinence.

A Cochrane review (the highest level of evidence) concluded that women with persistent urinary incontinence 3 months postpartum who received pelvic floor muscle training were 40% less likely to report incontinence 12 months postpartum. 

Even if you don’t experience incontinence during pregnancy, or immediately postpartum, it can crop up anytime. This can happen from 1-2 years to 20 years down the line.

It’s important to not do too much, too soon postpartum. You can activate the *4 “deep core” muscles right away by:

1.Breathe laterally

 Think about an accordion. Your ribs expand horizontally with an inhale. Your rips knit more closely together with an exhale. This helps engage your diaphragm and take the pressure off the pelvic floor.

2. Be mindful of your posture

This will keep your multifidi muscles active. The multifidi is a braid of muscles that runs along our spine. It's one of the most important muscles for keeping your back stabilized.

3. Pelvic floor range of motion.

 It’s important to Kegel, or lift your pelvic floor, but also to “bear down” and stretch it.

4. Bring your belly button in toward your spine with increased load. 

This activates a muscle called your transverse abdominus. It’s like your body’s natural belly band. You don’t have to draw your belly button in toward your spine consciously, all the time. But if you are lifting something, it’s definitely wise to activate this muscle to protect your back

*Fun fact: It is because of these 4 muscles that the “4” in Train4Birth is named after :)

One thing I see is that proactive moms like to jump back into yoga immediately after having a baby. I urge some caution here. Yoga is wonderful. I am certainly pro-yoga. However, many of the poses involve wide-leg stances and mini inversions. Like downward dog, for example. This can make it a little confusing for your body to know where to re-settle all your internal organs postpartum. Just because you might look and feel ready, doesn’t necessarily mean that everything internally has healed. 

Working with a variety of women in all stages of life has been immensely valuable. A common pattern I see is that women have less time for self-care after childbirth. Nurses, teachers, and other professions where routine bathroom breaks are challenging have more incontinence issues in their 50s and 60s.  

But the human body is amazing. Within a few weeks of pelvic health training, I’ve honestly never seen anyone who made zero progress.  It’s never too late. In fact, if you know anyone, of any age, with incontinence there’s a LOT within the Train4Birth course that's extremely applicable! 

Here are Some General Lifestyle Tips to Help Prevent Incontinence.

•  Avoid peeing “just in case”. This habit can teach your bladder to not be OK with filling up completely. It throws off the rhythm between your bladder and pelvic floor.
•  Avoid hovering over the commode when going to the bathroom. This also sends mixed messages to your bladder and pelvic floor.
•  Avoid holding your breath when exercising. Don't changw positions stressed —just doing this can add a lot of pressure to your pelvic floor! Even if you're wonderfully consistent with your pelvic floor/Kegel exercises. If you held your breath frequently, the two habits would cancel each other out.
• Avoid doing “crunches” to work your abs. This can put too much pressure on your pelvic floor! Please reach out if you’d like me to show you some safer, more appropriate ways of working on your core!
•  If you’re nursing, consider side-lying or semi-reclining positioning, when possible. Leaning forward in a “hunched” position can also put a good deal of strain on your deep core over time.

Summary

Once you’ve been cleared by your doctor, it's important to work with a pelvic health physical therapist. This is important both pre and postpartum. It will help you prevent postpartum complications like incontinence. It will also help you heal properly. This will help reduce your chances of getting incontinence. Even though incontinence is common, it’s not a “normal” part of the pregnancy experience. You don’t have to accept it as your destiny.