“I can’t jump since I had babies!” How many women have said this? Go ahead, admit it. I’ve heard it a thousand times. Friends, doctors, the internet, pad commercials, and social norms all keep telling us that leaking urine after having a baby is totally normal. IT’S NOT! Let me say that again - it is not normal to leak after having a baby!
Yes, it’s common, but not as widespread as you might think. Only 10% of women in their 20s-50s develop urinary incontinence but it does increase with age with 40% of women developing urinary leakage after age 65. But YOU do not have to be one of those women!
There are many causes of urinary leakage but let’s just focus on postpartum. You’ve had a drastic change in abdominal muscle strength just due to stretching of the muscles with pregnancy, and a change in pelvic floor function due to pregnancy postural and weight changes. On top of that a vaginal delivery stretches the pelvic floor in order for the baby to pass through the birth canal.
So what can you do to prevent leaking?
Diaphragmatic breathing. Taking relaxed breaths into the lower ribs and belly improves diaphragm and pelvic floor lengthening. This helps the pelvic floor relax fully and contract stronger.
Kegels. You should be doing a mix of short quick squeezes (muscle contractions) and longer holds that push the muscle to near fatigue. The last few reps should be very difficult. Each squeeze should be a full activation and a full release or we end up creating a shortened muscle that can’t work efficiently. Everyone will start at a different number of reps but an example would be 2 sets of 5 quick contractions followed by 4 reps of 4 second holds. If this is too easy for you you’ll want to add reps or length of the holds. If it’s too difficult, decrease the reps and holding time. Do these laying, sitting and standing 1x/day.
Wear perineal support after delivery. This is something simple such as a thick pad and snug underwear. You just want to gently support the muscles into an optimal position after having been stretched during pushing.
How to stop leaking once it’s started?
Track when you are leaking. If it’s only with coughing and sneezing then it may be as simple as addressing muscle function. If you leak when you have a strong urge to pee then there may be some habit changes that can benefit you (i.e. don’t keep ignoring the urge because you’re busy, or cut down the amount of coffee or soda you drink).
Diaphragmatic breathing and Kegels. See 1 and 2 above.
Find a Pelvic Health PT for a treatment plan specific to you. Give me a call!
Often during the postpartum period treatment is quickly effective and you are able to eliminate leaking in only a few short visits and be confident with your body again!