Managing the mother load
It’s more common than gestational diabetes, varicose veins, haemorrhoids, mastitis, birth defects and postnatal depression, but it’s probably the last thing being discussed in your mothers’ group.
Wetting your pants. Yep, if you thought the indignities of childbirth ended with a cast of doctors and midwives getting up close and personal with your hooha, think again.
Statistics show that one in three women who have ever had a baby wet themselves – and before you congratulate yourself, the ever bit means your risk of becoming incontinent doesn’t necessarily diminish over the intervening years, and can strike at any time.
Why is it so?
During pregnancy, the hormone relaxin is released to soften the tissues in your body, allowing it to expand as the baby grows. It also allows your pelvic floor to stretch during birth.
The softening effect of relaxin and the increasing weight of your baby places pressure on your pelvic floor muscles. This can make it harder for the muscles to hold your pelvic floor organs, i.e. bladder and bowel, in their correct position.
The pelvic floor muscles and ligaments are also stretched at birth, which can sometimes lengthen the tissues permanently, making it harder for the muscles to do their job and prevent unwanted leaks.
You are more at risk of pelvic floor problems if you have had:
- multiple births
- instrumental births (using forceps or ventouse)
- long second-stage labour (over 1 hour)
- severe perineal tearing, or
- large babies (over 4kg).
Essentially, your body’s clever way of adapting to childbirth can leave you with a poxy pelvic floor, unable to withstand the strain of standing up, squatting down, sneezing, laughing, coughing, lifting, jumping, running, walking, cycling or trampolining (dammit) – all of which can put a dampener on daily life.
Fixing the leaks
Despite the mortifying prospect of buying nappies for bub and yourself, most women prefer to ignore the issue and hope it will fix itself.
There are a number of reasons for this, according to continence nurse and maternal and child health nurse Janine Armocida.
“First-time mums are often too busy getting their head around becoming a parent and won’t necessarily know what’s normal, and those with more than one child are juggling multiple commitments and won’t always have time to prioritise their own health needs,” she said.
“Added to that, there is this perception that bladder leakage after pregnancy and childbirth is normal and can be managed with pads or by avoiding triggers like exercise.
“Bladder leakage might be common, but it should never be accepted as normal and needs to be treated.”
The good news is the problem can be fixed in most cases, with no cost or surgical intervention.
“Pelvic floor muscle exercises are a really effective way to maintain your pelvic floor fitness both during and after pregnancy,” Armocida said.
“Good pelvic floor muscle tone has been proven to assist in maintaining bladder and bowel control throughout pregnancy. A strong pelvic floor also helps reduce the risk of developing a prolapse during or after pregnancy, and assists with recovery after birth.”
How to exercise your pelvic floor
Pelvic floor muscle exercises will only work if they are done correctly, so it’s worth starting slowly to make sure you nail them. Read how to do them here or watch a short instructional video by pelvic floor physio Shira Kramer.
If you are still unsure, it’s best to check in with a pelvic floor physio to check your technique. There is a national directory to help you to find one closest to you.
As a maternal and child health nurse, Armocida has seen her fair share of mothers and babies, and knows the negative impact bladder leakage can have on mums.
“Having a baby can already be a socially isolating experience. Being too scared to leave the house in case you wet yourself in public just adds another layer of stress to an already demanding time,” she said.
“Studies show a link between incontinence and postnatal depression, so it’s not something to ignore. I always make a point of checking mum’s health, as well as bub’s. It’s generally something you have to ask about because people are too embarrassed to raise the issue, or mistakenly think it just goes with having a baby.
“They are always so relieved to learn it’s something they can treat and it’s not something they have to put up with it for the rest of their life.”
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