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It can be hard during pregnancy to imagine the day when it will end and there’s a baby to hold. This is especially true when pregnancy is uncomfortable and far from being a joyful time. Many women find pregnancy challenging, the changes to their body difficult to cope with and they long for the day their baby is born and they can have their body back.
Unfortunately, not all pregnancy related discomforts disappear once the baby arrives. Around 30-50% of women who have a vaginal birth will have permanent changes to their pelvic floor. The influence of pregnancy hormones, increased weight and changes to the ligaments and muscles in a woman’s body can all mean there’s work to be done to restore strength and tone.
The pelvic floor, quite literally, does most of the heavy lifting when it comes to supporting the baby. This means the organs supported by the sling of muscles sitting in the mother’s pelvis can change from their usual position if the muscles don’t hold them up and tight. The bladder, bowel and uterus can shift, causing changes in their function.
Forceps delivery or assisted birth, or having a large baby e.g., >4 kgs and/or a long second (pushing) stage of labour can also increase the risk of pelvic floor problems.
And although some women seem to bounce back in weeks, most women take up to six months or more to feel their body is getting back to what it once was. Many need to do exercises for a weak bladder by doing daily pelvic floor exercises.
The Internal Sphincter is a small opening at the base of the bladder which works like a valve. The urethra lets wee pass from the bladder out of the body. There are two urethral sphincters and their role is to control and release wee from the bladder. Having an overactive bladder, spasms and bladder irritation can all affect how well the urethra and the sphincters work in holding wee inside the bladder. Women who are having their first baby, who’ve had a long labour or who already have weak pelvic floor muscles are more likely to have incontinence. This is why it’s not uncommon for women who’ve had a baby to say, in the middle of a laughing session “please stop making me laugh, I’m peeing in my pants”.
One in three women who have had a baby will wet themselves. And for many, this is not a simple issue which will go away with time. Pregnancy itself can cause pelvic floor problems and with a vaginal birth, there’s additional stretching of the muscles as the baby is born. Even women who’ve had a caesarean section can experience bladder leakage.
Just like any other type of exercise, it takes time and repetition to feel the results. You may not sense you’re getting anywhere for the first month or so, but generally women find their pelvic floor strength and tone improves after six to eight weeks of repeated practice.
Written for Poise by Jane Barry, Midwife and Child Health Nurse 03/06/2021
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