Introduction
If you experience bladder control problems during pregnancy, you’re not alone! The information on this page is provided to help you start to understand bladder and bowel control during pregnancy and in the postpartum period. Note: This information does not replace seeing your doctor, nurse practitioner or physician’s assistant for an evaluation; rather, it helps you take an active part in your care as you work with your health care practitioner.
Pregnancy
Bladder control problems during pregnancy are very common. Literature reviews report rates of stress urinary incontinence average 59%. When you’re pregnant and a loss of urine occurs at the time you laugh, sneeze or cough, you are experiencing what is called stress incontinence. When you do these things, you are increasing the abdominal pressure on the bladder…then urine leaks out. This can occur quite easily during pregnancy, and especially so when you consider the situation—you likely have been instructed to drink lots of liquid each day, and you have all the baby weight and uterus sitting atop your bladder. Consider too that the bladder and uterus sit atop a group of muscles, commonly referred to as the “pelvic floor.” The bladder is the organ that collects the urine, which is excreted by our kidneys, and then is emptied away through the process of urination. The weight of the baby, your own weight gain, and, eventually, the baby’s delivery, really put a strain on the muscles of the “pelvic floor.” During pregnancy, be sure to give yourself lots of opportunities to void. And be sure to continue to drink lots of fluid—if you don’t, you may be more apt to experience urinary tract infections and/or dehydration.
Postpartum
In the postpartum period, stress incontinence may affect up to 50% of women. Remember, the uterus sits on the bladder, so as it shrinks in the weeks immediately following delivery, it can compress the bladder. Also, hormonal changes also affect y our bladder’s function. In addition, new moms may have an inability to control bowel movements—especially if you have had a long labor.
So—what to do? Do your Kegels! These exercises, developed by California gynecologist, Dr. Arnold Kegel, consist of relaxing and contracting the muscles of the “pelvic floor.” These exercises were first introduced in the 1940’s. But even today, studies show that about 1 out of every 3 women have a hard time in understanding which muscles to exercise. Many women need more than verbal instruction in order to isolate properly. Vaginal cones, such as the StepFree, provide the sensory aid that helps identify those muscles. The program consists of inserting a weighted plastic cone into the vagina (just like inserting a tampon). Contracting your pelvic floor muscles will hold the weight in place. As your muscles strengthen, you increase the weight inside the cone. This system allows you to see for yourself the progress and improvements you are making. The exercises are comfortable and discreet. And an often added benefit of Kegel exercises is an improved vaginal muscle sensation, which can make you more sexually responsive and improve orgasms.
However, if Kegels alone, or Kegels done with the aid of vaginal cones, don’t eliminate the leaking episodes, be certain to let your health care practitioner know. There are other options, such as using a biofeedback device with the assistance of a trained clinician. Once you identify the correct muscles and see improvement, keep up the exercises. These should become a part of your daily routine…you can do them while you’re doing other activities, for example, while washing dishes. You’ll be strengthening your muscles and, unlike other kinds of exercise, no one knows you are doing it!
