Guess what? When you are struggling with bladder leaks, you are not alone. In fact, one in three women who have given birth struggles with postpartum urinary incontinence. Just because it’s common doesn’t mean you have to put up with it. If you are one of the many moms to experience this, there are a few things you can do to help, from exercising to avoiding certain foods. We caught up with two incredible experts and asked them what new mothers can do about urinary incontinence after giving birth.
How to deal with urinary incontinence after childbirth
For these questions and answers, we spoke to Samantha Spencer, PT, and Aleece Fosnight, PA, who specialize in Urological Care. Here’s What You Need To Know About Urinary Incontinence!
1. What are some examples of pelvic floor exercises mothers should do after giving birth to manage incontinence?
Samantha Spencer says Keep in mind that stress incontinence and urge incontinence may require different approaches.
Stress incontinence often improves with a combination of pelvic floor strengthening and coordination so that the muscles fire at the right time. Exercises can include pelvic floor contractions (quick movements and longer holds), core exercises that involve pelvic floor coordination, standing up with coordinated pelvic floor recruitment, and mini-jump squats as you work on coordination with your landing.
Here are some resources where you can find examples:
Urge incontinence usually requires a mixed approach. Yes, strength is important, but so is the ability to UNLOCK those muscles. When we have to pee, we often cramp and tense these pelvic floor muscles! You may find that practicing letting go and downtraining your entire nervous system can help you overcome an urge without licking. Practice diaphragmatic breathing and relax your abdominal and pelvic floor muscles as you inhale. Try to do this daily for a couple of weeks – lying on your back, sitting, and the child’s pose are all great positions to practice on. Then, the next time you feel an urge, practice these deep breathing exercises and see if you can let the urge pass before you rush to the bathroom.
Aleece Fosnight also had some great exercise recommendations:
- Kegels are when you lift and compress your pelvic floor muscles. Doing 10 reps three times a day is a good place to start, and then working your way up to 50-75 squeezes a day can keep your pelvic floor muscles strong
- Hip exercises are often overlooked, but they are key to maintaining pelvic health and pelvic floor muscles in women. Clamshells and reverse clamshells with resistance bands are great ways to strengthen your hips.
- Adductor and abductor exercises are also helpful. Take a little exercise or a yoga / pilates ball and place it between your knees and squeeze it. For abductors, use a resistance band around the lower legs and take sideways steps.
- Strengthening your core (including abs and lower back) is a great way to improve your pelvic floor muscles.
- Expert tip! Be careful with postpartum crunches. If a woman has diastasis recti (detachment due to a pregnant uterus), these exercises can weaken the muscles and make the separation worse.
If I do these exercises, when should I start to see improvement?
Both experts agree, you might see improvement right away, or it might take several weeks to notice a real change.
Urgency issues sometimes get better almost immediately when you address bladder irritation and work on down training and loosening those pelvic floor muscles.
Stress incontinence takes a little more time to loosen as the muscles build strength. Once you’ve figured out how to properly contract and relax your pelvic floor muscles and coordinate them with the rest of your body, you should see an improvement in your symptoms within a few weeks that will continue to improve over several months.
2. Certain foods and drinks can irritate the lining of your bladder. Can you give us a list of some of these foods that should be avoided?
Here is a list of foods that should be avoided:
- Citrus (orange, grapefruit, lemon and lime)
- Spicy dishes
- Tomato based products
- Carbon dioxide (including simple seltzer!)
- Artificial sweeteners
3. When should new mothers with urinary incontinence see a doctor? Are there certain things that are normal or abnormal?
As Samantha Spencer says, Urinary incontinence is a signal that your pelvic floor is not working properly. For this reason, it is always a good idea to see a doctor or pelvic physiotherapist for any type of incontinence.
There are some cases where incontinence is more common, but it’s still a good idea to mention this at your next scheduled doctor appointment. For example, up to a third of pregnant women experience incontinence during late pregnancy and early postpartum, and some of this is simply due to increased pregnancy pressures and the early recovery process after childbirth. Research shows that assisting a pelvic floor specialist with incontinence during pregnancy can help you recover faster after giving birth and reduce the risk of persistent incontinence after giving birth.
If you notice incontinence for the first time after giving birth, you should definitely seek support if it does not go away by 3 months after giving birth.
Signs that you should seek treatment right away include sudden severe lower back pain, worsening numbness, tingling or changes in sensations in the pelvic area, hips, or lower body, and loss of control of the bowel or bladder with no sensation. These signs and symptoms could indicate a more serious condition. It is always a good idea to call your doctor if you are not sure about your symptoms.
4. Does urinary incontinence get better on its own?
Both experts agree that incontinence can get worse if not properly examined and treated! Hence, it is very important to see a pelvic floor physical therapist to make sure that you are working in the right direction based on your own body’s needs.
After the first 12 weeks after birth, research shows that urinary incontinence does not improve further without intervention. You can start working on the pelvic floor muscle contraction and relaxation exercises at home, but as mentioned above, it is always a good idea to schedule a check-up with a pelvic floor physiotherapist.
If we ignore incontinence at a young age, these symptoms can worsen after menopause. Estrogen plays a huge role in the health and strength of our pelvic floor muscles, and many menopausal women report an increase in symptoms of leakage, pressure, and other signs of pelvic floor dysfunction. The best way to proceed and be successful in the long term!
5. Can pregnant mothers do something to prevent postpartum urinary incontinence?
Necessarily! Here is something Aleece Fosnight recommends:
- Using a pregnancy belt can help relieve some of the strain on your pelvic floor muscles and support your hips as hormones cause your joints, including your hips, to relax.
- If you’re seeing a pelvic floor PT, they can use KT tape to support the sacroiliac joints, support your growing belly, and help with diastasis recti.
- Stretching is also a great way to prepare your hips and pelvic floor for vaginal delivery.
- Continued exercise will keep muscles strong and supportive – make changes as needed to avoid causing injury or trauma.
- Kegel exercises can be an easy way to keep pelvic floor muscles strong even at the end of pregnancy and can be done on the first day of delivery.
* This post is for information and entertainment purposes only. If you need medical attention, please see your own doctor.
Aleece Fosnight is a PA specializing in urological care and medical advisor with Aeroflow Urology.
Samantha Spencer is a physiotherapist specializing in pelvic health with an emphasis on prenatal and postpartum transitions. She is also a medical advisor to Aeroflow Breastpumps. You can find her rookie mom’s questions and answers about Postpartum Exercise here or connect with her on Instagram and Facebook.