It astounds us how incontinence after childbirth and leaking is often seen as a normal part of motherhood. We believe that it is time to put a stop to this archaic way of thinking.

We’re making it our mission to tell women everywhere:

YOU DO NOT HAVE TO PUT UP WITH THIS SHIT.

Sometimes, literally!

Urinary and faecal incontinence are, sadly, much more common than you would think, and it is so important to be aware of what you can do to support yourself.

The strength and function of your pelvic floor is hugely impacted by pregnancy and birth – from the weight of a growing child to the exertion, and potential tears and interventions, of a vaginal or caesarean delivery.

Once your baby has arrived, your pelvic floor may not be able to sufficiently support you. And when these muscles are struggling, there is more chance that you will experience leaking, pain and feelings of heaviness or dragging.

What is stress incontinence?

Stress incontinence is leaking when under pressure – such as sneezing, laughing or jumping, and around a third of new mums experience this during their first postnatal year. It could be just a few drops, or it may be enough to leak through clothing and cause severe embarrassment. Stress incontinence can have a real impact on women’s lives if it is not brought under control, in fact there is a clear link between continence and postnatal depression, so it is vital to seek help if this is something you are currently struggling with.

Why am I suffering from stress incontinence?

There are certain factors that mean that some people are more susceptible to stress incontinence than others. If you suffered with incontinence during your pregnancy, particularly earlier on in the first or second trimesters, you are more likely to experience it postnatally too. If you had a long pushing stage, a 3rd or 4th degree tear or an instrumental delivery, you are also more likely to experience postpartum incontinence issues.

How long will incontinence last after childbirth?

It really is different for everyone. Some people find that within a few days they don’t have any issues but, for some women, it can last months or even years. If you are still experiencing issues by the 6-week mark it is advisable to discuss this with your GP and ask for a referral to a Women’s Health Physio, if left untreated, it could cause you problems for the rest of your life. Please remember that this is not something that you simply have to live with and with the right support you can regain control.

What can I do to help prevent postnatal incontinence?

At the hospital when you have your baby you are likely to be given a leaflet that talks about pelvic floor exercises. Pelvic floor exercises or ‘kegels’ are proven to help reduce incontinence after childbirth and are a useful tool in restoring your pelvic floor postnatally. However, they are just one piece of the puzzle and you need all of the other pieces in order to build up a full picture of pelvic floor health.

Before we delve into the many other ways that you can improve your pelvic floor function, first let’s make sure that you can kegel properly.

Kegels aren’t everything, but they’re a good place to start…

How to kegel:

Pelvic floor health isn’t just about strength and it is very important to remember that the release of these muscles is just as important as the contraction. As with any muscle, in order to contract effectively, your pelvic floor needs to be able to release effectively too.

The way you breathe is also crucial to perfecting this exercise and your breathing should be relaxed throughout and not forced or restricted in any way. Your pelvic floor moves up and down with each breath you take – as you inhale, your belly should move outwards slightly, and as you exhale it should move slightly inwards. Your ribs should also move as you breathe, make sure you are not just breathing into your belly.

You can make your pelvic floor contraction more effective by coordinating the movement with your exhale. As you exhale, let your pelvic floor naturally lift and then add in a gentle contraction, like you are trying to pull a piece of spaghetti up your bum! Make sure you are not squeezing your bum muscles, tensing your shoulders or holding your breath. It might not feel like much is happening at first, especially if you have recently given birth, but as you gain strength you will get more sensation.

As you inhale visualise your pelvic floor releasing.

Be sure to release fully in between every single contraction.

The long-term aim is to hold the contraction for 10 seconds and repeat that 10 times.

You can do this exercise 3 times a day.

Is that all I need to do?

As mentioned before, this is only the beginning! How you use your body for the rest of the day is just as important as doing your pelvic floor exercises.

Here are some top tips for looking after your pelvic floor:

1. Consider your posture

When the rest of your body aligns well with your pelvis, your pelvic floor will function better. You want to have your rib cage stacked on top of your pelvis and your pelvis stacked above your ankles to allow everything to function as it should. Pelvic floor health is a full body issue. Everything is connected! Which means that your feet, legs, ribcage and head all have an impact on your pelvic floor. Tension and imbalance anywhere in your body can make a difference to what is happening in your pelvis, so you need to look carefully at your posture, your alignment and the way you are moving day to day.

2. Address your toilet habits

Constipation can cause straining which leads to a lot of problems for the pelvic floor. Make sure you are drinking enough water and eating enough fibre. The angle your legs are at when you poo can also help to reduce straining – think of a toddler squatting to poo in their nappy. Buy a squatty potty or similar so that when you are on the toilet your knees are higher than your hips and you are less likely to need to strain.

3. Move!

All low impact exercise is pelvic floor exercise. Going for a walk every day and being active in your life will ensure your pelvic floor switches on and does a better job of supporting you. When you sit too much, your pelvic floor tightens and then cannot contract as effectively.

4. Coordinate your breath with movement

As you’re aware, when you breathe out your pelvic floor lifts and contracts. Like with any muscle, we build strength by loading it and adding movement. The pelvic floor is not an isolated muscle, it works as part of your whole-body system and should be worked as such. Movements, like squats, can be coordinated with the breath to create a great pelvic floor work-out – simply inhale as you squat down, exhale as you push back up.

5. Exhale on the effort

This is a useful phrase to keep in your mind when you are picking up something heavy, like a baby! If you breathe out, it will help you to control the pressure that is created.

6. Release your pelvic floor

There is always a huge focus on the strengthening of your pelvic floor, but it is important to make sure you are releasing these muscles enough too, especially if you sit a lot.

Here are some helpful exercise suggestions to encourage release of your pelvic floor:

FASCIAL RELEASE

Take a fascia release ball, if you don’t have one, you can use a soft football, and sit on the ball, so your knees are facing forward and your legs are behind you. Sit for two minutes to give the tissue around your sit bones time to soften.

CAT COW

This is a gentle stretch for your pelvic floor. On all fours, in the position of the cat cow Yoga pose, consider the space between your sit bones. When you exhale, try to round your back into a cat position and imagine you are drawing your pubic bone towards your ribcage – notice how the space between your sit bones changes and gets smaller. As you inhale, release back into a flat back and notice again how your sit bones widen and create more space.

Repeat 10-times to really find the movement in your pelvic floor.

GLUT RELEASE

Standing up against a wall, take a spiky ball (you could also use a tennis ball) and massage it into your bum cheek. Your pelvic floor and gluts are really connected and releasing the gluts can help to reduce pelvic floor tension. Look for a tight spot at the top of your bum cheek, this is your piriformis which runs from your lower back to the inside of your hip and is often an area of tension.

We have a range of online and St Albans based classes (COVID restrictions permitting!) to help mums of any age with incontinence after childbirth. Get in touch for more information on our specialist Pilates classes, a great way to improve your pelvic floor health and reintroduce yourself to postnatal exercise.