Do you have wee-wee woes?

Do you leak (urine, that is) a little when you laugh, cough or jump? Do you have a sudden, strong urge to urinate? Do you wake more than 2 times to go to the toilet at night? Sound familiar? Well, firstly you’re not alone! Secondly, leaking is not an inevitable part of parenthood or ageing. In the majority of cases, it can be reduced, if not reversed. So, where do we start?

What and where is your pelvic floor?

Your pelvic floor is a sling of muscle and connective tissue that runs from your pubic bone at the front of your pelvis, to your tail bone at the back. Its purpose is to support the organs of the pelvis, i.e. the bladder, uterus and bowel. It also works to close off the opening at your bladder and bowel that helps maintain continence.

What happens during pregnancy?

During pregnancy your body releases hormones that soften the tissues in your body, allowing it to expand to accommodate your growing baby. The softening effect on tissues and the increasing weight of your baby place pressure on your pelvic floor. The pelvic floor muscles and connective tissue are also stretched at birth. This makes it harder for the muscles to do their job.

What to do?

The first thing to do is to start exercising your pelvic floor and keep exercising it for the rest of your life. It is like any other muscle; use it, or lose it!

How to contract your pelvic floor: Imagine that you are trying to stop the flow of urine or stop passing wind. Feel the squeeze in your muscles down below. This is a pelvic floor contraction. Now try and add a little lift to that squeeze. So squeeze in, lift, hold for 5-10 seconds, drop and relax. It is just as important to relax your pelvic floor after a contraction so it is ready for the next one. Three times a day, aim to do 10 quick squeezes and 10 squeeze, lift and holds for 10 seconds. Keep breathing! Holding your breath increases the pressure inside your abdominal cavity and puts more stress on your pelvic floor (that’s not what we’re after!).

NB: It is really important that you do not bear down (i.e. try to push, like the way you would if you were constipated, or having a baby!). The correct technique is vital, so if you are at all unsure about whether you are doing your pelvic floor contractions correctly, it is best to consult a women’s health physio or continence nurse. They can check it out and give you feedback to get you going in the right direction!

Once you have your pelvic floor muscles going, try to switch them on before you laugh, cough or sneeze and before you lift anything. If you have already had your baby, be aware of all the lifting that is involved with prams, capsules, and even just your baby – and make sure you switch on your pelvic floor before you lift.

What else to think about?

It is important to maintain good bowel habits and avoid constipation because straining to open bowels can put pressure on your pelvic floor and cause weakening. So be sure to eat a healthy diet including a lot of fruit and vegetables, maintain adequate fluid intake and take the time to open your bowels. It is easy for busy new mums to ignore that urge to go or not take the time to empty bowels completely and this may lead to constipation.

A final note…

There is still a lot of taboo around discussing bladder and bowel issues and the fact that one may occasionally wet oneself! And it is not normal despite that nearly all the mums in your new mothers’ group can relate! The only way we can break this taboo is to discuss these issues openly and not to be embarrassed. Remember, you are not alone. If you have any issues with your bladder or bowel, the best thing to do is have a chat to your GP, women’s health physio or continence nurse. In 90% of cases something can be done to improve, if not fix the problem. It is not something that you have to live with. By seeking help early you will not only be helping your condition now but preventing further decline in the future.

For more information and some great apps check out The Continence Foundation of Australia or phone the National Continence Helpline on 1800 330 066.

Sharyn Wappett
B.App.Sc (Physiotherapy)
Member of the Australian Physiotherapy Association (MAPA)
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