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Women's Health


Incontinence After Childbirth


Getting Total Pelvic Control



October 01, 2009
For some, it happens when they cough or sneeze. A belly laugh will bring it on for others. Some are affected when they're running or doing another physical activity. Yet, whenever urinary incontinence occurs, it's frustrating, uncomfortable—and treatable.

Many people think that urinary incontinence (the involuntary loss of urine) is an older adult problem. Unfortunately, it can affect women of all ages, often resulting during and after childbirth. Many women experience at least some degree of urinary incontinence during pregnancy and some continue to suffer incontinence after childbirth.

"It's very common for a woman to experience incontinence during pregnancy. Her growing belly is putting pressure on the bladder," explains Julie Schnieders, nurse practitioner, St.Vincent Center for Women's Health. "After pregnancy, incontinence problems may continue because childbirth has weakened the pelvic floor muscles. Things have gotten stretched out and it takes a while for the muscles to go back."

Schnieders says a woman's nerves, ligaments and pelvic floor muscles work together to support the bladder and make sure urine doesn't leak out. Overstretching or injury during childbirth can cause them (what's "them?" nerves, ligaments, bladder?) to stop working properly. The length of labor, the size of the baby and the size of a woman's pelvis all may increase the risk of pelvic floor damage, leading to urinary incontinence.

The chance of having urinary incontinence is higher for mothers who have had many children. Women who are obese are about four times as likely to have incontinence, and smokers are also at greater risk because nicotine irritates the bladder lining.

Pelvic health maintenance

For many moms, the leaking stops completely or becomes much less frequent within a few weeks of giving birth. But for others, though, it can persist in varying degrees for several months or even longer. If you are in the latter group, rest assured there is relief.

"It's so important for women to know that this condition is common. They are not alone – and we have non-invasive ways to help address it," says Schnieders.

In fact, women of all ages and stages are encouraged to take preventive measures as part of their pelvic health maintenance. Schnieders advises women to do is Kegel exercises on a regular basis. When done correctly and often enough, Kegel exercises strengthen your pelvic floor muscles, giving you better control.

Kegels are done by firmly tensing the muscles around the vagina and anus. Hold that position for about 10 seconds, then slowly release the muscles and relax for several seconds. Schnieders advises doing 10 Kegel contractions three times a day for three months. Women who do Kegel exercises tend to see results in four to six weeks. In the meantime, women suffering from incontinence should cut down on caffeine, avoid heavy lifting, and use the bathroom often so their bladder doesn't get too full.

In addition to Kegel exercises, there are other general exercises women can do to maintain good pelvic health. The St.Vincent Total Control ProgramTM – designed by a woman who had severe urinary incontinence – teaches exercises to strengthen the pelvic floor. (See box for registration information.)

Taking charge

In more severe urinary incontinence cases, women may need medicines, biofeedback or minimally invasive procedures to help alleviate the problem. Schnieders encourages women to come in and talk to a doctor if their condition lasts more than six weeks after childbirth. The loss of bladder control should be treated or it can become a long-term problem.

"I try to impress on women to get incontinence treated as soon as possible. It affects the activities of daily living and causes anxiety and embarrassment. No one wants to live like that—and they don't have to," says Schnieders.

(Box)

St.Vincent helps women get Total Control!

Total Control, offered through the St.Vincent Center for Women's Health, is a seven-week course (or one-time course with DVD). Total Control helps women strengthen their pelvic floor by exercising the pelvic floor muscles correctly can help reduce stretching injuries to the pelvic muscles and incontinence.

St.Vincent Center for Women's Health

Upcoming One-Day Sessions: Oct. 20, Nov. 17 and Dec. 15

Cost: $75

Register: 317- 338-4-HER

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