Postpartum Urinary Incontinence

Published on Jul 7, 2016

Postpartum urinary incontinence is post-baby urine leakage no one wants to talk about.

My patient and her friend who recently had children were in the gym trying to get back into shape. It was a routine that involved jumping, dance moves, and exercises aimed at building their core. Even though the moves were fun and they were getting a lot of good exercise, they suddenly noticed they were leaking urine with workout moves that required any type of straining. They now wear black and stand near the exit closest to the bathroom and buy panty liners by the bulk.

Why some have this issue and others do not?

During pregnancy and labor, muscles that support the pelvis and the pelvic floor muscles come under significant stress. During pregnancy, the weight of the baby causes stretching and pressure. During labor, tearing and damage to the muscle fibers and nerves can cause changes in the support they provide.

In ordinary circumstances, when we sneeze the pelvic floor muscles squeeze and stop the flow of urine. After the damage, the squeeze is a lot less effective and sometimes beyond their body’s ability to repair itself.

What can be done to fix it?

The good news is much can be done to help you with this problem. Pelvic floor exercises during and post-delivery can strengthen the muscles and help reduce the damage and encourage repair. Kegels are one such exercise. Kegels can be augmented with physical therapy to involve the internal and external abdominal muscles and back muscles that contribute to the functioning of pelvic floor muscles.

Weight loss is also crucial to regaining control. Studies show 10% weight reduction reduces incontinence by 40%. A healthy weight loss program is crucial to a healthy pelvic floor.

Surgical and non-surgical options include injection of bulking agents, repair of the defects, injection of Botox, and placement of nerve stimulators and are reserved for patients that do not respond well to conservative management.

OK, I Had My Baby. Now, What is Going to Happen to My Body?

Published on May 11, 2016

Fourth trimester is the three month period after delivery when a mother’s body deals with the residual changes from carrying the pregnancy and child birth. This time period is critical since neglect in correcting these changes can lead to chronic lifelong issues.

During pregnancy, significant changes occur to a woman’s body in order to support the pregnancy, including the following:

  • Swelling of the extremities
  • 25-30 pounds of weight gain (on average)
  • Stretching of the abdomen and the breasts due to the engorgement of the breast glands and growing uterus
  • Hormonal changes that affect mood and a sense of wellbeing
  • Changes in the body resulting in a disfavorable self-perception and body image
  • Tearing forces during labor may compromise control of the bowel and bladder function
  • Sex may become uncomfortable, unpleasant or even painful
  • Desire for sex and libido may suffer in some women
  • A bulge in the abdomen may indicate diastasis recti (an exacerbating hernia or splitting of the abdominal muscles)
  • Persistent back and arm pains affecting mobility
  • Bulging tissue from the anal area and bleeding with bowel movement may indicate fissures and hemorrhoids
  • Other mental, psychological and physical changes that leave the body different than the one prior to pregnancy

By paying attention to these changes, we have solutions that can correct or minimize the after effects of a pregnancy and allow the body to return to its emotional, psychological and physical state.