There’s so much evolution that comes after giving birth – not only do you have a precious little human to care for, your body goes through yet another set of changes. After giving birth, most women are actually shocked to discover that their pelvic floor muscles have weakened and are suddenly difficult to feel.
Pregnancy can change the urinary control abilities for one third to one half of women who have given birth, so if you’re struggling with urine leaking then you’re definitely not alone (1) – in fact, many mothers will understand the familiar scenario of running for the bus praying that your bladder doesn’t burst or crossing your legs every time you feel a sneeze coming on, worrying that you will leak, or have ‘the spritz’ as it’s commonly known (#momsneeze).
Also, a strong pelvic floor is not just needed for preventing urinary incontinence post-childbirth, it can make the second (pushing) stage of labour shorter, prevent back pain, prevent organ prolapse and even improve your sex life! (1)
Types of urinary incontinence
There are two types of urinary incontinence – stress and urge. If you tend to leak urine when you laugh, sneeze, cough, run, jump or lift something, then that’s stress incontinence. The body creates hormones during pregnancy that make your tissues and joints more elastic for delivery. That, combined with the weight of a baby, weakens the strength of your pelvic floor muscles – giving way for urine to flow and leak out (1).
On the other hand, if you find yourself rushing to the bathroom several times per hour even though your bladder is nearly empty, then you’re experiencing urge incontinence – caused by an overactive bladder (1).
If you feel that you’re constantly worrying about leaking, a visit to a women's health physiotherapist can be very helpful – a specialist can give you an assessment of the muscles and guidance on the many treatments and helpful strategies available.
Natural treatment for constant urge to urinate post pregnancy
The good news is that there is a simple, natural way to help you deal with and potentially stop struggling with leaking urine after pregnancy. Exercise is regarded as a top solution for urinary incontinence after childbirth for many. However, if you are suffering with complete loss of bladder control after childbirth, do seek the help of a medical professional.
Specifically, the traditional practice of yoga has a focus on mula bandha, or ‘the root lock’, often considered as the energetic closing of the base of the pot – your body. Mula bandha is a very powerful but subtle practice that links to the physical action required to strengthen the pelvic floor. In fact, women’s health specialists often advise that although kegels are a must for strengthening the muscles of the pelvic floor, there are many other factors we should consider to make them even more effective.
Pelvic floor weakness after childbirth
Here are five things to remember that can help you improve and strengthen the function of the pelvic floor after delivering a baby:
1. Be mindful of your posture
Good posture is very important for the function of the pelvic floor. Tightness in the chest and mid back can affect its function. Think of the body again as a pot, a whole unit that is connected from top to bottom. If the top of the pot is tight and constricted, the bottom of the pot gets over-worked, over-stretched and easily tired. Good posture involves stacking the rib cage over the hips, not slouching forwards or tucking the tailbone under. Yoga helps us focus on how to achieve good posture, and specific poses such as Tadasana (mountain pose) may be particularly helpful. Yoga postures such as twists that encourage thoracic mobility are also recommended.
2. Take complete breaths
The pelvic floor and the diaphragm work together to support full complete breathing and muscle balance within our core. The nervousness of incontinence can often cause us to hold or restrain the breath, but in doing so we weaken the pelvic floor further. In yoga classes, we practice how to be mindful of the breath and learn to take full complete breaths regularly which can therefore help the pelvic floor function.
3. Strengthen your behind
The pelvic floor works best when in balance with the gluteal muscles. Weak buttocks can result in a tight pelvic floor as the muscles compensate to try and bring more stability. A tight pelvic floor exhausts quickly which can contribute to incontinence. Strengthening the buttocks can help to balance the action of the pelvic floor.
4. Remember to ‘scoop’
The pelvic floor doesn't work in a straight up and down action – it is actually most effective if you engage the muscles in a scooping action. Practice lifting the pelvic floor from the back to front. Think about lifting from the back passage up towards the pubic bone and drawing up through the bladder to make the exercises more effective. It may be helpful to come to all fours with the forehead resting on the hands and the hips high to feel the muscles more easily engaging. You should not be sucking in your tummy or squeezing your inner thighs to feel these muscles working.
5. Look after your muscles
There are fast twitch and slow twitch muscles which both need looking after in order to support the bowel, bladder and uterus, and to prevent urine from leaking out involuntarily. This is why a big part of pelvic floor strengthening involves the muscle action of elevating the pelvic floor and holding for an extended count (working the levator ani).
As we age and also after having a baby, we have to work the slow twitch fibres of these muscles to help us maintain a healthy tone. These muscles can also become weaker after abdominal surgery, heavy lifting, hormonal changes or with obesity. This can be done by practicing daily with an aim to achieve a hold of approximately 10 to 15 seconds, when engaging the pelvic floor muscles. From there, try to repeat the move 10 to 15 times in a set.
It is also important to work the fast twitch fibres within our sphincter muscles. Our sphincter muscles can contract with significant force when we cough, laugh, sneeze or jump, for example. These fibres don't require holding as much as a quick contraction and release – you can try to work these fast twitch fibres by following the set of slow holds with 10 to 15 quick squeeze and release movements.
The great news is that often with time and effort, muscular strength can be regained and your pelvic floor can become reliable again. You'll be free to sneeze without having to cross your legs, be able to do star jumps with vigour in your gym class and bouncing on a trampoline may even become a possibility!
To save these helpful tips, Pin This!
1. Journal of Prenatal Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279110/