It’s one of the things that no-one tells you, but pregnancy can have a big effect on your bladder, and your ability to hold on to your wee! If you have friends who have had children, a sister or even your mum, you may have noticed a look of embarrassment after they sneeze, or laugh hard… and as for trampolines – well they’re just a no-no for many of us!!Â However there are steps you can take during your pregnancy and immediately after to limit the effect that your pregnancy and birth has on your bladder and your pelvic floor…
The best way to avoid bladder problems after your baby is born is toÂ do exercises to strengthen you pelvic floor muscles every day during the last few months of your pregnancy. The pelvic floor is a hammock of muscleÂ that stretches from back to front and side to side under the womb, bladderÂ and bowel and it helps to keep the outlets from the bladder and bowelÂ closed. The more familiar you are with these exercises before you giveÂ birth, the easier it will be to get the pelvic floor muscles working againÂ afterwards.
Some women get a urine infection during pregnancy â€“ you may get symptoms of discomfort in passing water. If this happens to you, get promptÂ treatment for it: your doctor should prescribe antibiotics to rule out any risk of the infection taking hold. You can take precautions to avoidÂ urine infections by good habit and hygiene:
- After you have had a bowel motion, always wipe yourself from frontÂ to back, so that any bacteria are washed from the urethra and vagina.
- Do not delay passing water unnecessarily: it is normal to empty theÂ bladder up to eight times in 24 hours, perhaps more often during pregnancy.
- Do not restrict your fluid intake: during pregnancy and breast-feeding,Â you should drink more than usual â€“ about 2-3 litres a day. (TheÂ usual figure is about 2 litres.)
- Try to avoid getting constipated both before and after having yourÂ baby by eating plenty of fresh fruit and vegetables. If you do becomeÂ constipated, do not get into the habit of straining: ask your doctorÂ or midwife for advice on a mild laxative.
Other things being equal, a Caesarean section carries less risk than natural childbirth to your later ability to control your bladder and bowels.Â But a Caesarean section is an operation with risks of its own, and so the increased (but still small) risk of bladder and bowel control problemsÂ can only be one factor in your decision.
If you have had an epidural anaesthetic, it will take longer for sensation to return in your bladder than elsewhere in your body, so that you mayÂ not realise that your bladder is full. Often after the birth women are fitted with a narrow tube (a catheter) to drain the bladder. If not, andÂ you leave it too long, your bladder may get stretched, with a risk that you could do some permanent damage. The answer is simple: make sure thatÂ you try to empty your bladder two or three times during the first eight hours after delivery even if you do not feel the need. If you are passingÂ only small amounts of water, ask the nurse of midwife for advice.
After giving birth
Carrying and then pushing out your baby has stretched your pelvic floorÂ muscles and weakened them. So you should start doing your pelvic floorÂ exercises again soon after your baby is born. Indeed, you should makeÂ them a permanent part of your daily life.
- In the first weeks after your babyâ€™s birth you should avoid anyÂ pushing down movements that might strain and weaken these important musclesÂ again.
- The only downward movement you should allow is when you are opening yourÂ bowels.
- When you do open your bowels, hold a pad of toilet paper firmly againstÂ the area just in front of your back passage. This will stop your pelvicÂ floor muscles from being over-stretched when you bear down. You may alsoÂ find it helpful to lean forwards with your feet on a footstool.
- If you are able; squeeze, lift and hold your pelvic floor muscles justÂ before and during a sneeze or cough. This is called “the knack”.Â Try to do it when you blow your nose or lift anything.
- If you want to do any exercise or go to a gym, do not do high impactÂ aerobics or lift heavy weights.
For more information and support you can call the Continence Foundation on 020 7831 9831. Telephone lines are open from 9.30am to 4.30pm every
weekday and staffed by specialist nurses.Â Alternatively take a look at the ContinenceÂ Foundation website.