Pregnancy increases the load on a women’s body but in particular the pelvic floor and bladder. As a result some women experience incontinence for the first time while they are pregnant or can experience a worsening of their condition.
What is the pelvic floor?
Pelvic floor muscles stretch from the pubic bone to tail bone like a sling or hammock. Pelvic floor muscles work with the deep abdominal muscles, the back muscles and the diaphragm to support the spine and control the pressure inside the abdomen (diagram 1). These muscles play the most important role in bladder and bowel control, supporting pelvic organs and sexual function in both men and women.
What is Incontinence?
- Urinary Incontinence: any involuntary leakage of urine.
- Stress Urinary Incontinence: involuntary leakage on effort or exertion such as exercise, or on sneezing or coughing.
- Urge urinary incontinence is the complaint of involuntary leakage accompanied by or immediately preceded by urgency.
Pregnancy and Incontinence Statistics
- 64% of pregnant women experience incontinence yet only 23% seek help.
- 1 in 3 women who have had a baby are affected by incontinence.
- 65% of all women with urinary incontinence during their life report it started either in pregnancy or soon after delivery
- Stress incontinence increases as the pregnancy progresses
- 84% of women attending a Continence and Pelvic Floor Physiotherapist improve pelvic floor strength regardless of age.
Changes during pregnancy
- The growing uterus and weight of the baby increases pressure on the pelvic floor muscles
- Pregnancy related hormonal changes lead to decreases in pelvic floor muscle strength
- The bladder and the urethra become more mobile
- Pregnant women with incontinence have significantly reduced pelvic floor muscle strength compared to continent pregnant women.
- In the 1st trimester normal bladder capacity equals 410ml and by the 3rd trimester it reduces to 272ml.
Recommendations for reducing incontinence during pregnancy and after delivery
International studies recommend the following:
Pelvic floor muscle training
- Pelvic floor muscle exercises are a safe treatment without complications, inexpensive and can be done anywhere, anytime.
- Pelvic floor muscle exercises should be performed during pregnancy and after delivery
- Research shows that pelvic floor muscle training should be 1st line non surgical treatment for women with stress urinary incontinence.
- Up to 70% of women may be doing pelvic floor exercises incorrectly.
- Research shows that an assessment with a Continence and Pelvic Floor Physiotherapist is safe during pregnancy and increases the likelihood of performing the exercises correctly.
- Doing pelvic floor muscle exercises does not affect the way a baby is delivered or potential perineal tears.
- No smoking before and during pregnancy
- Aim for normal weight before pregnancy and regain pre-pregnancy weight after delivery
- Low intensity exercise a few times per week.
- Avoidance of constipation during pregnancy and after delivery.
If you would like further information on how to reduce the risk of urinary incontinence before pregnancy, while pregnant or after delivery please do not hesitate to contact Rathmines Physiotherapy and Sports Injury Centre on 4975-1622.