Most women who have given birth experience issues later in life that directly relate to birthing children. One of these issues is not talked about much, even between women who are experiencing it together. And not many of us were warned about it from our mothers. Maybe they were afraid if they told us what could happen to our bodies, we wouldn’t give them those grandchildren. However, the condition I am referring to can happen to all women, not just the ones who have borne children.
I am referring to urinary incontinence, of which there are two types.
Stress incontinence happens with increased pressure in the abdominals or on the pelvic floor when we sneeze, cough, laugh, bend over, lift, jump or do certain exercises (trampolines can be brutal). Tension is created in the core and our muscles are not able to contain it.
Urgency incontinence occurs when we really need to find a bathroom, and/or we don’t quite make it onto the toilet in time (usually just some leakage but sometimes more drastic). Because of this urgency, women with this condition will try to find a bathroom at the slightest feeling of a full bladder and often getting up to pee several times at night. A lot of middle age and older women cut down on their liquid consumption because of this and get dehydrated, which causes additional health issues.
Urinary incontinence can be helped with medications but they come with side effects. If prolapse is causing the incontinence surgery may also be an option but I feel that the first approach to correcting this should be through exercising the muscles in the pelvic floor.
The pelvic floor is a group of intertwining muscles that tighten and relax enabling urination and bowel movements. Without strong enough pelvic core muscles, the bladder, bowels and uterus can fall out of place. This is called prolapse, which generally occurs for women who have given birth to multiple (or large) babies.
Specialized pelvic floor physiotherapists can help women learn to activate the many different muscles in their pelvic floor to prevent or help with prolapse. Kegel exercises are one type of exercise and important for all women to do, especially those who have borne children, but there are also other exercises that focus on all the core and pelvic floor muscles that are barely discernable to us. These should be taught by a physiotherapist who specializes in this area.
If you can stop urination in mid-stream, you are using the muscles that are developed by doing kegel exercises. According to Priya, the pelvic floor physiotherapist at UNBC Hospital, lying down is the best way to start the kegel exercise. One can progress to sitting, standing and then doing them throughout daily activities, as the muscles get stronger.
Once you have discovered which muscles you are contracting, exercise them several times a day if you can 10-20 contractions each time, holding each contraction for 2-10 seconds and resting between contractions for several seconds progressing to hold of 10 seconds. There are many videos online that explain proper technique. Pelvic floor strengthening is important enough to set a reminder on your phone.
There are other physical conditions that occur for women after childbirth, diastasis recti being one of them. Post-natal physiotherapy can help determine if there is anything that should be addressed to prevent long-term physical issues. All women who have given birth, whether vaginally or through c-section, should ask for a referral to a physio who specializes in post-natal care.
Breathing correctly is another way to engage the muscles in your core that help with pelvic floor issues.
In addition, menopause is a time of hormonal shifts as estrogen levels begin decreasing, which is why post-menopausal women are more susceptible to incontinence and overactive bladder.
Estrogen plays an important role in assisting with the function of the detrusor muscle which controls the release and flow of urine. These estrogen level changes may also play a role in some types of pelvic organ prolapse. It is believed that up to half of all postmenopausal women may experience vaginal atrophy (thinning of the vaginal wall), causing symptoms such as vaginal dryness, irritation, itching, and painful sex.
Pelvic floor disorders like incontinence and prolapse can significantly affect women’s quality of life and make some women hesitant to exercise for fear of exacerbating their symptoms. However, with the proper pelvic floor exercises and life-long health maintenance many of the issues can be avoided.
Incontinence doesn’t heal on its own. If you want to avoid wearing a Depends-type garment (for as long as possible), please get a referral from your doctor to see a pelvic floor physio.
Thank the mothers you know, as they all have all endured physical strain to bear their children, some of which have become life-long issues (the body stress — not the children (wink).
Here’s to the mothers — may they feel appreciated and worthy enough to take care of themselves.
Claire Nielsen is a health coach, author, public speaker and founder of www.elixirforlife.ca. The information provided in the above article is for educational purposes only and is not a substitute for professional health and medical advice. Please consult a doctor, health-care provider or mental health practitioner if you're seeking medical advice, diagnoses and/or treatment.
