THE BLOG

Giving Birth Doesn't Mean Losing Control of Your Bladder

05/29/2013 05:20 EDT | Updated 07/29/2013 05:12 EDT
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"It happens to me," "it happens to me," "it happens to me too." These happy, athletic stars of a feminine hygiene commercial could be you or me. There is nothing on the outside that would suggest that these otherwise normal, busy mothers secretly experience LBL or light bladder leakage.

LBL is not really a medical term; it is more discreetly a vernacular invented by the feminine hygiene industry to refer to "lightly peeing one's pants." I don't mean to make fun of an otherwise embarrassing problem, but just between you and me, let's call a spade a spade. Like anything else, there are varying degrees to this challenge. Long gone, for most, are the days of complete kindergarten-like accidents, but for many, jogging, sneezing or heaven-forbid, the thought of jumping on a trampoline are enough to cause annoying or downright embarrassing urinary leakage.

Although not the case for everyone, these symptoms commonly arise following the birth of a baby. Even more commonly, women manage the symptoms in silence after identifying with fictional, yet 'poised' women in a television ad. No one really wants to talk about it, although we are all willing to joke about this "normal right of passage" into motherhood. Like stretch marks and incessant fatigue, we laugh about light bladder leakage like it is a normal part of being a woman -- it is not and it doesn't have to be.

Bladder leakage, prolapse of the vagina or rectum (when the vagina or rectum or both protrude from the body) or chronic pelvic pain are symptoms that many women experience after having a baby, either immediately, within several months or when the hormonal environment changes during menopause.

Regardless of whether you have had a C-section or vaginal birth, the pelvic floor and supporting muscles go through a tremendous amount of strain while supporting the weight of a baby for 10 months. (Yes, I said 10 months!) Vaginal deliveries in particular, pull and stretch the pelvic floor muscles that support the bladder, vagina and lower abdominal organs. Like any other muscle in the body, over-stretching can lead to instability and an incapacity for a muscle to engage the way it is suppose to for normal function. Bladder leakage occurs when the pelvic floor muscles have been overstretched (like an old elastic band) and are no longer able to maintain the appropriate tension or respond to the body's attempt to provide biofeedback. Poise pads and eventually adult diapers are certainly an option, as is surgery for advanced cases. For most women however, a small commitment to rehab, and yes, a discreet internal exam, should be all one needs to get themselves back in their sneakers or laughing once again in a public forum.

For any new parent, the time following the birth of her baby is a joyous yet exhausting transition. In addition to addressing nutrition and appropriate supplementation for a breastfeeding mom, every post-partum visit includes talk of pelvic floor health and a referral to a physiotherapist specializing in pelvic floor rehab and assessment. Pelvic physiotherapy is an emerging area of rehabilitation and disappointedly not one frequently addressed by midwives or doctors at discharge appointments.

Unlike other musculo-skeletal injuries, muscle weakness and damage in the pelvic floor is not something we are aware of due to pain. For many women, chronic deficiencies in pelvic floor strength following childbirth are not noticed until menopause when a lack of estrogen leads to increased laxity in muscles that had been damaged decades earlier. Having an appropriate assessment following the birth of your baby facilitates an opportunity to not only effectively rehabilitate one's pelvic floor, but catch problems before they lead to light bladder leakage down the road.

As I sit and complete this article on the due date for my second child I can't help but dread the inevitable bombardment of stretching that is inescapably coming my way. The prize however is well worth the strain and my physio appointment is already set for mid-July. Let the baby jogging and sleepless nights begin!

You are a great candidate to see a pelvic floor physiotherapist when you:

  1. Have just had a baby (I send ALL new moms for an assessment. Treat the problem before you have symptoms).
  2. Pee, even a little, when you jog, laugh, sneeze etc... regardless of your age or whether you have had a baby
  3. Experience pain with intercourse (speak to your doctor as well)
  4. Experience fecal incontinence (speak to your doctor as well)
  5. Feel a sagging pressure in your pelvic floor or feel like your vagina, bladder or rectum is falling down (speak to your doctor as well)

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