Whether you're expecting or have already had your baby, you should be thinking hard about ways to protect and strengthen your pelvic floor. Failure to do so can lead to bladder weakness and stress incontinence. Some women also find that a weak pelvic floor leads to decreased sexual satisfaction.
If you're pregnant and want to make sure you protect your pelvic floor, or want to know how to tone up following the birth, read on for advice from Kari Bø, who hosted our Babyexpert pelvic floors webchat, in association with TENA.
Kari is an internationally renowned physiotherapist and specialist in the research and treatment of women’s urinary incontinence. She has spent 20 years researching this area and treating women with pelvic floor problems.
Q: My pelvic floor is shot after 2 kids and now I'm expecting No 3, I've heard of devices you can use with weights. Do they work? And which is the best? Kari says: It is great to hear that you want to train your pelvic floor muscles and I do not think they are totally gone! You can use devices like electrical stimulation, vaginal weighted cones and biofeedback as adjuncts to your pelvic floor muscle training.
However, the best way is to visit a women's health physiotherapist and have her help you in doing correct and maximum contractions. She would then tell you if you need any adjuncts.
The research in this area tells that there is no evidence that adding these adjuncts to pelvic floor muscle training is giving any additional effect.
Q: I went to see a physio about my back and she started asking me about my pelvic floor. I had to admit that it was weak and I didn't know how to fix it; all the mags say hold for 10 seconds but I couldn't even hold for 3. I have been doing them every day for about 3 weeks but I still dont seem to be able to hold past 5. Can you give me any tips to help me get it back to "perfect" please?
Kari says: It is good that your physio informed you to do pelvic floor muscle training as well, although there is no evidence that it helps for low back pain so far. It is however, very important in preventing and treating urinary incontinence and pelvic organ prolapse.
It is difficult to hold when starting a program. I suggest you train with the help of your physio, and that you use biofeedback to guide you through the contraction. Do not give in, this is how you will improve your pelvic floor muscle strength.
Try also to follow my program on the corewellness dvd and to hold for a longer and longer period.
Q: This is my first pregnancy and although it's early days, I was wondering what I could do to prepare my PF muscles?
Kari says: How great that you want to start to train the pelvic floor muscles during pregnancy. This is the best time, because after birth it is always difficult to understand how to contract as the muscles are then very weak.
You can follow the corewellness dvd throughout pregnancy, but after some months choose another position instead of the one on your tummy.
If you have any problems understanding how to do a correct contraction, ask a women's health physio if she can assess you to be sure to do a correct contraction. Studies have shown that women who do pelvic floor muscle training may have easier birth, and that it prevents urinary incontinence.
Q: I have always been sensitive in the bladder with fairly regular bouts of cystitis and I have recently been diagnosed with an over-active bladder, which I take medication for. I am 30 and will be thinking of starting a family soon but am really worried about what pregnancy will do to my already over-sensitive bladder! What can I do to prevent further problems during this time? Also do pelvic floor toning machines really work?
Kari says: We know that pregnancy will affect an overactive bladderl, as the uterus is above the bladder and the growth of the fetus will put additional pressure on your bladder. However, in most cases this improves after childbirth.
One technique to improve the urgency to void is to contract the pelvic floor muscles as hard as possible and hold this contraction till the urge disappears (this happens due to a reflex inhibition of the bladder wall during pelvic floor muscle contraction), then you may be able to walk to the toilet without leaking. Try also to avoid coffee, tea and soft drinks with sweetners. I hope this can help.
If you are not sure of how to do a correct pelvic floor muscle contraction, please visit a women's health physio, she will help you understand how to do this by assessing your pelvic floor.
Q: I'm having a c-section this Friday. Is there anything I can do afterwards to make sure my pelvic floor is ok?
Kari says: With a C-section it is also important that you train your pelvic floor muscles because you have had the increased weight on the pelvic floor during pregnancy and also the hormonal loosening up of the connective tissue, so do these exericises from now on and continue with regular exercises after childbirth.
Q: Is it better to opt for a Caesarean section rather than natural birth in order to keep your pelvic floor and all those other muscles in better shape?
Kari says: C-section may prevent some of the problems with the pelvic floor arising after vaginal birth. However, also pregnancy itself may cause problems, as you have the extra weight of the baby on the bladder and the pelvic floor muscles and the loosening up of the connective tissue due to hormonal changes.
Hence, c-section does not prevent all incidences of urinary incontinene. Furthermore, a c-section is a surgery and all surgeries also is a risk for both mother and child. It surely does not solve the challenges to the mother of being pregnant and giving birth.
One in four women in the UK experience bladder weakness at some point in their life. Pregnancy and childbirth is a time when this area of the body is under particular stress.
Experts in this area at TENA have devised a series of information pages and exercise sheets to help cope with pelvic floor problems.
If you have been a bit lax with your pelvic floor exercises, don't be ashamed - it is a very common problem. Bladder weakness shouldn’t stop you enjoying your pregnancy or your new baby. With the right products you can go anywhere and do anything without worrying about embarrassing leaks.
The range of TENA Lady and TENA Pants products are designed to keep you fresh and dry, so you can concentrate on your baby rather than your bladder. Why not take a look at the TENA range of products and choose a product that suits you? TENA Lady Ultra Mini Plus are ideal for new mothers. Click for info.
