Will a caesarean protect me from pelvic floor complications such as bladder leaks?

The joys of motherhood!

When preparing for childbirth, you can receive a lot of advice. But what is often not discussed during pregnancy or pre-birthing classes is the topic of incontinence post birth. Yet, women who have delivered a baby vaginally are twice as likely to develop stress incontinence compared to women who have delivered via caesarean[1].

Stress incontinence results in urine leakage when you laugh, cough, sneeze, jump, or lift heavy objects.

While caesarean births may reduce the risk of stress incontinence by protecting your pelvic floor muscles to some degree (particularly for first time mothers), they do not make you immune to challenges like incontinence and prolapse.

This is because pregnancy itself adds a heavy load on the pelvic floor muscles – increasingly stretching them. Added to that, the more frequent visits to the bathroom, tend to weaken the pelvic muscles (because when you don’t use them – you lose them). And for the trifecta – hormonal changes can affect muscle strength in your pelvic area, resulting in a loss of bladder control. All of these changes are experienced by women who give birth via c-section.

Some women receive the added bonus (NOT) of having to push during labour, only to then have a caesarean due to complications. Meaning, your pelvic floor muscles are strained and then layers of adhesion are required to close the C-section, which can impact a body’s core function, including that of the pelvic floor muscles.

Because apart from nerves and connective tissues, other muscles help the pelvic floor work. Including your diaphragm, your glutes, the adductors, and your abdominals. These all need to be strong, coordinated and flexible to help your pelvic floor muscles work their best.

Five key take-aways:

  1. One in three women, who have given birth, will experience bladder leakage.
  2. The stress of pregnancy and childbirth weaken your pelvic floor muscles.
  3. There is no guarantee an elective caesarean will prevent incontinence.
  4. Pelvic floor exercises are important both pre and post birth, because healthy, fit pelvic muscles before the baby is born will help the body mend more easily after the birth.
  5. Bladder leaks happen. They are pretty common. You can work to improve your pelvic floor muscles, but it’s not a quick fix.

Due to the joys of childbirth (among other things), sometimes we all need a little back-up protection. And that’s ok! Live life with confidence, freedom and control with Vivo Bodywear’s reusable absorbent underwear. 

Don’t let bladder leaks stop you from living life.

[1] https://www.sciencedaily.com/releases/2016/02/160223074738.htm

Why does my bladder leak when I’m coughing?

Alas, just standing on two legs puts pressure on your pelvic floor muscles. When you increase that pressure, through activities such as coughing, sneezing, laughing, and lifting, then it puts even more stress on the bladder and urethra, resulting in – you guessed it – bladder leakage!

Did you know?

That your pelvic floor muscles support a trifecta of goodness!
Yes indeedy! They support your bladder, bowel and uterus.

Experiencing bladder leakage while coughing is often related to having stress urinary incontinence. This is different to having an overactive bladder, where you get a sudden urge to pee and can’t control it before you get to a bathroom. This is caused by an abnormal contraction in the bladder, and it’s called urge incontinence.

One in three women who have given birth experience bladder leakage, as the stress of pregnancy and childbirth can weaken your pelvic floor muscles. But women are not alone. One in ten men also don’t have full control of their bladder for a variety of reasons.

It’s not just childbirth that can increase the risk of urinary incontinence. There are a number of other elements that put extra pressure on your pelvic floor muscles, which in turn increases the risk of bladder leaks. Including:

  • constant straining with number two’s –a big No No!
  • going to the toilet just in case (or too frequently), can weaken your pelvic floor muscles, because you are not letting your body use these muscles. Use them or lose them!
  • having a pelvic prolapse
  • carrying extra weight, which strains your pelvic floor muscles
  • smoking, which can lead to frequent coughing
  • lower back pain.

In addition to straining your pelvic muscles, there is the added joy of aging, which brings other issues into the equation that increase your likelihood of having bladder leaks, such as:

  • hormone changes
  • menopause
  • arthritis
  • dementia
  • diabetes etc.

And let’s not even get started on how consuming bladder irritants (such as caffeine, alcohol, carbonated drinks, and spicy/acidic foods) can irritate your bladder! What a minefield!

Another tricky element is that bladder leakage is rather unpredictable. Which is very unhelpful.

But there are some things that you can do to minimise bladder leakage. Check out last week’s article to find out more. Just tap HERE.

Should you need a little back up protection while strengthening your pelvic floor muscles, then try Vivo Bodywear! Hands down – the best bladder control underwear you will find!

Bladder leaks – speak up! Don’t suffer in silence.

Next week is Continence Awareness Week (from 15-21 June).

So I thought it would be a good time to share my story in the hope that we can get more people talking about bladder leaks in a more open and accepting manner.

Now I have two amazing children, who I love and adore. But they both came out ginormous! I am not kidding – they came out looking like toddlers! It was not ok. And as a result, my pelvic floor muscles were demolished!

For years I didn’t tell anyone about my bladder leak problem. Well, I mentioned it to my doctor every once and awhile, but I was told it was just normal.

One day I experienced a super embarrassing underwear leakage moment during a team building work rugby match. My pride took a big hit that day and so did my desire to ever exercise again.

So, I went back to my doctor and said that something needed to be done! I felt humiliated and at my wits end. Finally, I was referred to a specialist to get the mesh sling surgery. I was so excited. I thought it would fix everything instantly. But alas, my surgery ended up being postponed three times. And since the recovery time is 6 weeks off work – it was a logistical nightmare to manage the continual delays. I thought that maybe the universe was trying to tell me something. Consequently, I took myself off the waiting list and I continue to thank my lucky stars because I have heard so many bad stories about the sling surgery.

I now manage my bladder leaks in six key ways:

  1. With pelvic floor exercises. Where I’m currently focused on establishing a system to remember to do them.
  2. Bladder re-training, which I must say, also requires mental re-training because the concept of ‘go wees – just in case’ has been hard-wired into my brain since I was a child.
  3. I exercise early in the day before I have had anything to drink.
  4. I wear re-usable/washable leakproof underwear/pads/liners.
  5. I replace known trigger bootcamp exercises, such as star jumps, skipping and jumping jacks, with other exercises like froggy squats, reverse lunges, or an ab workout.
  6. Lastly, but most importantly, I am a lot more open with friends, family and even new acquaintances about my bladder leak problems.

Because realising how common it was – made me want to reduce the shame and stigma surrounding it. When you think about it because incontinence affects 1:3 women and 1:10 men, it’s really quite common. Yet, still we are embarrassed to talk about it. It’s not fair.

I thought that I could help a little by setting up a confidential facebook community group. Where members are encouraged to share their story and feel normal amongst their peers.

If this sounds like a group that you could benefit from – please join us today!

Incontinence │ light bladder leakage – tips, support and shared stories

Why talking about your bladder leakage problems can be beneficial

Humans aren’t perfect. We all have faults. I have a million!

Many of us have medical conditions and incontinence is just another medical condition. Unfortunately the word ‘incontinence’ has negative perceptions surrounding it, so I’ll ease us all in with a more user friendly term – bladder leakage.

I experience bladder leakage. Especially when I run, laugh uncontrollably, or sneeze. It’s embarrassing and I feel shame when I think about how I may be perceived.

For many years I did not tell my husband about my bladder leakage. But I can now tell you from experience that trying to keep it a secret is far more stressful than just getting it out in the open. If you have someone close to you and are scared to tell them about your bladder leaks, I strongly encourage you to tell them today!   

Why you ask? Here are three key reasons:

  1. I know it’s a cliché but talking about our feelings can really help. Yes, its true – and backed up by extensive research too. Talking through your experiences and putting your feelings into words has a positive impact on both your brain and your body.

    Because when you keep your feelings bottled up, this can then cause issues to escalate in other areas, for example, in your relationship.

    Furthermore, holding in the negative thoughts, anxiety and emotions can make you more susceptible to getting sick or feeling out of sorts.

    On top of that – holding in negative thoughts (especially ones targeted at yourself) can take your precious mind space away from more creative positive thoughts and energy.

    So be mindful of your internal negative thoughts. And to stop them before they take hold. 

Don’t forget – you get to choose how you feel about yourself.  

  1. It’s not just about helping you – it’s about helping the millions of other people who suffer from incontinence and are too ashamed to tell a soul. Sharing what you are dealing with in daily life can help you and others with the same struggles to realise that you are not alone, and what may feel overwhelming, is pretty standard for many people.

Remember one in three women and
one in ten men experience incontinence.
We are not alone. In fact – it’s really quite common!

  1. Lastly, sharing your bladder leakage problems with your partner, a trusted friend, a continence nurse, or a physio – can help you map out an improvement plan. This could present itself in many ways. It may be your physio suggesting medical options that will work, or it could be a friend giving you great tips on how to remember your pelvic floor exercises, or it may result in having your partner being more understanding about your needs e.g. why you want to do physical activities with the family first thing in the morning before you have too much liquid in your bladder.  

I admit – it can feel embarrassing and uncomfortable the first few times you share, but the more times you open up, the easier it will become. Try it today!

The do’s and don’ts – of dealing bladder leakage

Do seek medical helpIf you haven’t sought help – put this as a priority. Go to the doctor, your local continence nurse, or a physio.  
 2Do your pelvic floor exercisesStart today! Squeeze and draw-in the muscles around your bottom hole and your girly-parts at the same time. Lift them UP inside – all the way. Hold them strong and tight for 10 seconds. Relax and repeat 10 times (3 times a day).
 3Keep active and strengthen your coreSome activities are better than others. Yoga and pilates are two activities that are great for strengthening your core and they have the added benefit of incorporating mindfulness and relaxation. This is partially helpful – as incontinence is often connected with anxiety and depression.
 4Minimize bladder irritantsUnfortunately, caffeine, alcohol, carbonated drinks, and spicy/acidic foods can irritate the bladder and make leaks worse. If you find this to be a hard one to change – YOU ARE NOT ALONE.
Don’t strain with number 2’sTry to keep your bowel movements regular, because being constipated or straining while going number 2’s can overstretch your pelvic floor muscles and make urinary incontinence worse.
 6Avoid liftingLifting strains your pelvic floor muscles – so avoid it whenever you can.
Not such a bad thing. Ask for help!
 7Re-train your bladderOften your bladder is only 60% full when you get the urge to go pee.
Train your bladder to hold more urine without leaking by delaying your pee past the point of your urge to go. First try to delay by five minutes. Then aim to build up to twenty minutes or more. While you wait – take a few deep breaths and do a few pelvic floor exercises.
 8Wear something that won’t limit your activitiesReusable pads or leakproof underwear provide helpful backup support for you to rely on while you are working on the options above.  
 9Surgical treatmentSurgical treatment may be required for more acute cases of pelvic floor or prolapse. The operation involves inserting a synthetic mesh implant (aka a ‘sling’). But this comes with many mixed reviews. Up to 50% of US women are affected by pelvic floor prolapse – and of those who decide to have surgery – up to 30% may require re-operation to fix it.
 10Nonsurgical treatmentA number of internal and external treatments are available, including kegal toners e.g. muscle stimulators and kegel balls, laser therapy, and vaginal pessaries (removable prosthetic devise).

My embarrassing problem

I have an embarrassing problem. My bladder leaks when I run, sneeze, or even just walk too fast. And because I love food – I need to run (ok so running is overselling it. I jog.) But also, I sneeze a LOT – if its not hayfever, then its cats, if its not cats then its dust – you get the picture right. On top of that, I grew up in a relatively big city called Melbourne and this means I like to walk fast. Slow ambling walkers often annoy me. But all this fast walking results in bladder leakage. And I haven’t even started on the days when I’m trying to be good with my water intake!!! 

It all started 12 years ago when I had my first son. He was 10lb and boy did he have man-boobs. My second son, two years later was as 12lb. He came out looking like a toddler – which was not ok. My boys are the joy of my life but my pelvic floor muscles have never been the same.

Here lies one of my biggest problems. I’m told that I should be able to fix my pelvic floor muscles. My physio told me to do the exercises. My mum sent me a brochure about a wave machine I can sit on. My friend told me about electrodes that pulse and I put them up my girly parts. My doctor suggested a surgical mesh operation. But after three postponements of the operation (because compared to others, my needs were in no way urgent) I decided that the universe was trying to tell me something, so I gave up on that.

Instead I have decided to work on my pelvic floor muscles. Here is a link to my article on the 4 steps for how to do your pelvic floor correctly.

As you may read, I understand how to do the exercises correctly – my problem is – REMEMBERING to do them! At first I tried doing them every morning and night as I brushed my teeth. But for some reason that didn’t stick.

I need to create a habit. Google tells me that it takes on average more than 2 months before a new habit becomes automatic. I guess that’s why I have still done nothing about my embarrassing problem that has plagued me for over 12 years.

I’m hoping that maybe you might be able to help. Any guidance would be great. What has worked for you to start a healthy habit?