 How
can you help yourself?
During your pregnancy
The best way to avoid bladder problems after your baby is born is to
do exercises to strengthen you pelvic floor muscles every day during the
last few months of your pregnancy. The pelvic floor is a hammock of muscle
that stretches from back to front and side to side under the womb, bladder
and bowel and it helps to keep the outlets from the bladder and bowel
closed. The more familiar you are with these exercises before you give
birth, the easier it will be to get the pelvic floor muscles working again
afterwards.
Some women get a urine infection during pregnancy – you may get
symptoms of discomfort in passing water. If this happens to you, get prompt
treatment for it: your doctor should prescribe antibiotics to rule out
any risk of the infection taking hold. You can take precautions to avoid
urine infections by good habit and hygiene:
- After you have had a bowel motion, always wipe yourself from front
to back, so that any bacteria are washed from the urethra and vagina.
- Do not delay passing water unnecessarily: it is normal to empty the
bladder up to eight times in 24 hours, perhaps more often during pregnancy.
- Do not restrict your fluid intake: during pregnancy and breast-feeding,
you should drink more than usual – about 2-3 litres a day. (The
usual figure is about 2 litres.)
- Try to avoid getting constipated both before and after having your
baby by eating plenty of fresh fruit and vegetables. If you do become
constipated, do not get into the habit of straining: ask your doctor
or midwife for advice on a mild laxative.
During delivery
Other things being equal, a Caesarean section carries less risk than
natural childbirth to your later ability to control your bladder and bowels.
But a Caesarean section is an operation with risks of its own, and so
the increased (but still small) risk of bladder and bowel control problems
can only be one factor in your decision.
If you have had an epidural anaesthetic, it will take longer for sensation
to return in your bladder than elsewhere in your body, so that you may
not realise that your bladder is full. Often after the birth women are
fitted with a narrow tube (a catheter) to drain the bladder. If not, and
you leave it too long, your bladder may get stretched, with a risk that
you could do some permanent damage. The answer is simple: make sure that
you try to empty your bladder two or three times during the first eight
hours after delivery even if you do not feel the need. If you are passing
only small amounts of water, ask the nurse of midwife for advice.
After giving birth
Carrying and then pushing out your baby has stretched your pelvic floor
muscles and weakened them. So you should start doing your pelvic floor
exercises again soon after your baby is born. Indeed, you should make
them a permanent part of your daily life.
In the first weeks after your baby’s birth you should avoid any
pushing down movements that might strain and weaken these important muscles
again.
The only downward movement you should allow is when you are opening your
bowels.
When you do open your bowels, hold a pad of toilet paper firmly against
the area just in front of your back passage. This will stop your pelvic
floor muscles from being over-stretched when you bear down. You may also
find it helpful to lean forwards with your feet on a footstool.
If you are able; squeeze, lift and hold your pelvic floor muscles just
before and during a sneeze or cough. This is called "the knack".
Try to do it when you blow your nose or lift anything.
If you want to do any exercise or go to a gym, do not do high impact
aerobics or lift heavy weights.
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