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.
Where to next?
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