Welcome to kidsmalta.com


Incontinence and Pregnancy

 
 
During pregnancy many women experience some degree of urinary incontinence.  This can be mild and infrequent however in other cases leakage can occur several times daily.

Incontinence can resolve itself in the first few months after pregnancy, however the problem can persist even after three months of giving birth.  Some other women do not have urinary problems until in their forties, however the symptoms can still trail back to childbirth.
 
 
What are the different types of urinary incontinence?
Stress urinary incontinence is the most common form of urinary incontinence experienced during pregnancy and postpartum, where leakage occurs with activities that increase the pressure on the bladder such as coughing, sneezing, exercising, rising from a chair and laughing.
 
Urge urinary incontinence is also common and is characterized by a sudden urgent need to urinate followed by sudden urine leakage.  Occasionally some women have no warning or urge sensation.  Frequency of urination can be as often as every two hours and may be accompanied by urination during the night or bed wetting.
 
 
What are the causes of urinary incontinence?
The pelvic floor is a broad sling of muscles, ligaments and fascia that stretch from the pubic bone at the front of the body to the base of the spine at the back.
 
The pelvic floor muscles support the bladder, bowel and uterus and give a person control of when the bladder or bowels are opened.  Pelvic floor muscles and associated structures are at a risk of becoming weak during pregnancy or injured during childbirth. 
 
As the baby grows, the weight of the baby and the pregnant uterus produce anatomical changes to the bladder and urethra.  Hormonal changes also affect the pelvic floor.  This suggests that women undergoing Caesarean section are not free from the chances of having urinary incontinence.

As the baby is emerging, when born by vaginal delivery, the widest part of the babies’ head stretches the pelvic floor muscles, fascia and nerves which can lead to pelvic floor dysfunction. 
 
Obesity during pregnancy has also been suggested as a risk factor for postpartum urinary incontinence.  Chronic cough during pregnancy, previous vaginal deliveries and use of forceps also increase the chances of having postpartum urinary incontinence. 
 

How can urinary incontinence be prevented?
Pelvic floor exercises should be offered to all women in their first pregnancy as a means of preventing urinary incontinence as there is evidence that PFMT during the first pregnancy reduces the likelihood of postpartum urinary incontinence. 
 
Behavioural methods such as timed voiding and bladder training can be helpful in treating urinary incontinence during and after pregnancy.
 
Good pelvic floor muscles may help to:
  • Support the extra weight of pregnancy
  • Shorten the second stage of labour
  • Heal the area between the anus and vagina after birth
 
 
 
 
 
 
 
 
How can urinary incontinence be treated?
Women who have symptoms of incontinence should do pelvic floor muscle training, under supervision from a specialized health care professional regularly.  Exercises can be done in different positions such as lying, sitting, standing or kneeling.
 
An intensive exercise programme would consist of both slow and fast contractions with a specified hold and rest times to be done daily. 
 
Training has no negative side-effects and when done intensively has very positive results. 

Unfortunately, urinary incontinence is still a taboo subject and many women find it difficult to discuss this issued with their GP.  You do not have to suffer from urinary incontinence in silence as several treatment options are available.
 
 
 
 
Article written by Carolyn Sultana
Physiotherapist with a Special Interest in Women’s Health
E-mail: carolynsultana@gmail.com
Mobile: 79962109



73 Bir-Bal Street, Balzan BZN9015, Malta
Email: info@kidsmalta.com
© kidsmalta.com | Privacy Policy | Disclaimer | Contact Us | About Us | Advertising | Links | Site Credits