It’s a running joke amongst many women, you laugh too hard, sneeze unexpectedly, or go for a run and you may spring a leak post-baby birth. Once you open up the flood gates, it’s hard to close them back up again. But for many women it’s not funny. It’s a real problem that leaves them feeling embarrassed and isolated. However, if you look at women in France, you’ll find that incontinence post-baby or at any point is far from an inevitability, in fact, it’s highly preventable.
What is Incontinence?
According to the National Association for Incontinence, 25 million Americans suffer from incontinence at some point in their lives and nearly 75 percent of them are women. Incontinence is the term used to describe involuntary or accidental loss of urine from the bladder. It ranges in severity from a little leak to a complete loss of bladder control. Stress incontinence is the form of incontinence that’s common amongst many women post-pregnancy and childbirth when the pelvic floor muscles that support the urethra are weakened. This can cause leaking during activities that push down on this part of the body.
“During childbirth, the increase in gestational weight gain puts additional pressure on your entire pelvic floor. The muscles and ligaments in your pelvic floor are weakened and damaged, making it more difficult to hold your bladder,” says Laura Arndt, a certified strength and conditioning coach that recently started Matriarc, an app focused on pregnancy and postpartum health. “Relaxin is a hormone in your body that increases elasticity of your ligaments and joints to aid in delivery and this also causes issues. During delivery, there may be additional damage and strain to the muscles in your pelvic floor. This can later lead to Pelvic Organ Prolapse which effects urinary and rectal incontinence.”
Why Don’t French Women Suffer From Incontinence?
One of the main reasons that French women don’t suffer from incontinence is because post baby, French women are prescribed 20 post baby "pelvic floor re-education" sessions. The sessions consist of a probe being inserted into a women’s undercarriage after which she is instructed to squeeze on the probe with her pelvic floor muscles to test the strength of the pelvic floor. Then, the doctor sets what amounts to a dildo with electrodes in it to a level necessary to work the pelvic floor muscles into a tizzy. Women even play video games with their vaginas, one writer wrote about her favorite of the games which she calls "cooter Pac-Man". But embarrassing video games aside, after a few sessions, most women don’t have to worry whether a sneezing spell will cause an unexpected leak from below.
The difference in the U.S. versus France is that in the U.S. we view occasional leakage as a given post-baby and as the number of vaginal births increases, the worse the problem becomes. Add in an episiotomy and all bets are off. But it doesn’t have to be this way. For starters, says Gail Page, co-founder of Consortia, a personalized medical company which partners with physicians to provide diagnosis, treatment, and educational support to address pelvic floor disorders including urinary incontinence, pelvic pain, and sexual health.
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“People don’t want to talk about it,” says Page. “But incontinence is associated with isolation, depression, and reduced intimacy with partners. It can even cause marital problems.”
Consortia Health offers pelvic floor screening surveys, incontinence testing, and pelvic floor muscle training.
What to Do About Incontinence
Beyond contacting Consortia Health or another healthcare provider that specializes in treating incontinence, there are a number of other steps that you can take that according to Arndt, can do a lot to prevent incontinence post pregnancy.
1. Stay active during pregnancy and avoid too much weight gain.
In 2015, Yale School of Medicine published research that found that women who gained too much weight during pregnancy or weren’t active were more likely to experience weakening of their pelvic floor.
2. Make time to strengthen your pelvic floor.
In France, new moms make time for their pelvic floors because of the treatment regimen that nearly all moms go through. But in the U.S. it’s not seen as important. This shouldn’t be the case. If you make time for your pelvic floor post-pregnancy, you won’t have to deal with leakage later. According to Arndt, strengthening of your core and pelvic floor immediately postpartum and continuing for life can greatly reduce your risk of “mommy bladder”. “Your transverse abdominals (lower abs), hips, lower back, and pelvic muscles strength all play a role in your body's ability to control your bladder,” she says. She recommends kegels, pelvic tilts, bridges, dead bug crunch, supermans, and bird dogs for a couple minutes each day because they can play a huge role in prevention of incontinence.
3. Don’t do exercises post-pregnancy that could damage your pelvic floor.
Arndt warns against exercises that increase abdominal pressure in the first six months to a year postpartum. Recti Diastasis, or abdominal separation, is common in many pregnancies, but in order for it to heal properly, women need to avoid exercises like crunches, planks, and heavy lifting that can increase abdominal pressure and make diastases worse. “If Diastasis doesn't heal, your core muscles will remain weak and difficult to strengthen,” says Arndt. “This puts pressure on your lower back and pelvic muscles, causing pain, muscle weakness, strain, and increasing incontinence.”
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