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If you're feeling like a garden sprinkler without an off button then you're probably suffering from stress incontinence. Don't worry - this condition affects many women towards the later stages of pregnancy...
What is stress incontinence?
This condition occurs when urine leaks from your bladder, due to weakened pelvic floor muscles. Stress incontinence often occurs in the last weeks of pregnancy, when the combined effects of your heavy uterus (womb) and a flood of hormones that soften your joints and ligaments in preparation for birth can weaken your pelvic floor muscles. You may also suffer when the baby kicks your bladder, when you cough, sneeze or laugh, or when you lift anything heavy, or do any exercise.
Stress incontinence can also begin or continue after birth because muscles can be weakened by pushing, and forceps deliveries can pull the muscles that support the opening in the pelvic floor.
Ways to prevent it
Your pelvic floor is made up of three layers of muscles, which form a sling supporting your uterus, bowel and bladder. These muscles control the release of urine and faeces and, if they are weak or damaged, stress incontinence can occur. You can locate your pelvic floor muscles by pretending that you're trying to stop weeing or trying not to pass wind.
To prevent stress incontinence, the best thing to do is get into the habit of exercising these muscles as often as possible (see The solution - pelvic floor exercises, below).
How to treat it
Pelvic floor exercises are also a successful way of treating stress incontinence. These exercises strengthen and tone the muscles and they can be done at any time. Practise them regularly, and you will see an improvement - usually after three to six months.
If however, after regularly doing them, there is no improvement, ask your GP to refer you to a physiotherapist. She can help you with exercises or offer ultrasound treatment, which helps tone the muscles.
Staying fit is also important. If you're overweight, weight loss can help, as can eating a high-fibre diet. Also, avoid straining when doing a poo, and avoid any strenuous exercise until your muscles are toned.
The solution - pelvic floor exercises
The following exercise can be repeated as often as you like, including during pregnancy:
- Imagine you have a lift inside your body that can go up to your waist. It is made up of your pelvic floor muscles and you can make them rise from the ground floor to the fourth, stopping at each floor on the way.
- Pull your muscles slowly, as if the lift is going up to the fourth floor. Hold the contraction only as long as is comfortable. Stop if your muscles start to tremble and remember not to tighten up your buttock muscles at the same time.
- After each exercise, allow your muscles to relax slowly to ground level. Then relax them completely so you feel a slight bulging downwards.
'I learnt pelvic floor exercises, which helped control my incontinence'
'I started having problems when I went back to work as a fitness instructor, six weeks after Ben was born. I'd just begun a class when I felt this flooding - I'd completely let go of my bladder even though I'd had no sensation that I needed a pee. I was so embarrassed - I couldn't face talking to the doctor about it, so I ignored it.
'Eventually, though, I went to see my GP, who was really understanding and referred me to a physiotherapist. She taught me to do pelvic floor exercises, and to remember to control myself when I cough, which is when I tended to leak.
'Now I feel much more confident - and I teach pelvic floor exercises in my class.'
Jacqui Hoath, 35, first suffered from stress incontinence after the birth of her son Ben, five."
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