Women often experience reduced bladder control during and following pregnancy. If you feel you need further support with this please see the ‘How to Refer’ section below.
During Pregnancy
During pregnancy, the growing weight of your baby and expanding uterus both alters the anatomy in your pelvis and increases the load placed on pelvic floor muscles. This often makes it difficult for the pelvic floor muscle complex to assist in maintaining continence. It is therefore recommended that all pregnant women exercise the pelvic floor muscles daily using the technique below.
Following Pregnancy
During vaginal deliveries it is likely there will be an element of trauma to the pelvic floor muscles, fascia and nerves in the pelvis which may contribute to incontinence. It is therefore recommended that all post natal women exercise the pelvic floor muscles daily using the technique below.
Please do not assume that if you have had a caesarean section you do not need to exercise your pelvic floor muscles! Being pregnant for 40 weeks can alter the way the pelvic floor muscles function and lead to post natal incontinence.
Pelvic Floor Muscle Exercises
Technique
- Find a comfortable position
- Relax
- Imagine you are trying to stop yourself from passing wind and urine at the same time
- You should feel a lift as you contract your muscles and a drop as you relax them
- Breathe normally throughout
- Do not clench your buttocks
- Do not brace your abdominal muscles
- Include both long holds and short squeezes (see below)
Long Holds
- Contract your pelvic floor muscles using the technique above
- Hold for as long as you can up to 10 seconds
- Release and let them fully relax
- Rest for 5-10 seconds
- Repeat as many times as you can until the muscles fatigue
- Repeat 3 times per day
Short Squeezes
- Contract your pelvic floor muscles using the technique above
- Release and let them fully relax
- Rest for 1-2 seconds
- Repeat as many times as you can until the muscles fatigue
- Repeat 3 times per day
The Knack
Contract the pelvic floor muscles just before you know you might be about to leak such as when coughing, sneezing, laughing or lifting heavy objects.
Useful Links for Pelvic Floor Exercises
Need to see a Specialist Pelvic Health Physiotherapist?
We would strongly suggest you arrange an appointment with a specialist pelvic health physiotherapist, especially if you are having symptoms of incontinence and any of the following apply to you:
- Baby birth weight over 4kg or 8lbs 13oz
- Second stage of labour (pushing stage) longer than 1 hour
- Forceps delivery
How to Refer
You can self refer to pelvic health physiotherapy during your pregnancy and up until you are 6 weeks postnatal by calling 01786 434 061.
Alternatively if you are postnatal you can complete the booking form in the Postnatal Information and you will be contacted and offered an appointment.
If you are over 6 weeks postnatal you will need a GP referral.
Perineal trauma
9 out of 10 women experience perineal trauma or tears during childbirth. The perineum is the area of soft tissue between the vaginal opening and the back passage. For most women these tears are minor and will heal quickly.
1st degree small tears affecting the skin, will usually heal naturally without treatment
2nd degree moderate tear affecting the skin and muscles of the perineum, usually require stitches
3rd and 4th degree tears are more serious as they extend into the muscle that controls the back passage. These are also called Obstetric Anal Sphincter Injuries (OASI). They require to be repaired in theatre after delivery.
3rd degree large tear affecting the skin, muscles of the perineum and part of the anal sphincter
4th degree large tear affecting the skin, muscles of the perineum, complete tearing of the anal sphincter involving the bowel lining
If you have had a 3rd or 4th degree tear a pelvic health physiotherapist will contact you within a few days of delivery (normally on the postnatal ward) to discuss the management of your tear. You will also be offered a follow up appointment at 4-6 weeks postnatal.
Read more about 3rd and 4th degree tears here: