When you are pregnant, you get a lot of advice from many people. One issue that few people think about are signs of bladder and bowel control problems in pregnancy and after the birth.
See the picture of the pelvic floor. The pelvic floor muscles do a number of things, they:
There are a few things that might happen if you have weak pelvic floor muscles. You might:
You may also have sexual problems. Just after your baby is born, you will be very tired and busy with your baby. Vaginal birth can cause weakness around the vagina or a lack of feeling. Vaginal tears and trauma can cause pain for many months. While breast feeding, oestrogen levels may be low and so the vagina may be dry, which can cause more problems. It may be helpful for you and your partner to talk about these issues with a health professional.
Some women seem more likely to have bladder and bowel problems, even if they have had quite easy birth. We can’t yet tell who these women might be.
Women who already have bladder or bowel symptoms, such as irritable bowel syndrome or an urgent need to pass urine (also called overactive bladder) will be more likely to have this problem worsen or to gain new problems. Constipation, coughing and obesity can also make problems worse.
Certain things about the birth can make a woman more likely to have bladder and bowel problems:
Choosing a caesarean birth might seem like a way to avoid these problems, but it is not that simple. A caesarean birth might reduce the risk of severe bladder control problems from 10% to 5% for a first baby, but after the third caesarean there may be no benefit at all. And caesarean births carry their own risks. Babies born this way are more likely to have breathing problems at birth. It can be more risky for the mother and scarring from caesarean births can make pelvic surgery more difficult in the future. So you may be trading one problem for another.
In many cases, a vaginal birth runs just as planned and is a lovely event for parents, so this type of birth is best when possible. But problems can still happen. Research is now looking at how we can better know about and stop harm to the pelvic floor during birth. For now, pregnancy and birth involves making a choice between different kinds of risk. You and your partner need to think about these risks and discuss them with your pregnancy care professional. No one can promise you and your baby a perfect outcome.
The birth of a baby might have stretched your pelvic floor muscles. Any ‘pushing down’ action in the first weeks after the baby’s birth might stretch the pelvic floor again. You can help to protect your pelvic floor muscles by not pushing down on your pelvic floor. Here are a few ideas to help you.
For more information, see the leaflet “Good Bladder Habits for Everyone.”
Do not lose heart. Even very poor bladder or bowel control just after giving birth can get better without help in the first six months, as the pelvic floor tissues, muscles and nerves mend.
Regular pelvic floor muscle training kept up over the long term, as well as the right advice, will help.
Don’t forget to look after yourself at a time when it is easy to neglect your own needs.
If things are not getting better after six months, speak to your doctor, physiotherapist, or continence nurse advisor.
It is best to ask for help if you are worried about any bladder or bowel issue.
Call Expert Advisors on the National Continence Helpline for free:
On FREE CALL* 1800 33 00 66 (8 am to 8 pm Monday to Friday), or
Visit this website: www.bladderbowel.gov.au
The Helpline can arrange for an interpreter through the Telephone Interpreter Service (TIS). Please ring 13 14 50 Monday to Friday and ask for the Helpline.
Some pregnant women can have bladder and bowel control problems. You can get help.
* Calls from mobile telephones are charged at applicable rates.
NATIONAL CONTINENCE HELPLINE 1800 33 00 66 | www.bladderbowel.gov.au | October 2010