‘Accidents’ happen, but you can deal with it

Urinary incontinence is a problem faced by one-in-three women who have given birth. Pictures: Supplied

By Jade Glen

It’s a wee problem that affects one in three mothers – but you don’t have to put up with it.
Urinary incontinence – otherwise known as poor bladder control – is a common condition associated with pregnancy, childbirth, menopause and a range of chronic conditions such as asthma, diabetes or arthritis.
Poor bladder control can range from the occasional leak when you laugh, cough or exercise to the complete inability to control your bladder, which may cause you to completely wet yourself.
Other symptoms include the constant need to urgently or frequently visit the toilet and subsequent ‘accidents’.
Sue Blinman, National Continence Helpline manager and continence nurse advisor with the Continence Foundation of Australia, said there were different types on incontinence with a number of possible causes.
“Urinary incontinence can be caused by many factors, of which pregnancy and child birth is one, but it can be treated, better managed and in many cases cured. For this reason, it is important to talk to your doctor or a continence advisor about your symptoms to get on top of them,” she said.
For some women, incontinence can be an unwelcome legacy of a seemingly straight-forward pregnancy and birth.
“Some women seem more likely to have bladder and bowel problems, even if they have had quite an ‘easy’ birth. We can’t yet tell who these women will 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 gain new problems.”
If you have just had your first baby, a large baby, a long second-stage of labour, or a difficult vaginal delivery with stitches or a vacuum or forceps delivery, you are more likely to have bladder and bowel problems.
“A caesarean birth might reduce the risk of severe bladder control problems from 10 per cent to 5 per cent for a first baby, but after the third caesarean there may be no difference at all,” Ms Blinman said.

How can women manage incontinence?
“Childbirth can stretch a woman’s 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 protect your pelvic floor muscles by not pushing down on your pelvic floor during this period. Some steps you can take include:
* Try to squeeze, lift and hold your pelvic floor muscles before you sneeze, cough, blow your nose or lift
* Cross your legs and squeeze them tightly together before each cough or sneeze.
* Avoid lifting heavy loads.
* Avoid bouncing exercises such as weights and running.
* Do pelvic floor muscle training to strengthen your pelvic floor muscles.
* Don’t get constipated, or if you suffer from constipation, manage it as best you can.

Will incontinence get better after childbirth?
Don’t lose heart. Even very poor bladder or bowel control just after giving birth will often improve 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.
In many cases, incontinence can be prevented by adopting healthy diet and lifestyle habits, including:
* Drink well – 6-8 cups/2 litres of fluid per day (Tip: Don’t reduce your fluid intake if you have a bladder control problem, as this will concentrate your urine and make the problem worse).
* Eat a healthy diet high in fibre.
* Lead a positive lifestyle – aim for Body Mass Index (BMI) of 25 or less and stop smoking.
* Get active – aim to exercise for 30 minutes most days.
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. To find a service provider in your area, visit the continence service provider directory athttps://www.continence.org.au/service-providers.php

Where should women go to seek help?
You should always seek help for bladder and bowel problems, as the symptoms will not go away on their own and may worsen over time.
For further information speak to your doctor or a continence nurse advisor on the National Continence Helpline on 1800 33 00 66.