Leakage After Having a Baby: Common but Not Normal
Pregnancy and childbirth are transformative experiences, bringing excitement, challenges, and profound changes to the body. For many women, these changes include post-partum symptoms like urinary incontinence, diastasis recti, and pelvic floor dysfunction. While urinary leakage after having a baby is common, it is not normal, and it is certainly not something you have to live with forever. Here in Cincinnati, there are effective resources and treatments, such as pelvic health physical therapy, to help you regain confidence and comfort in your body.
Why Does Incontinence Happen After Childbirth?
During pregnancy, your body undergoes significant changes. The added weight, shifting posture, and stress on the pelvic floor during pregnancy and delivery all play a role. The pelvic floor, shaped like a bowl and made of muscles, supports your pelvic organs and helps control continence. However, the trauma of childbirth—including tearing or stretching—can disrupt these muscles’ ability to contract and function properly.
Similarly, the deep core muscles, which work in harmony with the pelvic floor, are affected by pregnancy. As your baby grows, these muscles are stretched and weakened, impacting their role in stabilization and coordination. When the pelvic floor and deep core muscles are not working optimally, incontinence often follows.
Steps to Address Postpartum Incontinence
The good news is that with the right strategies, exercises, and support, you can restore strength and coordination to your pelvic floor and core. Here are some steps to consider:
1. Coordinated Breathing with Core and Pelvic Floor Activation
This foundational exercise helps you reconnect with your pelvic floor and deep core.
- Lie on your back with your knees bent and feet flat on the floor.
- Inhale deeply, imagining your breath traveling all the way to your pelvis, gently lengthening the pelvic floor.
- As you exhale, engage your deep core by drawing your belly button toward your spine and gently lifting your pelvic floor upward.
- Repeat with each breath. This subtle exercise may take practice, so be patient with yourself.
2. Pelvic Floor Activation Before a Cough or Sneeze
Stress incontinence, or leakage during a cough or sneeze, is common postpartum. A useful strategy is to consciously activate your pelvic floor (think of gently lifting it) before a cough or sneeze to retrain this reflex.
3. Targeted Pelvic Floor Strengthening
Pelvic floor muscles, like any other muscles, can be strengthened with the right exercises. Kegels are a well-known option, but doing them correctly is crucial. Instead of pressing down, focus on lifting the pelvic floor. A pelvic health physical therapist can assess your technique, guide you on proper dosage, and help you target both slow-twitch and fast-twitch muscle fibers.
Addressing Tightness in the Pelvic Floor
Some women experience tightness in their pelvic floor muscles after childbirth, often due to healing or scar tissue from tearing. Tight muscles cannot fully contract or relax, making strengthening exercises less effective. A pelvic health physical therapist can:
- Assess resting muscle tension and scar tissue.
- Use manual therapy and prescribed stretches to restore optimal muscle length.
Once tightness is resolved, coordination and strengthening exercises become more effective, allowing you to progress to more functional movements.
Progressing to Functional Strength Training
As you regain strength and coordination, it’s important to integrate pelvic floor activation into functional movements like squats. Squats are particularly relevant postpartum because they mimic daily activities such as picking up your baby or toys. A physical therapist can guide you on proper squat mechanics to protect your back and joints.
Pelvic Health Support in Cincinnati
Becoming a parent comes with countless joys and challenges, but dealing with incontinence doesn’t have to be one of them. Pelvic health physical therapy offers targeted, effective solutions to address the postpartum changes in your pelvic floor and core. Whether you’re experiencing incontinence, diastasis recti, or general discomfort, there are resources here in Cincinnati to help you feel like yourself again.
Don’t hesitate to seek support—your health and confidence are worth it.
About the Author
Dr. Meredith Ramsey is a licensed Physical Therapist. Over the past eight years, I have had the opportunity to work in a variety of settings with patients throughout the lifespan. During this time, I have completed specialty training in pelvic health and completed a comprehensive Pilates training program. Pilates has become a passion of mine, and I love the holistic approach and possibilities it brings to the rehab setting. My goal is to be able to share my passion and combine my interests of rehab and Pilates to serve my patients and the wellness community in a unique way.