It isn’t something easily discussed, but there is one aspect of pregnancy and childbirth that few people think about. For a small number of mothers, the joy of having a new baby can be clouded by difficulties – usually temporary – of unwanted leakage from the bladder and occasionally the bowel. The risks are not great, but there are some simple steps that can help to reduce them.

During pregnancy

The best way to avoid bladder problems after your baby is born is to do exercises to strengthen your pelvic floor muscles every day during the last few months of pregnancy. The pelvic floor is a hammock of muscle that stretches from back to front and side to side under the womb, bladder and bowel. It helps to keep the outlets from the bladder and bowel closed. Pregnancy and childbirth put great strain on the pelvic floor muscles, and the exercises will help to tone them up. The more toned they are, the more they will be able to prevent accidental leaks.

Some women get a urine infection during pregnancy – you may get symptoms of discomfort or pain in passing water. If this happens to you, get prompt treatment: your doctor should prescribe antibiotics to rule out the risk of the infection taking hold. You can take precautions to avoid urine infections by good habits and hygiene:

• After you have had a bowel motion, always wipe from front to back, so that any bacteria are washed away from the urethra and vagina.
• Do not delay passing water unnecessarily: it is normal to empty the bladder up to eighth times in 24 hours, perhaps more often during pregnancy.
• Do not restrict your fluid intake: during pregnancy and breast-feeding, you should drink more than usual – about 2-3 litres a day.

During delivery

If you have an epidural anaesthetic, it will take longer for sensation to return in your bladder than elsewhere in your body, so that you may not realise that your bladder is full. Often after birth, women are fitted with a narrow tube (catheter) to drain the bladder. If not, and you leave it too long, your bladder may become stretched, with a risk that you could do permanent damage. The answer is simple: make sure you try to empty your bladder two or three times during the first eight hours after delivery – even if you do not feel the need. If you are only passing small amounts, ask the nurse or midwife for advice.

Afterwards

Continue with your pelvic floor exercises! If you have a persistent continence problem, seek help. The Continence Foundation is a national charity providing help for people with continence problems. Our Helpline is staffed by continence nurse specialists who can send free information about pelvic floor exercises (as well as other information), and provide contact details for enquirers’ local NHS Continence Clinic.

By Ian Holland, Communications Director, Continence Foundation

Helpline: 0845 345 0165 (9.30-1.00 M-F)
E-mail: continence-help@dial.pipex.com
Web: www.continence-foundation.org.uk