Urinary Leakage is NOT Normal after Childbirth
We spend all this time thinking, planning and prepping our bodies for pregnancy and delivery, but what happens after delivery? We get so caught up in the busyness of having a newborn, and are so sleep deprived that it is hard to do even that, but what about our post natal body? I think we have this expectation that once we deliver our baby, and maybe give it a little time, everything will eventually go back to the “way it was.” I once heard someone say, “Once you are post natal, you will always be post natal.” Considering every single system of the body is effected by pregnancy, there is probably something to this. So what is the reality?
The body generally does a pretty good job of recovering post delivery, but it is also not uncommon to be left with some significant changes or actual problems. First, it is said that 100% of women in their third trimester have a diastasis recti abdominus (DRA). This is when the two halves of the rectus abdominus muscle separate in the front to allow for expansion of the abdomen to make room for the growing fetus. So it is normal for a DRA to occur. Over the next eight weeks following delivery, this separation should slowly come back together. But for 35-39% of women it does not fully close and she is left with a protruded abdomen that can look like she is still pregnant. The condition of the DRA at 8 weeks remains unchanged at one year. So if you are noticing these symptoms at eight weeks post delivery it would be beneficial to seek treatment. But this is more than just a cosmetic issue. 66% of women with persistent DRA’s will develop urinary incontinence or a pelvic organ prolapse within the next couple decades of life. Stress incontinence, or dribbling urine when you cough, laugh, sneeze, lift something or exert increased force against the pelvic floor is also a common symptom that typically begins during the third trimester, but can persist and even worsen long after delivery.
I need to say this so you can hear me loud and clear, NO amount of leakage is normal and should not persist after six weeks post delivery. I hear women say all the time, “I just leak a little. It is just because I have had a couple babies.” Please do not accept this, it will worsen over time and weakness can progress and a pelvic organ prolapse (POP) can occur. POP is when one of the organs – bladder, uterus or rectum – descends into the vaginal canal. In the earlier stages you do not feel that it is happening, however, with increased time and age it can descend further into the vaginal opening and cause you to feel like you are sitting on a marble. In extreme cases, the organ protrudes out of the vaginal opening.
Another condition that people often experience is pelvic pain. Sometimes this occurs during puberty and persists or worsens with pregnancy and delivery. Other times, it begins as a result of pregnancy or delivery. This can leave you having pain at all times or only experiencing pain with insertion of a tampon or during intercourse. In any case, therapy can provide significant or complete relief and therefore this is something that should not be ignored.
Women’s Health physical therapists (PT) have specialty training for all of these and many other conditions and women find great success with treatment. If you have any concern, please talk with your doctor or call a women’s health PT. I urge you to take care of yourself. It is very difficult to give all that is required in the life of a busy mom when you are not feeling well yourself. And if you seek help soon after the problem develops, often times treatment time is shortened and will prevent future problems that tend to compound.
Renee Spinella, PT, DPT, Cert MDT has been a physical therapist for over 16 years and currently works at the RIC-Silver Cross out-patient facility in Homer Glen. Renee has a specialty certification in mechanical diagnosis and treatment (the McKenzie Method) as well as specialty training in pelvic floor and pre/post natal care. Renee has 4 children of her own, so she understands and relates to women who are experiencing symptoms during pregnancy and after delivery.