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.
What do my pelvic floor muscles do?
See the picture of the pelvic floor. The pelvic floor muscles do a number of things. They:
How do I know if I have a problem?
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.
How can I tell if I might get bladder and bowel problems?
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:
What if I have a caesarean birth?
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.
What can I do about weak pelvic floor muscles?
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.”
Will things get better?
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.
Qualified nurses are available if you call the National Continence Helpline on 1800 33 00 66* (Monday to Friday, between 8.00am to 8.00pm Australian Eastern Standard Time) for free:
If you have difficulty speaking or understanding English you can access the Helpline through the free Telephone Interpreter Service on 13 14 50. The phone will be answered in English, so please name the language you speak and wait on the phone. You will be connected to an interpreter who speaks your language. Tell the interpreter you wish to call the National Continence Helpline on 1800 33 00 66. Wait on the phone to be connected and the interpreter will assist you to speak with a continence nurse advisor. All calls are confidential.
* Calls from mobile telephones are charged at applicable rates.
如果你致电国家排便节制热线，有资质的护士会接听你的电话1800 33 00 66*（周一至周五，澳大利亚东部标准时间8:00am—8:00pm）。
如果你在讲英语或者理解上有困难，你可以通过拨打13 14 50获取免费电话传译服务以接通国家排便节制热线。电话会用英语接通，因此请说明你要讲的语言并且不要挂机。你会被连接到一个讲你母语的传译员。告知传译员你想要致电国家排便节制热线，电话是1800 33 00 66。待电话接通后传译员会帮助你与排便节制护理顾问对话，所有的来电均保密。