One In Three Women Who Ever Had A Baby Wet Themselves in Maltese

Women who have even just one baby are nearly three times more likely to leak urine and wet themselves, than women who have not had a baby. The more babies you have, the more chance there is that you will leak urine and wet yourself.

Nisa li kellhom saħansitra tarbija waħda biss x’aktarx huma kważi tliet darbiet aktar probabbli li jqattru ammonti żgħar ta’ awrina u jpixxu taħthom minn nisa li qatt ma kellhom tarbija. Aktar ma jkollok trabi, aktar ikun ikbar iċ-ċans li int ser tqattar ammonti żgħar ta’ awrina u tpixxi taħtek.

Why do you leak urine after having a baby?

When the baby moves down through the birth canal, it stretches the nerves and muscles that keep the bladder shut. These are called the pelvic floor muscles, and they can sometimes be left weak, and not able to keep the bladder from leak ing. Leaking happens mostly when you cough, sneeze, lift or do exercise. It is rare for the bladder to be hurt during birth, but the muscles and nerves often are, and you need to do pelvic floor muscle training to help the muscles get strong again.

Għala tqattar ammonti żgħar ta’ awrina wara li jkollok tarbija?

Meta t-tarbija tinżel mill-kanal tat-twelid, hi tistira n-nervituri u l-muskoli li jżommu l-bużżieqa tal-awrina magħluqa. Dawn jgħidulhom il-muskoli tal-qiegħ tal-pelvi, u xi kultant jistgħu jibqgħu dgħajfa u għalhekk ma jkunux jistgħu jżommu l-bużżieqa tal-awrina milli tqattar ammonti żgħar ta’ awrina. It-tqattir iseħħ l-aktar meta tisgħol, tagħtas, terfa’ jew tagħmel eżerċizzju. Hi ħaġa rari li l-bużżieqa tal-awrina jġarrab xi ħsara matul it-twelid, imma spiss il-muskoli u n-nervituri jgħaddu minn dan, u int trid teżerċita l-muskolu tal-qiegħ tal-pelvi biex tgħin il-muskoli jerġgħu jissaħħu.

Will this leaking go away by itself?

If you have any leaking, it will not go away if you just ignore it. Leaking is likely to stop if you train your pelvic floor muscles, to help get their strength back. If you don’t get pelvic floor muscle strength back after each baby you have, you may start wetting yourself, as the pelvic floor muscles get weaker with age.

Dan it-tqattir għad jieqaf waħdu?

Jekk int qed tesperjenza t-tqattir, mhux ser imur waħdu jekk sempliċiment ma tagħtix kasu. X’aktarx li t-tqattir jieqaf jekk int teżerċita l-muskoli tiegħek tal-qiegħ tal-pelvi, biex tgħinhom jiksbu lura s-saħħa tagħhom. Jekk ma terġax issaħħaħ il-muskoli tal-qiegħ tal-pelvi wara kull tarbija li jkollok, int tista’ terġa’ tibda tpixxi taħtek hekk kif il-muskoli tal-qiegħ tal-pelvi jiddgħajfu bl-età.

How does my bladder work?

The bladder is a hollow muscle pump. It fills slowly from the kidneys, and can hold at least one and a half to two cups of urine (300 to 400mls). The bladder outlet tube is kept closed by the pelvic floor muscles. When the bladder is full and you decide to pass urine, the pelvic floor muscles relax when you sit on the toilet, and the bladder squeezes the urine out. Then the same “fill and empty” cycle begins again.

Kif taħdem il-bużżieqa tiegħi tal-awrina?

Il-bużżieqa tal-awrina hija pompa tal-muskoli battala. Timtela’ bil-mod mill-kliewi, u tista’ tesa’ tal-anqas minn kikkra u nofs sa żewġ kikkri ta’ awrina (300 sa 400millilitru). It-tubu tal-ħruġ tal-bużżieqa tal-awrina jinżamm magħluq permezz tal-muskoli tal-qiegħ tal-pelvi. Meta l-bużżieqa tal-awrina tkun mimlija u int tiddeċiedi li tgћaddi l-awrina, il-muskoli tal-qiegħ tal-pelvi jirrelassaw meta tpoġġi fuq it-tojlit u l-borża tal-awrina tagħsar l-awrina ‘l barra. Imbagћad dan l-istess ċiklu ta’ “timla u tbattal’ jerġa’ jibda mill-ġdid

What do my pelvic floor muscles do?

See the picture of the pelvic floor. The pelvic floor muscles do a number of things, they:

• help to close off the bladder, the vagina (front passage) and the rectum back passage); and
• help to hold the bladder, the uterus (womb) and bowel in their proper place.

X’jagħmlu l-muskoli tiegħi tal-qiegħ tal-pelvi?

Ara l-istampa tal-qiegħ tal-pelvi. Il-muskoli tal-qiegħ tal-pelvi jagħmlu numru ta’ affarijiet, huma:

• jgħinu jagħlqu l-bużżieqa tal-awrina, il-vaġina (ll-passaġġ ta’ quddiem) u r-rektum (il-passaġġ ta’ wara); u
• jgħinu jżommu l-bużżieqa tal-awrina, l-utru (l-ġuf) u l-imsaren f’posthom.

What happens if my pelvic floor muscles are weak after having my baby?

• You might leak urine when you cough, sneeze, lift, laugh or do exercise.
• You might not be able to control passing wind.
• You might feel an urgent need to empty your bladder or your bowel.
• You might not have good support for your bladder, your uterus or your bowel. Without good support one or more of your pelvic organs might sag down into your vagina. This is called pelvic organ prolapse. Prolapse is very common and happens to about one in ten women in Australia.

X’jiġri jekk il-muskoli tiegħi tal-qiegħ tal-pelvi jiddgħajfu wara li nwelled?

• Int tista’ tqattar ammonti żgħar ta’ awrina meta tisgħol, tagħtas, terfa’, tidħaq jew tagħmel l-eżerċizzju.
• Jista’ jiġri li int ma tkunx kapaċi tikkontrolla l-ħruġ tar-riħ.
• Jista’ jkollok mnejn tħoss bżonn urġenti biex tbattal il-bużżieqa tal-awrina tiegħek jew imsarnek.
• Int għandek mnejn ma jkollokx sapport tajjeb tal-bużżieqa tal-awrina tiegħek, tal-uteru tiegħek jew ta’ imsarnek. Mingħajr sapport tajjeb wieħed jew aktar mill-organi tiegħek tal-pelvi jistgħu jiddendlu ġol-vaġina. Dan hu magħruf bħala prolass tal-organi tal-pelvi. Dan il-prolass huwa komuni ħafna u jiġri lil madwar waħda minn kull għaxar nisa fl-Awstralja.

What can i do to stop these things from happening?

• Train your pelvic floor muscles (we tell you how later).
• Keep good bladder and bowel habits:
  - eat fruit and vegetables;
  - drink 1.5 - 2 litres of fluid per day;
  - do not go to the toilet ‘just in case’ as this might cut down how much your bladder can hold; and
• Protect your pelvic floor muscles when opening your bowels. A good way to sit on the toilet is to put your forearms onto your thighs and, with your feet close to the toilet, raise your heels. Relax your pelvic floor muscles and gently push.
• Keep your weight within the right range for your height and age.

X’nista’ nagħmel biex ma nħallix dawn l-affarijiet jiġru?

• Agħmel l-eżerċizzji tal-muskoli tal-qiegħ tal-pelvi tiegħek (aħna ngħidulek kif aktar tard).
• Żomm drawwiet tajba tal-bużżieqa tal-awrina u tal-imsaren:
  - kul frott u ħaxix;
  - ixrob 1.5 – 2 litri ta’ fluwidu kuljum;
  - tmurx it-tojlit ‘għalli jista’ jkun’ għax dan jista’ jnaqqas l-ammont li l-bużżieqa tal-awrina tiegħek tiflaћ iżżomm; u
• Ħares il-muskoli tal-qiegħ tal-pelvi tiegħek meta tbattal imsarnek. Pożizzjoni tajba gћal meta tpoġġi fuq it-tojlit hi li tpoġġi minkbejk fuq koxxtejk u b’saqajk qrib it-tojlit u erfa’ għarqbejk. Serraħ il-muskoli tal-qiegħ tal-pelvi tiegħek u imbotta bil-mod
• Żomm il-piż tiegħek fi skala skont it-tul u l-età tiegħek.

How can i care for my weak pelvic floor muscles?

The birth of a baby might have stretched your pelvic floor muscles. Any ‘pushing down’ actions in the first weeks after the baby’s birth might stretch the pelvic floor muscles 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.

• 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.
• Share the lifting of heavy loads.
• Don’t strain when using your bowels.
• Do not do bouncing exercises.
• It’s alright to get up once a night to pass urine—don’t go to the toilet just because you had to get up to baby.
• Strengthen your pelvic floor muscles through training.

Kif nista’ nieħu ħsieb il-muskoli dgħajfin tal-qiegħ tal-pelvi tiegħi?

It-twelid ta’ tarbija seta’ stira l-muskoli tal-qiegħ tal-pelvi tiegħek. Kwalunkwe moviment ta’ “imbuttar ‘l isfel” fl-ewwel ġimgħat wara t-twelid tat-tarbija jista’ jerġa’ jistira l-muskoli tal-qiegħ tal-pelvi. Int tista’ tgħin biex tħares il-muskoli tal-qiegħ tal-pelvi tiegħek billi ma timbuttax l-isfel fuq il-qiegħ tal-pelvi. Hawn xi ftit idejat biex jgħinuk.

• Ipprova agħfas, erfa’ u żomm il-muskoli tal-qiegħ tal-pelvi tiegħek qabel ma tagħtas, tisgħol, tomħot jew terfa’.
• Sallab riġlejk, u agħfashom flimkien sewwa qabel ma tisgħol jew tagħtas.
• Aqsam ma’ ħaddieħor l-irfigħ ta’ tagħbijiet tqal.
• Titqanżaħx meta tkun qed tbattal imsarnek.
• Toqgħodx tagħmel eżerċizzji li jinvolvu qbiż.
• Tikkonfondix jekk tqum darba matul il-lejl biex tagħmel l-awrina - tmurx it-tojlit sempliċiment għax trid tqum minħabba t-tarbija
• Saħħaħ il-muskoli tal-qiegħ tal-pelvi tiegħek permezz tal-eżerċizzji.

Where are my pelvic floor muscles?

The first thing to do is to find out which muscles you need to train.

1. Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed.
2. Squeeze the ring of muscle around the back passage as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks together.
3. When sitting on the toilet to empty your bladder, try to stop the stream of urine, and then start it again. Only do this to learn which muscles are the right ones to use—and only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.

If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t stop your stream of urine as talked about in Point 3, ask for help from your doctor, physiotherapist, or continence nurse advisor. They will help you to get your pelvic floor muscles working right. Even women with very weak pelvic floor muscles can gain from pelvic floor muscle training.

Fejn huma l-muskoli tal-qiegħ tal-pelvi tiegħi?

L-ewwel ħaġa li trid tagħmel hu li ssib liema muskoli trid teżerċita.

1. Poġġi bilqegħda jew imtedd komdu bil-muskoli ta’ kuxtejk, tal-warrani u tal-istonku mitluqin.
2. Issikka ċ-ċirku tal-muskolu madwar il-passaġġ ta’ wara qiesek qed tipprova twaqqaf il-ħruġ tar-riħ. Issa irrilassa dan il-muskolu. Issikka u erħi darbtejn sakemm tkun żgur li sibt il-muskoli t-tajba. Ipprova tagħfasx iż-żewġ partijiet tal-warrani tiegħek flimkien.
3. Meta tkun bilqiegħda fuq it-tojlit biex tbattal il-bużżieqa tal-awrina tiegħek, ipprova waqqaf il-fluss tal-awrina u mbagħad erġa’ ibdiha. Agħmel hekk biss biex titgħallem tagħraf liema huma l-muskoli t-tajbin li għandek tuża - u darba biss fil-ġimgħa. Jista’ jkun li l-bużżieqa tal-awrina tiegħek ma tkunx vojta kif suppost jekk tieqaf u terġa’ tibda tagħmel il-fluss tiegħek aktar ta’ spiss minn hekk.

Jekk ma tħossx b’mod distint “għafsa u refgħa” tal-muskoli tiegħek tal-qiegħ tal-pelvi, jew jekk int ma tistax twaqqaf il-fluss tiegħek tal-awrina kif tkellimna f’Punt 3, iltob l-għajnuna tat-tabib, il-fiżjoterapista, jew in-ners konsulent tiegħek tal-kontinenza. Dawn ser jgħinuk tagħmel l-muskoli tal-qiegħ tal-pelvi tiegħek jaħdmu kif suppost. Anki nisa li għandhom muskoli tal-qiegħ tal-pelvi dgħajfin ħafna jistgħu jibbenefikaw mill-eżerċizzju tal-muskoli tal-qiegħ tal-pelvi.

How do i do pelvic floor muscle training?

Now that you can feel the muscles working—

1. Squeeze and draw in the muscles around your back passage, your birth canal and your front passage all at the same time. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 8. Now, let them go and relax. You should have a distinct feeling of “letting go”.
2. Repeat (squeeze and lift) and let go. It is best to rest for about 8 seconds in between each lift up of the muscles. If you can’t hold for 8, just hold for as long as you can.
3. Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 12 squeezes. When you first start after having your baby you might like to begin with 3 squeezes only, and work up to more over a few weeks.
4. As you get stronger, try to do three sets of 8 to 12 squeezes each, with a rest in between.
5. Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing.

While doing pelvic floor muscle training—

• Do NOT hold your breath;
• Do NOT push down, only squeeze and lift; and
• Do NOT tighten your buttocks or thighs.

Kif nagħmel l-eżerċizzji tal-muskoli tal-qiegħ tal-pelvi?

Issa li tista’ tħoss il-muskoli jaħdmu—

1. Agħfas u iġbed ‘l ġewwa l-muskoli madwar il-passaġġ tiegħek ta’ wara, il-kanal tiegħek tat-twelid u l-passaġġ tiegħek ta’ quddiem kollha fl-istess ħin. Ogħllihom ‘IL FUQ ġewwa. Int għandu jkollok sens ta’ “refgħa” kull darba li tissikka l-muskoli tal-qiegħ tal-pelvi tiegħek. Ipprova żommhom qawwija u magħfusin hekk kif tgħodd sa 8. Issa, erħihom u strieħ. Int suppost tħoss fi-żgur li “qed terħi għal kollox”.
2. Irrepeti (agħfas u erfa’) u ntelaq. L-aħjar tistrieħ għal xi 8 sekondi bejn kull darba li terfa’ ‘l fuq il-muskoli. Jekk ma tistax iżżomm għal 8, ipprova żomm sakemm tista’.
3. Irrepeti dan “agħfas u erfa’” daqs kemm tista’, sa limitu ta’ minn 8 sa 12-il għafsa. Meta tibda għall-ewwel darba wara li jkollok it-tarbija int tista’ tagħżel li tibda bi 3 għafsiet biss, u żiedhom fuq firxa ta’ ftit ġimgħat.
4. Hekk kif issir aktar b’saħħtek, ipprova agħmel tliet settijiet ta’ minn 8 sa 12-il għafsa, b’perjodu ta’ serħan bejniethom.
5. Agħmel dan il-pjan sħiħ ta’ eżerċizzju (tliet settijiet ta’ minn 8 sa12-il għafsa) kuljum waqt li tkun mimduda, bilqiegħda jew bilwieqfa.

Waqt li tkun qed tagħmel l-eżerċizzju tal-muskolu tal-qiegħ tal-pelvi —

• IŻŻOMX in-nifs;
• TIMBOTTAX l-isfel, agħfas u erfa’ biss; u
• TAGĦFASX il-warrani tiegħek jew koxxtejk.

Do your pelvic floor muscle training well

Fewer good squeezes are better than a lot of half hearted ones! If you are not sure that you are doing the squeezes right ask for help from your doctor, physiotherapist, or continence nurse advisor.

Agħmel sewwa l-eżerċizzju tal-muskolu tal-qiegħ tal-pelvi

Inqas għafsiet tajba huma aħjar minn ħafna ta’ nofs kedda! Jekk m’intix ċerta li qed tagħmel l-għafsiet kif suppost itlob l-għajnuna tat-tabib, tal-fiżjoterapista, jew tan-ners tiegħek konsulenta tal-kontinenza.

Make the training part of your daily life

Once you have learnt how to do pelvic floor muscle squeezes, you should do them often. Every day is best, giving each set of squeezes your full focus. Make a regular time to do your pelvic floor muscle squeezes. This might be when you:

• go to the toilet;
• wash your hands;
• have a drink;
• change the baby;
• feed the baby; or
• have a shower.

It’s a good idea to get into the lifelong habit of doing one set of pelvic floor muscle exercises every time you go to the toilet, after passing urine or opening your bowels.

Agħmel l-eżerċizzju parti mill-ħajja tiegħek ta’ kuljum

Hekk kif titgħallem kif tagħmel l-għafsiet tal-muskolu tal-qiegħ tal-pelvi, int għandek tagħmilhom ta’ spiss. Kuljum hu l-aħjar, ikkonċentra totalment fuq kull sett ta’ għafsiet. Iffissa ħin regolari meta tagħmel l-għafsiet tal-muskoli tal-qiegħ tal-pelvi. Dan jista’ jsir meta int:

• tmur it-tojlit;
• taħsel idejk;
• tixrob xi ħaġa;
• tbiddel lit-tarbija;
• titma’ lit-tarbija; jew
• tieħu doċċa.

Hi ħaġa tajba li int tidra tagħmel għall-kumplament ta’ ħajtek sett wieħed ta’ eżerċizzji tal-muskoli tal-qiegħ tal-pelvi kuldarba li tmur it-tojlit, wara li tgћaddi l-awrina jew tipporga.

What if things don’t improve?

Pelvic floor muscle damage may take up to six months to get better. If things are not getting better after six months, speak to your doctor, physiotherapist or continence nurse advisor.

X’jiġri jekk l-affarijiet ma jmorrux għall-aħjar?

Il-ħsara fil-muskoli tal-qiegħ tal-pelvi tista’ tieħu sa sitt xhur qabel ma jmorru għall-aħjar. Jekk l-affarijet ma jmorrux għall-aħjar wara sitt xhur, kellem lit-tabib, lill-fizjoterapista jew lin-ners tiegħek konsulenta tal-kontinenza.

Also ask your doctor for help if you notice any of the following:

• any leaking of urine;
• having to rush to get to the toilet, to pass urine or open your bowels;
• not being able to hold on when you want to;
• not being able to control passing wind;
• burning or stinging inside when you pass urine; or
• having to strain to start the flow of urine.

Barra minn dan, itlob lit-tabib tiegħek jgħinek jekk tinnota xi wieħed minn dawn li ġejjin:

• xi tqattir tal-awrina;
• ikollok tmur tiġri biex tmur it-tojlit, biex tpixxi u jew tipporga;
• ma tkunx tiflaћ ‘ iżżomm meta trid int;
• ma tkunx tista’ tikkontrolla l-ħruġ tar-riħ;
• ħruq jew tingiz ġewwa meta tagħmel l-awrina; jew
• ikollok titqanżaħ biex tibda l-fluss tal-awrina.

Seek help

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:

• Information;
• Advice; and
• Leaflets.

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.

Itlob l-għajnuna

Hemm nersis ikkwalifikati jekk iċċempel lin-National Continence Helpline fuq 1800 33 00 66* (mit-Tnejn sal-Ġimgħa, bejn it-8.00am to 8.00pm AEST (Ħin Standard tal-Lvant tal-Awstralja)) mingħajr ħlas:

• Informazzjoni;
• Pariri; u
• Fuljetti.

Jekk ikollok diffikulta’ biex titkellem jew biex tifhem bl-Ingliż jista’ jkollok aċċess għall-Helpline permezz tat-Telephone Interpreter Service fuq 13 14 50 b’xejn. It-telefon ikun imwieġeb bl-Ingliż, għalhekk għid liema lingwa titkellem u stenna fuq it-telefon. Tkun ikkonnettjat/a ma’ interpretu li jitkellem il-lingwa tiegħek. Għid lill-interpretu li tixtieq li ċċempel lin-National Continence Helpline fuq 1800 33 00 66. Stenna fuq it-telefon biex tkun ikkonnettjat/a u l-interpretu jgħinek biex titkellem ma’ ners li tagħti pariri dwar il-kontinenza. It-telefonati kollha huma konfidenzjali.

* Telefonati minn fuq telefonijiet mowbajl ikunu ċċarġjati r-rati li japplikaw.