Causes of incontinence after birth
Incontinence is not uncommon during pregnancy or after the birth of a child. Although few women talk about it openly, more than 20 percent of all mothers suffer from urinary incontinence, at least in the first few weeks after a vaginal birth. A few women also suffer from fecal incontinence.
Pregnancy and childbirth place an enormous strain on the female body, particularly on the pelvic floor. The pelvic floor muscles are a plate of muscles in the small pelvis that support the abdominal organs, including the bladder, downwards and hold them in the correct position. During childbirth, the pelvic floor muscles are greatly overstretched and often injured. This can lead to pelvic floor weakness, which causes the organs above to sink. If the bladder is no longer in its intended position, this can impair the closing force of the bladder sphincter.
Symptoms and types of incontinence after birth
Many women notice immediately after giving birth and during the postpartum period that they can no longer reliably hold their urine. Involuntary urine loss can occur particularly when coughing, laughing or sneezing, i.e. when there is pressure in the lower abdomen. This type of bladder weakness is known as stress incontinence.
Difficult births with injuries can also result in fecal incontinence. This occurs more frequently in vaginal births with high birth weight and a long expulsion phase, and can lead to pelvic floor injuries and perineal tears.
Duration of incontinence after birth
Temporary bladder weakness in the first few weeks after a vaginal birth is very common. The pelvic floor usually recovers within a few months. To this end, postnatal exercise should be carried out, in which the pelvic floor is trained and strengthened with targeted exercises. In some cases, however, incontinence can persist for longer, particularly if nerves have been damaged.
Risk factors for prolonged incontinence after birth
- Pre-existing pelvic floor weakness
- High birth weight of the child
- Multiple previous vaginal births
- Difficult births, e.g. with forceps or vacuum extraction
- Long expulsion phase
- Older age of the mother (over 35 years)
- Obesity before and during pregnancy
- Severe weight gain during pregnancy
- Gestational diabetes
Treatment of incontinence after birth
Many women are ashamed of incontinence after giving birth and therefore do not discuss the subject. However, this is fatal because there are a number of good treatment options. It is therefore important to consult a gynecologist or midwife as soon as possible. They are familiar with the problem and can determine the exact causes of the incontinence through a detailed medical history and physical examination and then draw up an appropriate treatment plan.
Treating incontinence after the birth of a child is comparable to treating incontinence for other reasons. In most cases, there is more or less severe stress incontinence after birth, which occurs as a result of a weakened pelvic floor. The most important thing for treating a weakened pelvic floor is pelvic floor training. The aim of pelvic floor training is to strengthen the weakened pelvic floor muscles again. Stress incontinence then usually improves or disappears completely.
Pelvic floor training
Pelvic floor training is a group of special exercises that are usually learned and practiced under the guidance of a midwife or physiotherapist. These exercises should be performed during pregnancy if possible. It is even better to train the pelvic floor muscles regularly before a planned pregnancy. The stronger and firmer the pelvic floor is, the better it can cope with the stresses of pregnancy and childbirth. Possible incontinence afterwards can thus be prevented to a certain extent.
Importance of pelvic floor training after birth
However, if pelvic floor exercises were not carried out either before or during pregnancy, the young mother should start after the birth at the latest. This is because the expulsion phase during a natural birth puts a particularly heavy strain on the pelvic floor. As a result, pelvic floor weakness - combined with urinary incontinence - often occurs after the birth, which often remains permanent without treatment. To prevent this, targeted postnatal or pelvic floor exercises should always be carried out after the birth. However, the exercises should not be started too early. This is because immediately after the birth, the body needs some time to recover from the strain and possible injuries of the birth. The optimal time to start postnatal exercises is after the postpartum period, i.e. around six weeks after the birth at the earliest. Sports such as fitness training or jogging should also be avoided in the first few weeks after the birth, as they can make the symptoms worse. At this point, the tissue is usually still very weak, so that running, lifting weights or jumping can quickly lead to incontinence with involuntary loss of urine. Only when the pelvic floor is stable again with the help of pelvic floor training can you carefully start doing sports that are gentle on the pelvic floor, such as swimming or cycling.
Aids for incontinence during and after pregnancy
In addition to pelvic floor exercises, various aids have also proven to be very effective in treating incontinence during and after pregnancy. These aids offer additional support and security when dealing with bladder weakness and should always be used in consultation with a doctor to ensure that they are suitable for the individual situation and do not cause further problems. Here are some of them:
Discreet incontinence pads and liners
These small pads and large pads are discreetly placed in the briefs to safely absorb small amounts of urine. They are particularly practical and unobtrusive in everyday life and offer reliable absorption of urine to avoid unpleasant situations.
Cerclage Pessare
Cerclage pessaries are used during pregnancy to close the cervix. This can help reduce the risk of premature birth and prevent complications. By closing the cervix, pressure on the bladder is also reduced, which helps relieve incontinence symptoms in some women.
Pessaries for the treatment of prolapse
Prolapse symptoms can occur both during and after pregnancy and can affect various organs in the pelvic area, including the bladder. Pessaries are special devices designed to support and stabilize organs to relieve prolapse symptoms. They can also help reduce the symptoms of bladder weakness and improve the quality of life of affected women.
Tips for women to promote continence
Discover other different approaches to promoting continence and dealing with incontinence! From targeted lifestyle changes to psychological support, we offer you insights into effective methods to minimize involuntary urine loss. Because actively dealing with incontinence can help to strengthen self-confidence and maintain the joy of life.