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Regaining body control after giving birth

Posted by Lara Salahi  November 8, 2013 09:43 AM

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Losing control. It’s a common feeling for many mothers the first few weeks after giving birth. It may seem difficult to get a grip on your emotions let alone your schedule with your seemingly nocturnal newborn (what time is it again?).

But what is more often overlooked is the physical toll birth takes within many women's lower bodies, beyond just gaining baby weight. The conditions are known as pelvic floor disorders and occur when the muscles, ligaments, nerves and tissue that keep our pelvic organs like the bladder and uterus – which undergo incredible pressure during birth -- weaken or tear.

Left untreated, it can lead to embarrassing conditions like incontinence or pelvic organ prolapse -- which is likely why we don’t want to talk about it. But we should, because it’s the most common disease women experience after pregnancy. 

1 in 3 women will experience a pelvic floor disorder in their lifetime with a majority of cases happening in older adults. While most postpartum cases happen in women who have vaginal births, a handful of women who undergo a c-section are also at risk because of the baby’s weight or placement. It can also happen from exercising too hard too soon after giving birth.

Valerie Clark, a nurse in Boston, began experiencing incontinence while she was pregnant.

“Anytime I coughed or sneezed, or ran or laughed, I couldn’t hold my urine,” she said.

Although she delivered her son by c-section, her symptoms seemed to have gotten worse over time.

“I wondered why it continued if I didn’t have my son vaginally,” she said. “I thought originally that it was normal.”

With a new baby to care for, women often ignore their own pain symptoms and chalk it up to normal postpartum recovery or inevitable changes from childbirth. Some women who are not done having children simply ignore their symptoms because they mistakenly believe surgery is the only treatment, said Dr. Janet Li, section chief of urogynecology at Beth Israel Deaconess Medical Center.

For six years, Clark held out on seeking help for what was later diagnosed as stress incontinence -- partly because she thought it was a normal and temporary change she would have to deal with, and partly because she felt too embarrassed to say anything. She thought pelvic exercises would be sufficient to her regain muscle control.

“I put this in the category of an older woman’s problem,” she said. “I was determined, methodical about Kegels. As many as I could do them.”

While Kegels seem to be an effective strengthening method, the truth is many women don’t do them correctly or it’s just not enough.

“The great thing about Kegels is that there’s nothing bad that can happen, even if you do it wrong,” said Li, adding that many women could benefit from seeing a pelvic floor physical therapist.  

In fact, a small study released Thursday in the Journal of Obstetrics and Gynecology found that for a handful of women, Kegel exercises were not effective a preventing urinary incontinence 6 months after giving birth. 

For Clark, the treatment was a simple outpatient surgery. Had she known her problem would have been corrected in just a few hours, she said she would’ve sought help years earlier.

Women should get a pelvic health assessment as early as 6 weeks postpartum, and even earlier if bladder control or pain is bothersome and impacting your activities, said Li.

Depending on the type of incontinence or bladder disorder, treatments can include pelvic floor exercises, medications, and devices, before surgery is even considered.

“Time will tell whether it’ll go away on its own or need intervention but seek advice early,” said Li. “Calling it ‘normal’ is a slippery slope.”

To learn more about pelvic floor disorders, visit the PFD Alliance 

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This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Lara Salahi is an award-winning multimedia journalist whose specialty is reporting health and medical stories. She has worked in local, network, and cable television, international print, and documentary film. She More »

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