Staying in Control

When Mom's Sneezes Make Unpleasant Surprises

After giving birth, nearly half of women suffer incontinence due to the stretching of ligaments and muscles in their pelvic floors. For a majority of affected moms, these symptoms subside after three to six months, but others experience leakage and weakness of pelvic muscles even after six months, with about 10 to 20 percent requiring medical help. Yet, many don’t know how common the problem is, and have a hard time asking for help.

Dr. Gazala Siddiqui sees more than a thousand patients a year for this condition in her position as an Urogynecologist at McGovern Medical School at UTHealth, affiliated with Memorial Hermann-Texas Medical Center. She notes certain factors can increase the likelihood of post-partum incontinence.

• Excessive caffeine use
• Obesity or excessive weight gain during pregnancy
• Prolonged pushing during labor
• Use of vacuum and/or forceps during delivery
• Giving birth to larger babies or twins
• Genetic history

Fortunately, Dr. Siddiqui says moms experiencing mild incontinence can decrease its effects with a few do’s and don’ts.

• Avoid smoking, which weakens ligaments and increases the risk of bladder cancer
• Avoid constipation
• Maintain a healthy weight to relieve excess pressure on your pelvic floor
• Limit the weight you lift from the floor—such as doing deadlifts or carrying children—to no more than
• 20 pounds per session and bend your knees to properly distribute lifting effort
• Do Kegel exercises to help regenerate pelvic floor muscles

If the incontinence continues, there are three categories of treatment available.

Pelvic Muscle Training

Kegels are great for decreasing leakage, but tricky to master. Dr. Siddiqui frequently refers her patients to “pelvic floor trainers” who, similarly to physical therapists, can teach you the right way to exercise and measure your progress over several months.

Pessaries

Patients who don’t see improvement after pelvic muscle training may consider using a pessary — a plastic device that supports the urethra. Pessaries can be worn throughout the day or during specific activities to prevent urinary leaking.

Surgery

Surgical intervention for post-partum incontinence is a minimally invasive procedure. It’s a good option for moms who don’t plan further pregnancies.

Dr. Siddiqui advises women to seek medical advice as soon as incontinence affects their quality of life. She says many of her patients have only one regret: that they didn’t begin treatment earlier to experience.