pelvic floor issues

Prevention of pelvic floor issues during & post-pregnancy – Annette Beauchamp

Doctors of South Melbourne welcomes our first guest blog contributor, Annette Beauchamp from SHE Physio & Pilates.

Nearly 4.8 million Australians are affected by incontinence.1

Women are more likely than men to be affected by bladder and bowel issues; the main contributing factors are vaginal labour, pregnancy and menopause. Over half of women who suffer from incontinence are under 50!1

Key facts on incontinence

The incidence of urinary incontinence in pregnant women rises starkly from 10.8% in the first trimester to 55.9% in the final trimester. Urinary incontinence before pregnancy is associated with childhood incontinence (enuresis). Incontinence in pregnancy increases with higher body mass index in pregnancy.2

Following pregnancy, there’s a 1 in 3 chance of urinary incontinence persisting. One thing is for certain; incontinence rarely goes away without some effort by the new mum.

Hands-on education is the key to recovery. Over a third of women get it wrong when trying to learn pelvic floor exercises by listening to instructions. Pelvic rehabilitation should begin early-on after having a baby to speed up recovery and get mama ready for the return to pre-baby activities.

Abdominal separation

There’s an association between persistent abdominal separation and pelvic problems, including incontinence and pelvic organ prolapse.

Abdominal muscles separate in the last trimester to allow growth of the babe. Muscle recovery varies greatly in mamas post-natally.

Some activities slow down the repair of the separation and should be avoided. These include:

  • burpees
  • swinging kettlebells
  • star-jumps
  • planks
  • sit-ups.

Include Kegels in your daily routine

It’s beneficial to learn the correct techniques for contracting your abdomen and pelvic muscles together. Pelvic muscle exercises are sometimes called Kegels.

Make pelvic floor exercises part of your day when you’re pregnant. This will assist with issues during pregnancy and to set a pattern for post-natal exercise when muscles are weaker.

There’s much debate about frequency and variety of contractions. I suggest mamas make pelvic and abdominal exercise part of their daily routine rather than setting time aside to do these in isolation. With mamas being so busy, it’s easier and better for such exercises to form part of your daily activities.

There are other issues faced by women in pregnancy and post-pregnancy, such as:

  • pelvic pain affecting the pubic joint
  • sacroiliac joint
  • the coccyx and lower back
  • pain in wrists and hands, upper back and neck.

These all respond well to manual therapy and exercise.

Annette Beauchamp is a local physiotherapist and owner of SHE Physio & Pilates in Middle Park. SHE focusses on continence and women’s health.

1 https://continence.org.au/data/files/Access_economics_report/dae_summary_final_web_version.pdf

2 Brown SJ, Donath S, MacArthur C, McDonald EA, Krastev AH 2010 ‘Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors’, International Urogynecology Journal and Pelvic Floor Dysfunction, 21(2): 193 – 202