If you are experiencing incontinence after childbirth, know that you’re not alone and, no, it’s normal. Here’s how your current exercises may be worsening the issue.
In the United States, the average prenatal checkup lasts six minutes. Birthing people usually have 12-13 visits total during their pregnancy, which equates to an average of 87 minutes of prenatal care over nine months.
Once the baby is born, the average postpartum person receives one postnatal checkup at around six weeks postpartum. That’s an average of six minutes of postpartum care. This number could be slightly more if you had a c-birth.
Birth is a significant physical event, and a cesarean section is a major surgery, yet we are left to our own devices to heal while caring for a tiny human (or humans) without much direction from care providers, especially when it comes to your pelvic floor.
Pelvic floor issues and postpartum healing
During the six-week postpartum checkup, care providers do not routinely screen patients for diastasis recti, pelvic organ prolapse, or pelvic floor function.
Instead, most people are cleared to resume “normal activities” such as exercise, sex, and routine daily life movements with little, if any, further guidance.
When I asked my OBGYN about leaking urine, she simply replied, “Welcome to motherhood! It’s part of the package.” But that answer isn’t sufficient or supportive.
Those who have just given birth aren’t given the tools needed to rehabilitate and heal, especially their pelvic floor.
With this level of postpartum care, it’s no wonder that, according to a study by NCBI, “an average of 41% of people who have given birth experience some degree of stress incontinence.”
Postpartum incontinence and exercise
You leave that six-week checkup ready to lace up your running shoes and hit the pavement, or jump back into the boot camp class you loved pre-pregnancy. Then when it feels extra hard or leaking is experienced, it’s often chalked up to being “out of shape” and thinking you need to “push through it.”
That’s where things get tricky. When you leak during movements and exercises (whether it’s urine, gas, or stool), it is your body’s way of telling you whatever the activity is you’re doing is too much.
Your pelvic floor can’t handle the pressure, literally, and it’s critical to pay attention.
Certain high-intensity moves can increase intra-abdominal pressure:
- Jump squats
Intra-abdominal pressure is the steady state of pressure confined within the core and is regulated by the interaction between the diaphragm, pelvic floor, transverse abdominis, and multifidus muscles.
If we don’t know how to control intra-abdominal pressure properly (and how could we if we aren’t taught), the pressure gets pushed down onto the pelvic floor, making concerns like stress incontinence worse.
That doesn’t mean you can’t still work hard or that you can’t continue to do the exercises and activities you enjoy. It just means you need to adjust your strategy.
Taking the time postpartum to rehabilitate your pelvic floor and core through programs such as LUNA Mother Collective’s Core Restore program or Every Mother – as well as seeing a pelvic floor physical therapist for a thorough assessment – can make all the difference.
These programs will help you get back to the activities you love faster with less risk of setbacks or worsening pelvic floor issues. Then build a foundation of overall strength with workouts designed for postpartum first, before returning to higher impact movements.
Final thoughts on incontinence after birth
It is not too late if you are further along in your postpartum journey and have older kids but still experience stress incontinence.
It is never too late to rehabilitate and heal your body after having children.
Seeing a qualified pelvic floor physical therapist is the first step. They will assess to see what is going on with your body and provide you with a path to recovery.
It’s also essential to work with a certified trainer in pre and postnatal fitness and is well versed in pelvic health. These trainers can help you bridge the gap between rehab and exercise and can help you adjust your strategies so that you can get back to higher impact training while keeping you dry.