Leakage after having a baby

Anonymous writes:

Can we talk peeing? Our own peeing?

Several years after the birth of our kid, I’m still dealing with significant stress incontinence. Our kid was born vaginally with nearly zero molding of her head. So her round basketball of a dome “turtled” for two hours.

I used to run regularly but it’s been ruined. Coughing, slipping, a good sneeze here and there and I have leakage. This was a long, long winter.

I know Kegels. But have any of you done anything more substantial? Pelvic floor therapy? Surgery? Something else?

I mourn running but more I mourn in advance not being able to do things with my daugher because I’m worried I’ll pee. I don’t want to be the sedentary parent. And I’m cognizant that this just gets worse as we get older.

I want to believe there are answers and success stories.”

I would try physical therapy specifically for pelvic floor injuries. I’ve heard of plenty of success stories for stress incontinence and even prolapsed uterus, but don’t know enough to recommend anything specific other than starting with physical therapy. 

Does anyone have any experience with this that they’d like to share with Anonymous? (Feel free to comment anonymously yourself, obviously.)

22 thoughts on “Leakage after having a baby”

  1. Physical therapy! I saw NINE different people (urologist, ob/gyns and midwives, PTs, …) before finding an amazing physical therapist. Basically, everybody said that I would never improve without surgery, but after three visits with this awesome PT, I was 95% better. I was doing kegels wrong in a very subtle way. Most PTs rely on electronic feedback to analyze kegels, but the electrode didn’t pick up what I was doing wrong.

  2. So after the birth of my first, I had some major issues. I was in induced labor with him for 27 hours, pushed for almost 2, and had a third-, almost fourth-degree, tear. I was having both types of incontinence and it was horrible and embarrassing. I got up the courage to speak to my OB about it and he recommended PT for it. I was able to do it at their office (a nurse specialized in it; it was mainly for the older patients) and it was great. I learned the proper way to do Kegel’s and did some biofeedback with her, as well. It definitely helped. I don’t think it’s something we necessarily have to just live with. I have now had three kids and definitely need to be doing some Kegel’s again!

  3. I was doing Kegels wrong which was making the problem worse. This is, apparently, not uncommon. So I’d say stop doing them.

  4. Pelvic floor rehabilitation PT was a godsend, and it’s a GREAT place to start. And, it might be all you need.

    I learned in PT that good pelvic floor integrity has so much more to it than just effective Kegels. I learned how to pair pelvic floor exercises with exercises for related muscle groups to maximize efficiency and effectiveness. I also learned different ways of approaching Kegels to address different types of muscle fibers, both fast twitch (for quick squeezes/holding it in) to slow twitch (for deeper strength to better support the bladder and other organs in proper position in the pelvis).

    I really can’t recommend this enough.

    Also, I had some internal tearing from birth that had left some adhesions as they scarred over. My PT was able to do scar mobilization massage on those tissues so that they weren’t painful anymore. She said that I could kinda work that out myself with intercourse if it was too much in PT or I wasn’t comfortable with her doing it. I decided that I’d rather SHE do it (it was painful to release the adhesions, but then they didn’t hurt after), than have a painful association with having sex, y’know?

    I’ve known too many women whose docs recommended surgery without ever trying PT, and that makes me sad. The PT is so worth trying. Go for it!

  5. Obstetric fistula. It’s not a shameful, anonymous thing. PT might help, but some cases benefit from surgery. This happened to my neighbor after her (unnecessary) induction and she will have surgical repair followed by PT. Good luck!

  6. This is totally timely, as I am scheduled for rectocele surgery (bad epis that dehisced) as well as introitus repair (ummm, I don’t really have a taint anymore is probably the easiest way to explain) in June.

    I’ve known this was coming for a while. The only reason I’m continent is pelvic floor physiotherapy. It is the best.

    Anyone had pelvic floor surgery and care to comment? I’ve also had a hemoroidectomy, so I know how hurty it can be.

  7. Goddess Babe could be me. Exact same story here. It was simple, effective, painless, and it wasn’t something I could have done without professional help. It really helped to have a professional guiding and assessing me. And it’s also hugely helpful to have the issue normalized. It happens to so many people and it’s not a lone embarrassment or humiliation, just part of life. Plus, you can fix something that might otherwise bother you for years. Googling pelvic floor therapy, pelvic therapy, or asking your OB/GYN should help you locate somebody. Don’t let your OB/GYN or anyone tell you to just do some Kegels. It’s more complicated than that!

  8. My massage therapist / osteopath is helping me with this right now. Apparently my uterus and bladder are turned in towards each other and facing downward, or more downward than they should (hard to describe this in words). And this is contributing to the leakage. The first treatment for starting to reposition everything was kind of painful, but manageable, and helped things a bit. He will keep treating, but if we aren’t seeing enough results he will refer me to someone who specializes in this specific issue (another osteopath, I think). Almost 6 years post partum and I had no idea this was a thing (other than me) and that there was something other than kegels that could be done. It was thanks to a FB Ask Moxie post that I ended up mentioning it to my massage therapist/osteo. I decided I wanted to start with the absolute least invasive/painful treatment and proceed up from there as necessary.

  9. Try Chiropractic! Make sure you get a good one who is minimally hands on. Mine is great and does most of it with a "clicker"

  10. Quick tip: If you aren’t sure whether you are sweating, leaking vaginal fluid or leaking urine, try wearing a good pantyliner/Poise pad and using Azo Standard for 2-3 days. It will be obvious when you are leaking urine then! (my surgeon’s PA suggested this) Apparently a few drops are normal for anyone, but anything more is an indication of a possible problem. PT absolutely can help and is still a good idea – if you can find a good therapist and can afford it. But, sometimes PT isn’t enough.

    At the beginning of 2013, I started PT for stress incontinence. After just a few sessions of me learning the proper way to do Kegels and practicing on my own, we were able improve my muscle tone an impressive amount. Sex was sure a lot more fun and enjoyable 🙂

    BUT, the problem remained and my PT told me that I had a level 1 prolapse that would likely require surgery. She recommended I try a pessary, but it was really uncomfortable and I decided it wasn’t a realistic solution. So I went to see the urogynecologist that my OB/Gyn recommended. He didn’t agree that I had any significant prolapse, but agreed that surgery would be the most effective in preventing leakage. He was very supportive of my doing PT, saying it definitely helps improve the health of vaginal tissue. While scheduling surgery, I found out it would require staying out of the swimming pool for 4 weeks. It was the start of swimming weather here (central Texas – not an option for me to stay out of the water with my boys…), so I put it off for a while.

    Forward to this past February. I had the TVT sling surgery 7 weeks ago and am mostly healed by now. The surgery went smoothly, with almost no pain. I took it very easy for the first few days – sat on my couch, caught up on emails and movies on Netflix, etc. Then I slowly returned to my normal activities. I was able to gradually return to running after 2 weeks, but couldn’t lift anything over 10 pounds until 6 weeks. No sex until 4 weeks, but the internal stitches hadn’t completely dissolved, so I chose to abstain for another 2 weeks.

    I’ve made it a point to be open about my surgery (when appropriate) because it is such a tabu topic. Can’t tell you how many women have opened up and been excited to talk about it freely! I hate that so many of us suffer and feel embarrassed by something that is so common!

  11. Try mutusystem. it’s an exercise program I used for abdominal diastasis. lots of people in the group used it to fix uterine prolapse/leaking

  12. Several people mentioned that they’d been doing kegels incorrectly. I know you probably need a PT to analyze this properly, but can you describe what the basic problem was and how you changed what you were doing?

  13. I’d recommend checking out the Hab-it program. After having my son, I didn’t have problems with peeing, but I did feel like my insides were falling out, especially when I’d try to run. The Hab-it programs, I did both the basic and advanced, made a world of difference for me.

  14. Thank you for this…struggling with this myself, almost 27 months post-birth now, and winter colds and such have me feeling SO unsexy. Good to know the direction to go for assistance!

  15. I also had some problems in this area – eventually resolved without PT but I had a referral (couldn’t figure out what to do with a 1 year old and 3 year old while I did it… blech). But PT! All the way! I was living in a big city at the time and there were PTs who specialized in the issue – I highly recommend looking for someone well-trained, as it’s a bit of a delicate business.

    I’d also like to mention to the OP that she might want to look at her medications, if any. Most antihistamines (claritin, benadryl, etc), and many other drugs, are mild diuretics, which can make the problem worse. Not that it’ll solve the problem but it might help a little.

  16. Consider this–in France, where evidence of effectiveness is required by their national system of healthcare is mandated, all women are given a script to see a PT for an evaluation postpartum. A good PT will look at your abdominal and hip strength and see if you have an issue with diastasis recti, prolapse, or scarring internally during the exam as well as if your kegel technique. They are trained to look at all the issues and work out a plan to treat what’s there. You really can’t know why it’s happening until you get the eval. A midwife, ob, trainer, osteopath may all have great suggestions, but the physical therapists are trained to prioritize and teach you what you need to do based on an internal exam and will quickly refer you back to your ob to talk surgery with a urologist if things would not improve by addressing the neuromuscular issues. I am a DPT, but I don’t have more than a little training in this, And made radical improvements on leakage after 2 sessions and homework. It does require you to work in order to be successful, and the last 20% to goal is not easy, nor is the cost or time away from baby, but it Is at least worth an eval.

  17. Acupuncture is also very helpful for incontinence as well as postpartum depression and a host of post-birth related issues.

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