Following childbirth, it is common to experience accidental leakage of urine or even bowel contents. Sometimes leakage is related to a lack of sensation when there is a full bladder or need to have a bowel movement, and sometimes it is purely due to weakened, stretched muscles and/or damaged nerves following childbirth. This may seem overwhelming when faced with the need to care for a new infant. It is important to know that postpartum incontinence is common, and often improves or resolves within a few months. It is even more important to realize that physical therapy following childbirth is even more likely to result in restoration of continence. There are several studies documenting the utility of pelvic floor physical therapy following childbirth, unfortunately, in the United States, receiving this treatment is relatively rare. It is very important to be proactive and ask about therapy for incontinence and pelvic floor rehabilitation, since the best results are achieved by starting as soon as the tissues have healed following delivery.
Although many doctors will advise performing “Kegel” exercises, often women really do not know how to perform the exercises properly. In addition, there are other aspects to pelvic floor physical therapy which involve more than squeezing the vaginal muscles. I often use the analogy of going to the gym for a workout. Few people would go to a gym and start lifting weights without receiving at least some training in proper technique, in order to avoid injury and achieve optimal results. This is certainly the case with pelvic floor physical therapy, as performing “squeezes” comprises only a part of the full program of rehabilitation.
Biofeedback, muscle training, and appropriate testing are all important in achieving optimal results. If you have delivered recently and are experiencing problems with bladder or bowel control, ask about physical therapy. Another option which may be helpful is a device; InTone (R), which is provided through your doctor but is performed at home for twelve minutes per day.
If it is not possible to get to an office for weekly half-hour sessions, using this device may allow for proper instruction as well as more convenient practice. For more information, ask your doctor, or call 561-701-2841.
Linda Kiley, MD
Dr. Kiley is a Board Certified subspecialist in Female Pelvic Medicine and Reconstructive Surgery, and is also Board Certified in general Obstetrics and Gynecology.