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We all know that there are many changes to our bodies during pregnancy and, although we can cope with most of them, bladder weakness is one of the more irritating of these changes. Many women are unprepared for the inconvenience they will experience and 2 out of 3 pregnant women will experience some form of
bladder weakness during and after pregnancy. This is because pregnancy, labor and birth place additional strain on the pelvic floor muscles, thus weakening them.
You may leak a few drops when you sneeze, cough or laugh. Some women find this to be a real problem. So to avoid any embarrassment, particularly while you are building up the strength of your pelvic floor muscles, wear a panty liner.
Helping your bladder to stay healthy
The good news is that you can do a lot to help your bladder to stay healthy:
o Drink plenty of fluids, but if you find you have to go to the toilet frequently during the night then cut out drinking before bedtime but make sure you make up for it during the day.
o When you are on the toilet, trying rocking backwards and forwards. This lessens the pressure of the womb on the bladder so that you can empty it properly. If you do this, you won’t need o pass water quite as often as before.
o Don’t go to the toilet “just in case” or every time you get the urge – try to hold on.
o Cut down on bladder irritants such as coffee, tea, cola drinks and of course no alcohol should be consumed.
o Maintain a healthy weight.
o Learn to do pelvic floor exercises.
Strengthening pelvic floor muscles through exercise
Your pelvic floor muscles are just like any muscles and need a regular workout to stay strong! Your pelvic floor muscles need particular attention both during your pregnancy and after the birth of your baby.
The floor of your pelvis is made up of layers of muscle and other tissues. From the tail bone at the back to the pubic bone at the front, your layers of muscles stretch like a trampoline. The urethra, the vagina and the rectum all pass through those pelvic floor muscles which support both the uterus and the bowel. If you can strengthen your pelvic floor muscles through exercise, you will be able to improve your control of your bladder.
You need patience as it may take 6 to 12 weeks before you notice any improvement so the earlier you can start in your pregnancy the better.
If you find it difficult to remember to do your exercises, then put a note to yourself on the toilet door to remind you! These exercises should be done at least 3 times per day but preferably 6 times per day.
o Squeeze and draw up the muscles around your anus, vagina and urethra as strongly as possible. Try to hold this squeeze and lift for 3 seconds and then relax completely. Repeat this exercise 3-5 more times. Gradually increase your pelvic floor muscle strength by holding the squeeze and lift for a longer period.
o To progress your exercises, hold each contraction strongly for as long as you can, slowly increasing to 10 seconds. Rest between each contraction and repeat as many times as you can, aiming for a maximum of 10 contractions. Always stop exercising when the muscle fatigues.
o It is also important to include fast strong pelvic floor contractions holding each exercise for only 1 second. The action is necessary for retraining the muscle to contract quickly when you cough laugh or sneeze. Now try doing 5-10 quick strong exercises. Do not forget to rest between each exercise.
This exercise is very effective and can be done while sitting, standing, lying down or even walking.
After the birth of your baby
After your baby is born, carry on with these exercises to help the healing process. In addition:
o Rest in a horizontal position (15-30 minutes) at least twice a day or as much as possible on your tummy or back.
o Support the perineum when having a bowel movement.
o Do not lift anything heavier than your baby.
Twelve weeks after your baby’s birth, you can check your pelvic floor strength by:
o stopping the flow of urine mid stream
o Coughing with a full bladder
o Prior to commencing strenuous exercise, check your pelvic floor strength by jumping with a full bladder.
If there is no urine leakage you can reduce your pelvic floor exercises to one set per day. This set should include the long holds and quick squeeze.
However if you have leakage, do see a women’s health physiotherapist and if you have any pain or blood when passing urine, you may have a urine infection that will need treatment. Please contract your doctor, midwife or healthcare provider straight away for treatment and do drink plenty of water to reduce the irritation.