We’ve all been there. The kids are jumping on the trampoline and want you to join them. Or maybe when you feel a sneeze or cough coming, so you say a silent prayer that you won’t pee your pants. Urinary incontinence is common for women after childbirth and I always thought it was just the price we had to pay for having children. Women who are candid enough to talk about it often get knowing looks and laughter from other women who have experienced urinary incontinence, otherwise known as stress incontinence- the stressor being the cough, sneeze or jump. Some women have fecal incontinence as well. The opposite condition can exist too, which is constipation and not being able to empty the bladder entirely. I had four vaginal deliveries and was 46 years old before I discovered there is a treatment available for these emotionally and physically-taxing pelvic floor dysfunctions.
The pelvic floor is made up of 26 individual muscles. They look much like a hammock, connect at the pubic bone and cross the pelvis all the way to the tailbone. The four main functions for pelvic floor muscle group is:
- support pelvic organs (bladder, uterus and bowels)
- support bladder and bowel function
- stabilize the spine
- allow for sexual appreciation
Childbearing is just one of the life events that can affect optimal function of the pelvic floor. Each delivery increases chances of pelvic floor dysfunction.
I have suffered and been embarrassed plenty of times by pelvic floor dysfunction, including an accident at work. It has also compromised my ability to exercise and run. I was ecstatic that there could be help for me. I was also a little angry that nobody had ever mentioned this to me before. I had a least 36 doctor visits between my four pregnancies, not counting general female care in between my children. I was told to do kegels, without anyone showing me how to kegel properly, or explaining how often to kegel, or the importance of kegels. None of my providers ever mentioned pelvic floor health before delivery and never asked me about symptoms of dysfunction after my deliveries.
Then, I found Lovelace Women's Hospital Outpatient Rehabilitation. I attended a mom and baby event where the physical therapists gave an informative presentation on pelvic floor health. I was “floored!” (Haha--get it?) My history had all the earmarks of likely pelvic floor dysfunction.
Some of the causes of pelvic floor dysfunction include:
- operative vaginal delivery (use of forceps, or vacuum)
- episiotomy or perineal laceration
- prolonged second stage of labor (pushing)
- size of fetus
- maternal age
Several of these factors often happen in conjunction with another, so it is difficult to tell if one is more of a risk factor than another. For example, a woman who pushes for longer than an hour is more likely to have a vacuum used on the fetus or a perineal laceration.
Therapy for the pelvic floor muscles can include biofeedback, medication and surgery. A proper physical exam and an extensive conversation with the appropriate care provider is an essential part of the healing process.
I ended up choosing biofeedback. I may need further intervention later, but this was the best start for me. I went to Lovelace Women's Hospital Outpatient Rehabilitation after getting a referral from my primary care provider. I was treated with respect and was given privacy. The biofeedback probe can be placed in the vagina or the anus. The muscle wall is the same, so you can choose based on your preference. It did not hurt at all. There is also a sensor placed on the abdominal area. There is a screen that reflects muscle use and the session lasts about an hour. I went for approximately 8 weeks. I can go back for another session at any time. I am not 100% better, but there is a marked improvement. I am also now more aware of how to care for and strengthen my pelvic floor. I have an alarm on my phone to remind me to do my kegels for maintenance along with other simple exercises provided by my physical therapist. I am thankful to Lovelace Women's Hospital Outpatient Rehabilitation and hope you will look into their services if you think you might have pelvic floor dysfunction
To schedule an appointment or learn more about the services offered at Lovelace Women's Hospital Outpatient Rehabilitation, call 505.727.4725.
Community Health Worker/Labor of Love