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The Femina Physical Therapy Blog
Featuring original articles by our staff about current events and trends
Explore our insightful blog articles on pelvic health, where we delve into essential topics that empower and educate. From understanding pelvic floor disorders to strategies for conquering infertility, our content is designed for those seeking knowledge and support. We discuss the latest research, expert advice, and practical tips to enhance your well-being and foster a deeper connection to your body.
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Postpartum Recovery Series Part 5
Managing Urinary Incontinence After Childbirth
Urinary incontinence is the unwanted leakage of urine, also known as accidental bladder leakage. There are a few main types. Stress urinary incontinence is leakage associated with activities, such as lifting, exercising, coughing, sneezing, or laughing. Urge urinary incontinence is leakage associated with the urge and people often experience leaking on the way to the toilet. There is also mixed incontinence which is a combination of the two types. Continence is managed by the complex interaction of bladder physiology, central nervous system, and the pelvic floor muscles. When there is dysfunction in any part of the three systems, incontinence may occur.
Read more: How to Manage Urinary Incontinence After Childbirth |...
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What causes incontinence during pregnancy?
There are many causes for incontinence during pregnancy and postpartum. Some of the proposed factors are:
- hormonal changes,
- pelvic floor muscle and connective tissue modifications,
- bladder neck widening (due to the weight of both the uterus and the growing fetus),
- anatomical injuries during delivery.1, 2
A hormone called relaxin is produced during pregnancy to help soften the muscles and ligaments in preparation for delivery. As the uterus and baby grow throughout pregnancy more load is placed on the pelvic floor muscles causing the pelvic floor muscles to become weaker.3 Also constipation, which is commonly seen in pregnancy, puts an additional load on the pelvic floor.4 Furthermore, the pelvic floor has additional strain placed on it during labor; the pelvic floor muscle is stretched five times its original length.5
Read more: Incontinence During Pregnancy & Postpartum | Postpartum...
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Upright Labor Positions for the Second Stage of Labor
If you missed part 1 in the vaginal childbirth positioning series, go back and read it here.
Childbirth/labor is quite an experience, and it can be scary waiting for the unknown. Being prepared, knowing, and being familiar with different options and labor positions is the best way to approach childbirth to help decrease as much anxiety should surprises arise.
This article will go over specific labor positions that help progress labor, and prevent perineal trauma.
As mentioned in Part 1: Pre-Birth article, it’s important to keep changing labor positions to help progress, preferably in different upright labor positions. As a reminder, the first stage is all about increasing the pelvic inlet to help guide the baby through the mid pelvis and finally towards the pelvic outlet/vaginal canal.
Read more: Vaginal Childbirth Positioning Series | Part 2: Upright...
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Positioning for the Pre-Birth Stage of Labor
What to Expect and What to Focus On:
If you have been pregnant for many months now, it is time to get ready for your upcoming birth! Similar to a marathon, we need to train for childbirth to prepare the muscles and body for the big event. For this reason, it is a good idea to start practicing being in different positions either with movement or holding a position for a long time. The pre-birth stage of labor involves contractions to dilate and open the cervix. Once the cervix is fully dilated, the second stage includes the passive and active phases of the baby crowning and coming out of the vaginal canal. The third stage involves the delivery of the placenta. We will go over how to best support our bodies throughout your childbirth journey.
Positioning for the Stages of Labor
Practicing and knowing different positions during this first stage can be helpful when pain may escalate. Upright positioning such as: walking, standing, rocking back and forth, kneeling over birthing ball, leaning against wall, holding onto partner are just some of the many, many positions that can be helpful.
Read more: Vaginal Childbirth Positioning Series | Part 1: Pre-Birth...
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What can a mother do to prepare her pelvic floor for pregnancy and childbirth?
First, you might be asking yourself “what is the pelvic floor”?
The pelvic floor is a group of muscles inside the pelvis that form a hammock from your pubic bone to your tailbone and from sit bone to sit bone on the sides. The function of these muscles are to stabilize your pelvis and spine, support your organs (bowel, bladder and uterus) and maintain continence. In pregnancy and childbirth, these muscles go through a lot of changes. The goal of this article is to try and achieve optimal pelvic floor function throughout pregnancy and after.
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Laxity in Pregnancy is what may be causing you those aches and pains
The Role of the Relaxin Hormone
As discussed previously on the blog, pregnant people undergo some major changes in their bodies, including producing different hormones that play various roles during pregnancy. One hormone that affects the musculoskeletal system in a pregnant person’s body is called relaxin.
Relaxin is a hormone produced by the corpus luteum (an endocrine gland made in the ovary when a follicle has matured and released an egg during ovulation) and the placenta (an organ developed in the uterus during pregnancy that provides oxygen and nutrients to your baby). Relaxin inhibits uterine activity and helps relax the pelvic joints so your hips can widen in preparation for birth. Relaxin peaks during the first trimester. However, relaxin can also contribute to laxity in other areas of the body during pregnancy, not just the pelvis.
Read more: Joint Laxity and Pregnancy | What is it and What can you...
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Do you really know what happens to your hormones during pregnancy? Do you know what hormones are in play during pregnancy?
Well, let’s go through some of the hormones and their functions during pregnancy, so you can have a better understanding of what is occurring in your body.
Read more: What's Happening To Your Hormones During Pregnancy?
