During pregnancy and birth, it is normal for your pelvic floor muscles to stretch and weaken. This can cause you to leak urine (urinary incontinence) after the birth of your baby. In some cases, it can also affect your ability to control your bowels (stool incontinence).  A weak pelvic floor may lead your uterus to slip down from its normal position and into the vagina (uterine prolapse).

The more pregnancies and births – vaginal or caesarean section - you have, the more likely you are to have bladder and bowel control problems. Those who have their first child later in life are more likely to have pelvic floor injuries during vaginal birth.

You may find you leak urine (pee) in the first two weeks after having a baby. After that, common signs you may have a weak pelvic floor include:

• leaking urine when you cough, sneeze or laugh;

• leaking urine when you exercise;

• leaking urine when you pick up your child;

• having a sudden strong urge to urinate and leak before you can get to the bathroom;

• needing to wear pads in your underwear to catch urine or stool leaks;

• feeling like you are sitting on a ball;

• having a pulling or heavy feeling in the pelvis.
  

Kegels are exercises you can do to improve the muscle strength in your pelvic floor. They are an important part of your core muscle strength. They can help prevent urine leaks when laughing, sneezing or lifting, and they help support your pelvic organs.

First, find your pelvic floor muscles by:

• stopping the flow of urine while emptying your bladder;
• tighten your vaginal muscles and feel the squeeze with 2 fingers inserted in your vagina;
• tighten the muscles around your anus as if stopping the passing of gas.

This is just a test to find your pelvic floor muscles. Do not try to do Kegel exercises while urinating.

Remembering what it felt like to control your pelvic floor muscles when urinating, try to contract them when you are not urinating. If your stomach or thigh muscles tighten, your pelvic muscles are not being exercised correctly.

• tighten your pelvic muscles; hold for 3 seconds, then relax for 3 seconds;
• Do the Kegel exercise 10-15 times a session. Try to do 3 sessions per day.
• With each week that passes, add 1 second to the Kegel hold until you are able to squeeze for 10 seconds and relax for 3 seconds;
• View the Kegels exercise sheet for more details.



Make Kegel exercises a part of your daily routine. Practice them anywhere, anytime, such as while travelling, at work, while on the computer or cuddling your baby. There is no clear agreement on how long and how often to do pelvic floor exercises. You may find it easier to learn how to do Kegel exercises with the help of a physiotherapist.

Other things in addition to Kegel exercises that you can do to improve your pelvic health:

• minimize drinking caffeine and alcohol which can irritate your bladder;
• try to urinate at regular intervals;
• try to have regular soft stool movements;
• try to avoid heavy lifting;
• try to manage chronic conditions that cause you to cough excessively.

If these measures do not help, speak to your doctor or midwife to discuss other options for treatment. You may benefit from a referral to a physiotherapist and/or specialist doctor. Most incontinence can be cured or improved without medications or surgery.