Mom and baby

After childbirth it’s not uncommon for a woman’s pelvic floor to let her down, which can be embarrassing and distressing. We talk to specialist Rohna Kearney at the Nuffield Hospital about ways to treat the problem

‘I see a lot of women who have problems with their pelvic floor after childbirth,’ says Dr Rohna Kearney of the Nuffield Hospital. ‘It’s not uncommon for women to have urinary incontinence or bowel problems, or problems with prolapse or the perineum. Having babies is the biggest single contributing cause to women developing pelvic floor problems.’

Until recently such things were considered an inevitable consequence of childbirth, and women thought they just had to live with it. Even today, women are often too embarrassed to confess to such problems, even to their GP. ‘Many women find it very distressing,’ says Dr Kearney. ‘They’ve suddenly go from not even really being aware of their pelvic floor to leaking urine when they cough, jump or exercise, and having to wear pads. That can obviously be upsetting.’

Self-esteem issues

It is also not uncommon for women to have problems with their perineum after childbirth, which can cause pain and difficulty having sex. Some women are unhappy with the way the perineum looks after having a baby. Both of these problems can cause self-esteem and relationship issues.

More severe problems include prolapse, where women notice a protusion or bulge in the vagina, caused by pelvic floor damage during childbirth, and damage to the anal sphincter, which can cause a leaking bowel, which obviously is very distressing.

Don’t suffer in silence

But, says Dr Kearney, there is no need for women to suffer in silence. Talk to your GP who can refer you to a specialist. ‘There is so much we can do to help,’ she says, ‘and the earlier somebody comes to us, the more we have an opportunity to intervene and help them maximise the pelvic floor they have.’

Help available at the Nuffield comes in the form of simple lifestyle advice, specialist pelvic floor physiotherapy, psychosexual counselling and, if required, surgery. The most important thing, though, says Dr Kearney, is not to leave finding and strengthening your pelvic floor muscles until after you’ve had a baby. ‘Learn to do pelvic floor exercises properly when you’re pregnant for the first time. If you can do them before you give birth, you’re much less likely to have problems.’

Have you got the knack?

One of the things that physiotherapists at the Nuffield teach their patients is ‘the Knack’.

‘This is when you know you’re going to cough or sneeze and you automatically contract your pelvic floor muscles in anticipation,’ says Dr Kearney. ‘Women who haven’t had children often do this naturally, but for some reason after having children the coordination between coughing, sneezing and contracting your pelvic floor is lost.’

Top tips to protect your pelvic floor

* Learn to do your pelvic floor exercises properly before you have your first child. ‘It’s not 100 per cent preventative, but it does help,’ says Dr Kearney, ‘plus you then know how to do the pelvic floor exercises properly after birth - that’s quite important.’

* Avoid being overweight - the heavier you are the more your pelvic floor is carrying around.

* Cut down on smoking.

* If you have an overactive bladder (an urgent need to go to the bathroom and sometimes not getting there in time), watch your fluid intake and cut down on caffeinated drinks

* Check your lifestyel. ‘If, for instance, you have a job that requires lots of heavy lifting, that is going to have more of an impact on your pelvic floor,’ says Dr Kearney. ‘Modify what you do or how you do it to protect the pelvic floor.’

Dr Rohna Kearney is a uro-gynaecology specialist at the Nuffield Hospital, 4 Trumpington Road, Cambridge CB2 8AF, 01223 370922, nuffieldhealth.com/cambridgehospital