Incontinence is a common condition postpartum, roughly affecting upwards of 1 in 3 women postpartum. It’s so common it’s joked about in memes, on ads with mothers crossing their legs laughing about “peezing” themselves while trying to sell you pads, and discussed by our grandmothers, mothers, and friends as just “part of motherhood.” But does it need to be?
Common but not “normal” and not something you need to live with!
As mentioned above, peeing yourself is incredibly common after having a baby, but it is a sign of pelvic floor dysfunction. Meaning, that once you hit the 6-8 week mark postpartum and you are still experiencing some leakage (give yourself some grace before that – we all need time to heal after labor), your pelvic floor (your vaginal and anal muscles) aren’t able to complete one of its main tasks – maintaining continence – also known as holding in your pee!
So what’s next?
If you can access a pelvic floor physical therapist, they can help you assess the next steps and have proven to be incredibly successful in healing incontinence. There are pelvic floor PTs who do virtual consultations (don’t worry, you won’t be showing them your private bits on camera) if you don’t have a pelvic floor PT in your area or can’t find the time!
If I can’t get into a pelvic floor PT, should I just do Kegels?
Kegels are a popular exercise that most people think of when we think of incontinence because if your pelvic floor isn’t strong enough to maintain urine, you should strengthen it, right? Well, not necessarily.
For one thing, it has been found that 80% of women that think they are doing kegels correctly are doing it incorrectly.
There is also a LARGE percentage of women that have what is known as a hypertonic pelvic floor. At my company, The Lotus Method, we call this a pelvic floor with “no chill”. It is constantly in a gripped/tight position, and a hypertonic pelvic floor can cause incontinence, just like a weaker pelvic floor. Therefore, if you continue to squeeze your pelvic floor over and over again (which is a Kegel), you are only adding to the problem.
Diaphragmatic breathing is queen!
If you can get assessed by a pelvic floor PT who can let you know if you need to work more on strengthening or relaxing your pelvic floor – you’re ahead of the game, and that’s an amazing start!
If you are unable or uncomfortable going to a pelvic floor PT here is my recommendation:
• Find a comfortable position making sure you are sitting on the front of your sit bones (not tucked under like most of us sit), leaning forward so your ribcage is directly over your pelvis (not tipped forward or back)
• Put your hands on either side of your ribcage and take a deep breath. Imagine breathing into your hands like there is an umbrella expanding 360 in your ribcage
• As you inhale, imagine your air floating downwards to your pelvic floor and imagine your pelvic floor muscles dropping onto whatever chair/couch you are seated on. That hammock of muscles softens and lengthens on the inhale
• Now, as you exhale – imagine that you are picking a blueberry up through your vagina (your pelvic floor muscles should lift up and in towards your belly button) or you are zipping up a tight pair of pants on the exhale
• Exhale as if you are blowing out of a straw or blowing out candles (we have a connection in-between our jaw and our pelvic floor, so this is a very important bit that shouldn’t be missed!)
Congratulations, you just completed diaphragmatic breathing with pelvic floor awareness! I find this far superior to Kegels as it works on both the softening and engagement of the pelvic floor – which we need for a healthy/functioning pelvic floor!
Now you can play with this breath and see if the engagement or the softening is easier for you to feel. If you have a more challenging time with one over the other – focus on the one that is harder for you until you become more even.
Cool – so just breathing will fix my incontinence?
It’s your best start! But now we need to put it into practice.
Stop and think about when you leak. Is it when you cough, sneeze, laugh, or jump? Or only after you’ve been running for 2 miles or only when you have a full bladder?
Depending on when you leak, you want to start incorporating this pelvic floor breath awareness into movement patterns that mimic when you leak so you can strengthen your pelvic floor to meet that specific demand or task.
High-pressure scenarios like laughing, coughing, sneezing, and jumping/running often means your pelvic floor doesn’t have the quick reflexive strength to meet that demand. See if you can quicken your breath and practice “pick up a blueberry” before coughing or sneezing. Then see if you can have your workouts mimic this. Can you find quick movements like a lunge with a knee drive where you inhale and soften into the lunge and then quickly drive your knee up as you imagine zipping up your pelvic floor?
Endurance scenarios like leaking when you only have a full bladder, mile 2 of your running, after wearing your baby on a long walk means that you need to focus on the softening and then holding that blueberry up for a count of 3, then 5, then working up to holding that for 10 seconds. Do that same lunge knee up, but instead of quickly lifting your pelvic floor, hold at the top, hold that engagement for as long as you can and then release. Then again, incorporate holds into your workouts and movement patterns.
You can play with your breath and breathing patterns in almost every exercise or movement pattern and see what works for you! It seems simple but trust me (after 14 years of experience training pre/postnatal women), it works!
You can also play with these different breathing strategies in bridges(bridges are great cause gravity helps us lift our pelvic floor), clams, and bridges with your feet on a wall or couch, as you pick up your kid! Finding other times throughout your day or within the activities you already love doing is one of the best ways to start to improve and stop leaking.
Remember to give yourself time and grace. Your body just underwent a massive transformation, and pregnancy, labor, and motherhood are one of the most physically demanding things we will ever experience. You are doing fantastic, and you will get there.
Caitlin Ritt is the founder and CEO of The Lotus Method and Mallory Risner is a pre/postnatal expert at The Lotus Method and the Head of Social Media. The Lotus Method is personalized fitness designed specifically for motherhood by pre/postnatal experts. The Lotus Method has been helping thousands of new and expecting motherhood for almost 9 years have prepare for the demands of labor, pregnancy and motherhood at our brick and mortar studios (San Francisco & New York) and virtually around the world.