Health Blog

Preventing Long-term Postpartum Incontinence

Female patients all too frequently, unwillingly, admit to urinary incontinence. If you have noticed that your quality of life has suddenly diminished and you find yourself avoiding running, lifting, playing or laughing with your child because of the fear of incontinence, you should consider addressing this matter sooner rather than later. Urinary incontinence is not solely related to aging. The postpartum population is at higher risk for long-term incontinence because you have been pregnant. Factors affecting incontinence include neuromuscular dysfunction, vaginal delivery, obesity, diet, exercise and lifestyle. Later stage problems include worsening leakage, depression and decreased physical activity.

Attention to this problem can help postpartum women with leakage or signs of incontinence dysfunction and may minimize effects of long-term postpartum incontinence. (Dumoulin C, 2008). In some situations, postpartum incontinence resolves, but in then may worsen with subsequent pregnancies, age, weight gain, smoking, and drinking. (Brubaker, 2002) (Chiarelli, 2002) Women who have been pregnant are 2.6 times more likely to suffer from urinary incontinence, then their non-pregnant counterpart female. (Low LK, Miller JM, Guo Y, Ashton-Miller JA, DeLancey JO, Sampselle CM, 2013). In 2008 a study reported women spending an average of $900 annually, out of pocket just to manage their symptoms; the women were willing to spend even more for a cure. Younger women are affected by limitation of recreational activity. Older women, reveal deficits in standing, walking speed, and balance. (Subak, Brubaker, T.C., & et.al, 2008). (Hunskaar S, 1992) (Tinetti, Inouye, Gill, & Doucette, 1995).

Seeing a physical therapist can diminish the feeling that you are helpless. Many MTI Physical Therapy therapists are trained in this area — our program will provide education about exercise, including pelvic floor contraction, biomechanical improvement for lifting, and an ability to give you the confidence and power to change the situation. We can explain how exercise performance is a step that can be built into any daily routine, even during play time with your kids. These measures will build the confidence you’ll need to treat your pelvic floor weakness and address your pathology. Direct physical therapy intervention will include evaluation and assessment of related musculoskeletal pathology and structured exercise or relaxation for the pelvic floor. Pre and postpartum pelvic floor weakness or tone issues can be addressed by our rehabilitation to minimize risk of long-term incontinence. New mothers should seek help if your incontinence continues beyond your child’s first birthday.

Robin Schoenfeld, PT, COMPT
Physical Therapist
MTI Physical Therapy – Magnolia

References
Brubaker, L. (2002). Postpartum urinary incontinence: The problem is clear, but there is no simple solution. BMJ , 324, 1227–8.

Disease-Specific Estimates of Direct and Indirect Costs of Illness and NIH Report. US Public Health Services. (1997). Retrieved August 4, 2013, from National Institutes Of Health.

Dumoulin C, H.-S. J. (2008). Pelvic floor muscle training versus no treatment for urinary incontinence in women. A Cochrane systematic review. Eur J Phys Rehabil Med , 44 (1), 47-63.

Hunskaar S, V. A. (1992). The quality of life in women with urinary incontinence as measured by the sickness impact profile. J Am Geriatr Soc , 40, 976-7.

Low LK, Miller JM, Guo Y, Ashton-Miller JA, DeLancey JO, Sampselle CM. Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial. Int Urogynecol J. 2013 Mar;24(3):453-60.

Chiarelli, J. C. (2002). Promoting urinary continence in women after delivery: randomised controlled trial. BMJ , 324, 1-6.

Subak, L., Brubaker, L., T.C., C., & et.al. (2008). High Costs of Urinary Incontinence Among Women Electing Surgery to Treat Stress Incontinence. Obstet Gynecol , 111 (4), 899-907.

Tinetti, M. E., Inouye, S. K., Gill, T. M., & Doucette, J. T. (1995). Shared Risk Factors for Falls, Incontinence, and Functional Dependence: Unifying the Approach to Geriatric Syndromes. JAMA , 273 (17), 1348-1353.