Expecting A Baby? in Dinka

When you are pregnant, you get a lot of advice from many people. One issue that few people think about are signs of bladder and bowel control problems in pregnancy and after the birth.

Të liɛɛc yïn, yïn aye lɛ̈k kɔc juëc. Töŋ kërac ye kɔc juëc tak alɔŋ alɛ̈ɛ̈c ku gël la roor ee liëcic ku të cïn dhiëth.

What do my pelvic floor muscles do?

See the picture of the pelvic floor. The pelvic floor muscles do a number of things. They:

• help to close off the bladder, the vagina (front passage) and the rectum (back passage); and
• help to hold the bladder, the uterus (womb) and bowel in their proper place.

Yeŋö ye räl acuek kiëën aŋuum looi?

Tïŋ thuura acuek aŋuum. Acuek aŋuum aa kä juääc looi, kä yekä looi aa kïk:

• Keek aa alɛ̈ɛ̈c thiöök thok, ku thiökkä mur ku amook thok ku; ku
• Mukkä alɛ̈ɛ̈c, adhiëët ku yäc ke kä yiic nyiɛn den.

How do i know if i have a problem?

There are a few things that might happen if you have weak pelvic floor muscles. You might:

• leak urine when you cough, sneeze, lift, laugh or do exercise;
• not be able to control passing wind;
• feel an urgent need to empty your bladder or your bowel;
• leak bowel motion after you have been to the toilet;
• have trouble cleaning yourself after a bowel motion;
• find it hard to pass a bowel motion unless you change position or use your fingers to help; or
• feel a lump in your vagina or a feeling of dragging like a period, mostly at the end of the day, which could mean that one or more of your pelvic organs might be sagging down into your vagina. This is called pelvic organ prolapse. Prolapse is very common and happens to about one in ten women in Australia.

You may also have sexual problems. Just after your baby is born, you will be very tired and busy with your baby. Vaginal birth can cause weakness around the vagina or a lack of feeling. Vaginal tears and trauma can cause pain for many months. While breast feeding, oestrogen levels may be low and so the vagina may be dry, which can cause more problems. It may be helpful for you and your partner to talk about these issues with a health professional.

Ba ŋic kädä tɛ̈ leŋ yen kë wääc tɛ̈n ɣɛɛn?

A leŋ kä reen bë röt looi tɛ̈ cï acuek kuun aŋuum lär. Tɛkdä ka:

• Lɛc aa bë ya thiu tɛ̈ ɣɔɔl yïn, tïïm yïn, jöt yïn, dɔl yïn, wälä tɛ̈ tuuk yïn në tuk kɔc rïïl gup;
• Tɛkdä ka köth a cï bë ya gur;
• Yïn ee kat tɛ̈ nɛ̈k lɛc/la roor yïïn;
• Yïn ee thar thiu cɔkalɔn puɔc yïn la roor;
• A ce yï thar ŋiɛc weec tɛ̈ cïn thök la roor rin yen ŋuɔt bɔ̈ bei;
• Këdäŋ a ce lac bɛ̈n bei tɛ̈ le yïn roor – ku ye nhiaar diët yï ben rot cɔ̈k piny ku diët yï ɣɛɛk yï cin ba wuööt bei; wälä
• Yïn ee mur doot piny rin leŋ yen kën nyuc mur nhom bë ya piëk piny, ku kën ee rot lac looi tɛ̈ le akɔ̈l piny, ku kën a ye nyuɔɔth lɔn leŋ yen kä yiic cï wiëën ken lär ku yekä dïïr mur nhom. Kën a cɔl thiɛk mur. Thiɛk mur ee rot lac looi ku tiɛŋ tök diäär ka thiäär baai Ɣothralia ee mur thiɛk tɛ̈ puɔc yen dhiëth.

Tɛkdä ka täc du ke moc a bë yic riɛl. Tɛ̈ puɔc manh du dhiëëth, ka yïn a bë ya rëër ka yï cë guöp thiai ku ye rëër ka yï cë la yölyöl ke meth. Manh bɔ̈ bei wɛɛth ee mur cɔl a lär wälä a lëu bë noŋ bï tik cï ye yök lɔn yen muör de. Na cë mur rɛɛt wälä cë dhiääc ka tik a lëu bë reem pɛ̈y juëc. Ka tik thuëët meth, miöktik (oestrogen) a lëu bë kur ku keya ka mur ee rëër cë kɔɔu wei, ku kën a lëu bë tik thɛ̈l kä juɛ̈ɛ̈c kɔ̈k. Tɛkdä ka path ba wël kä jääm yiic wek wun meth ka raan kïïm rɛ̈ɛ̈r thïn.

How can i tell if i might get bladder and bowel problems?

Some women seem more likely to have bladder and bowel problems, even if they have had quite easy birth. We can’t yet tell who these women might be.

Women who already have bladder or bowel symptoms, such as irritable bowel syndrome or an urgent need to pass urine (also called overactive bladder) will be more likely to have this problem worsen or to gain new problems. Constipation, coughing and obesity can also make problems worse.

Certain things about the birth can make a woman more likely to have bladder and bowel problems:

• having your first baby;
• having a large baby;
• having a long labour, chiefly the second stage of labour; or
• a difficult vaginal delivery, when you have stitches after being cut or having a big tear just outside or in your vagina when the baby is helped out by the vacuum cap or the doctor uses forceps.

Ba ŋic kadä lɔn bï aläny ku yäny dië cak?

Diäär kɔ̈k aa ye aläc ku yääc ken lac cak, cɔkalɔn cï kek dhiët ka cïn kë wääc. A ŋuɔt kucku ye diäär yïndä kä cït käkä.

Diäär wën cï aläc wälä yääc ken cak wënthɛɛr, cëmën tɛ̈ yeke yiil yääc wälä tɛ̈ ye kek riiŋ ɣön laac (cɔl aläny tuc guöp) aa tuany den ye nyin juak wälä tɛkdä ka bë laŋ tuɛnytuɛɛny kɔ̈k tul ke gup. Kuil, ɣɔɔl ku cuai dïït wën cï raan ŋer aa tuɛnytuɛɛny ë lär acuek juak yic.

A leŋ kä kɔ̈k ë dhiëth wën tik cɔl alɛ̈ɛ̈r alɛ̈ɛ̈c ku yäc, kä cït:

• Dhiënh ë manh kai;
• Dhiënh ë manh dït tet;
• Rɔ̈p ë kaam bär yic, rɔ̈p rou; wälä
• Tɛ̈ cï meth rïk wɛɛth, tɛ̈ mur kɔc thok rin cï ye kac thok bë cuɔt yic ciëën wälä tɛ̈ cï tik rɛɛt tɛ̈ thiääk ke mur wälä ye mur yen cë thok rɛɛt tɛ̈ mïït meth bei luöŋ.

What if i have a caesarean birth?

Choosing a caesarean birth might seem like a way to avoid these problems, but it is not that simple. A caesarean birth might reduce the risk of severe bladder control problems from 10% to 5% for a first baby, but after the third caesarean there may be no benefit at all. And caesarean births carry their own risks. Babies born this way are more likely to have breathing problems at birth. It can be more risky for the mother and scarring from caesarean births can make pelvic surgery more difficult in the future. So you may be trading one problem for another.

In many cases, a vaginal birth runs just as planned and is a lovely event for parents, so this type of birth is best when possible. But problems can still happen. Research is now looking at how we can better know about and stop harm to the pelvic floor during birth. For now, pregnancy and birth involves making a choice between different kinds of risk. You and your partner need to think about these risks and discuss them with your pregnancy care professional. No one can promise you and your baby a perfect outcome.

Na rëët meth bei ka ŋö yïndä?

Na lɔc bë meth rɛ̈ɛ̈t bei ka yï yök ciët yï cë kä rɛc lïr, kekëdäŋ dhiëth a ce kë puɔl. Manh rëët bei a lëu bë lär alɛ̈ɛ̈c tek yic 10% ɣet 5% tɛ̈n manh tueŋ, ku na la manh diäk rɛ̈ɛ̈t bei ka rɛ̈t a cïn kë pɛɛth dɛ̈d ben kuöny yïïn. Ku mïth rëët bei aa leŋ kä kɔ̈k jöör tɛ̈n keek röt. Mïth rëët bei aa ye wëëi jöör tɛ̈ puɔc ke dhiëëth. Rɛ̈t a lëu bë yic riɛl tɛ̈n tik ku piär aŋuum aa lëu bïk rɛ̈t dɛ̈d bï tik bɛn rɛt akölrial cɔl a ril yic. Ka yeen tɛkdä ka yïn awar jaŋ tök në jɔŋ dɛ̈d.

Kä juääc yiic, manh bɔ̈ bei wɛɛth ee bɛ̈n bei ka cïn kë wääc ku ye kë path aländeen tɛ̈n man meth ku wun meth, ka yeen dhiënh kën yeen ee dhiënh path tɛ̈ lëu yen rot. Ku a lëu bë laŋ kë ŋuɔt wääc. Jäc a loi ebën buk ŋic tɛ̈ acuek aŋuum ya gël thïn bïk cï lär tɛ̈ dhiëëth meth. Ye mën, liëc ku dhiëth aa kɔɔc ë meth lɔc thïn tɛ̈ bë gɛ̈l kä wääc. Week wek wun meth wek aa dhil kä lëu bïk wääc jääm yiic ke raan ë kïïm. A cïn lëu bë ye lɛ̈k week lɔn bï meth dhiëëth ka cïn kë wääc – ee ŋɔ̈th yen a ye kɔc ŋɔ̈th lɔn cï käŋ bë wääc.

What can i do about weak pelvic floor muscles?

The birth of a baby might have stretched your pelvic floor muscles. Any ‘pushing down’ action in the first weeks after the baby’s birth might stretch the pelvic floor again. You can help to protect your pelvic floor muscles by not pushing down on your pelvic floor. Here are a few ideas to help you.

• Try to squeeze, lift and hold your pelvic floor muscles before you sneeze, cough, blow your nose or lift.
• Cross your legs and squeeze them tightly together before each cough or sneeze.
• Share the lifting of heavy loads.
• Don’t do bouncing exercises.
• Do pelvic floor muscle training to strengthen your pelvic floor muscles (See the leaflet “Pelvic Floor Muscle Training for Women”).
• Keep good bladder and bowel habits:
  1. eat fruit and vegetables;
  2. drink 1.5 - 2 litres of fluid per day;
  3. do not go to the toilet ‘just in case’ as this might cut down how much your bladder can hold; and
• Try not to get constipated.
• Don’t strain when opening your bowels. A good way to sit on the toilet is to put your forearms onto your thighs and, with your feet close to the toilet, raise your heels. Relax your pelvic floor muscles and gently push.
• Keep your weight within the right range for your height and age, and try not to gain too much during pregnancy.
• Continue to exercise.
• Ask for advice about bladder infections.

For more information, see the leaflet “Good Bladder Habits for Everyone.”

Yeŋö ba looi tɛ̈ niɔɔp acuek kiëën aŋuum?

Tɛkdä ka dhiënh meth a cë acuek kuun aŋuum cɔl a lär. Na leŋ kë bɛn cɔl wiik puɔc meth dhiëët thïn yiic ka acuek aŋuum aa lëu bïk bɛn lär apɛy. A lëu ba acuek kuun aŋuum cɔl dhuk nyin deen thɛɛr tɛ̈ pëën yïn cölcöl. Loi käkä ba acuek kuun aŋuum cɔl a dhuk nyin deen thɛɛr.

• Ye them ba yï thar ya rot tɛ̈ tïïm yïn, ɣɔɔl yïn, thoony yïn yï wum wälä tɛ̈ jɔt yïn kë thiek.
• Ŋan yï kuöl ku nyith ke yiic tɛ̈ wïc yïn ɣɔɔl wälä tɛ̈ tïïm yïn.
• Ye rot cɔl a kony tɛ̈ jɔt yïn kë thiek.
• Duk ye tuk kä yï cɔl a kɛɛc nhial ku kaac piny.
• Ye acuek kuun aŋuum duääny bïk riɛl (kuen athɔ̈rthi: “Duɛ̈ɛ̈ny Acuek Aŋuum tɛ̈n Diäär”).
• Ŋic alɛ̈ɛ̈c ku yäny du ŋiëëc:
  1. Ye cam mïth tiim ku liëëm;
  2. Dek lita tök ku abak agut litaa karou (1.5 – 2 litres) ee pïu aköl tökic;
  3. Duk ye la ɣön laac tɛ̈ këc la yï mät rin bï yen aläny du cɔl a cak; ku
• Duk rot cɔl a kuil.
• Duk kë riëëc ebën ye piëk bei ebën tɛ̈ le yïn roor. Rin ba ŋiɛc nyuc thöny la roor nhom, kan yï kök yï ɣɔ̈ɔ̈m ku, ka yï cë yï cuök cuɔt thööc lɔ̈ɔ̈m, jat cök ŋuur nhial. Päl acuek kuun aŋuum yiic piny ku jɔl cɔl amääth.
• Duk rot cɔl a cuai apɛy ku ye dhiɛk du thɔ̈ɔ̈ŋ ke bɛ̈r du ku ruön ku – ku duk rot cɔl apɛy tɛ̈ rɛc yïn guöp.
• Ye rot duääny.
• Thiëc akïm tɛ̈ aläny du cak.

Na wïc lëk kɔ̈k ka yï kuen athɔ̈rthi: “Raan ebën a dhil aläny de ŋiɛc ŋiëëc”.

Will things get better?

Do not lose heart. Even very poor bladder or bowel control just after giving birth can get better without help in the first six months, as the pelvic floor tissues, muscles and nerves mend.

Regular pelvic floor muscle training kept up over the long term, as well as the right advice, will help.

Don’t forget to look after yourself at a time when it is easy to neglect your own needs.

If things are not getting better after six months, speak to your doctor, physiotherapist, or continence nurse advisor.

Bë kë riëëc ebën ye nyin cɔ̈k piny?

Duk puöu go ŋɛɛr. Na cɔk acueŋ aŋuum cë lär wälä yäny cë cak ke bɛn dhuk nyiɛn rot pɛ̈y ka dhëtem yiic tɛ̈ cï meth dhiëët, rin ye rïŋ acuek aŋuum, acuek ku räl röt dɔm röt.

Na ye tik acuek keen aŋuum ŋiɛc duääny në kaam bär yic, ku cɔl rot cɔl a ŋic lɛ̈k, ka acuek keen aŋuum aa dhuk nyiɛn den.

Duk nhom wɛ̈y ku rin kaam rɛc yïn guöp ë kën meth rot yen kë lui yï nhom.

Na cïn kë cë yic waar pɛ̈y ka dhëtem yiic, ka yï jam kek akïm, raan kɔc duääny wälä akuɔnyakïm ë thiu thar.

Seek help

Qualified nurses are available if you call the National Continence Helpline on 1800 33 00 66* (Monday to Friday, between 8.00am to 8.00pm Australian Eastern Standard Time) for free:

• Information;
• Advice; and
• Leaflets.

If you have difficulty speaking or understanding English you can access the Helpline through the free Telephone Interpreter Service on 13 14 50. The phone will be answered in English, so please name the language you speak and wait on the phone. You will be connected to an interpreter who speaks your language. Tell the interpreter you wish to call the National Continence Helpline on 1800 33 00 66. Wait on the phone to be connected and the interpreter will assist you to speak with a continence nurse advisor. All calls are confidential.

* Calls from mobile telephones are charged at applicable rates.

Wïc kuɔɔny

Mathaat akïm cï piöc aabï tɔ̈ na yï ayup telepun Kuɔɔny Baai käk thiu thar ee nïmra kënëic tök, bɛ̈t, gueu, diäk, diäk, gueu, dhetem, dhetem*/ 1800 33 00 66* (aköl Tök agut aköl Dhiëc ee Läätic (Monday- Friday) kaam thaa bɛ̈t nhiäk-duur (8am) ku thaa bɛ̈t thëëi (8pm) ee thaa kɔc Australia ciëŋ Ciëën) aye gäm kɔc abɛc:

• Lëk/Wël;
• Wëët; ku
• Athör thiin ë lëk.

Na yïn acie ŋiëc jam thoŋ English apiɛth ka yïn alëu ba telpun luɔi ye kɔc Kuɔny wɛ̈r thokic yuɔ̈p. Cɔl nïmra kënë tök diäk, tök, ŋuan, dhiëc/13 14 50. Tueŋic, abï raan kɔŋ dhuk nhom ee thoŋ English, luel thoŋduɔ̈n ee yïn jam ku tiɛ̈ɛ̈t ee telepunic. Yïn abï tuɔ̈ɔ̈m thok kek raan kɔc waar thook/duwër jam thuɔŋdu, ku jal kek lɛ̈k wɛ̈tduɔ̈n wïc ee yïn kɔc Baai Kuɔɔny Käk thiu thar yuɔ̈p ee nïmra kënëic tök, bɛ̈t, gueu, diäk, diäk, gueu, dhetem, dhetem/ 1800 33 00 66. Tiɛ̈ɛ̈t ee telepunic ku bï yï gam ku duwër abï kony ba jam kek mathaat akïm kɔc lɛ̈k. Telepun duwër aye kɔc yup thïn abɛc/majan ee rin cïn en wëu ye wïc tënë yïn. Kek wël ëbɛ̈n aye thiaan yiic.

* Yup mobaalic ee wëu cam tëcït cɔ̈t baai ëtɛ̈n.