Pregnancy and childbirth

Many bladder and bowel problems, particularly during pregnancy, can be due to weak pelvic floor muscles. If you have weak pelvic floor muscles you may:

• leak urine when you cough, sneeze, lift, laugh or do exercise (stress incontinence)
• not be able to control passing wind
• feel an urgent need to empty your bladder or bowel (urge incontinence)
• 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 (constipation)
• feel a lump in your vagina or a sensation of dragging (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 (pelvic organ prolapse).

Some women may be more likely to have bladder and bowel problems, even if they have had an easy birth. We don't know who these women will 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) may be more likely to have this problem worsen or to gain new problems.

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

• having a large baby
• having a long labour, particularly during the second (pushing) stage of labour
• having a difficult vaginal delivery, when you have stitches or a tear just outside your vagina.

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.

The birth of your 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, and
• do pelvic floor muscle training to strengthen your pelvic floor muscles.

Read more about pelvic floor muscle exercises for women.

Bladder or bowel control problems just after giving birth will often improve in the first six months, as the pelvic floor tissues, muscles and nerves recover.

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.