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Feeling Well, Healing Well After Pregnancy

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woman holding a baby

The bra that fit perfectly before the baby might not be as flattering now. And your bathroom habits? Well, they may be different, too.

“Urinary incontinence during pregnancy is not uncommon. and makes sense given the changes that take place during pregnancy,” says Uduak Andy, MD. Dr. Andy is a urogynecologist at Penn Medicine, an ob/gyn that specializes in treating women with pelvic floor disorders.

“You have this baby growing in your uterus pushing down on your bladder and urethra. For some women, incontinence will increase as the pregnancy progresses.”

Childbirth can lead to urinary incontinence, too. As your baby makes its way down the birth canal, your pelvic floor muscles may be stretched and, in some cases, even damaged. Even women who have a C-section are not without risk.

Dr. Andy says that because of all the changes a woman may experience throughout her pregnancy and childbirth, it may take anywhere from six weeks to a year to fully recover.

“If a woman is still experiencing pain, painful sex, or urinary incontinence six months after she’s given birth, she may want to see a urogynecologist, who can offer her treatment options and exercises to improve the pelvic floor,” says Dr. Andy.

Bladder and Pelvic Floor Issues

Women with stress urinary incontinence may leak urine while coughing, sneezing, laughing or exercising.

According to urogynecologist Pam Levin, MD, stress incontinence occurs when the urethra and surrounding muscles of the bladder lose their strength and support.

“Urinary incontinence and pelvic floor disorders don’t have to be a rite of passage for women, or something we just have to deal with as we age," she says.

That's why she created the Feeling Well, Healing Well Program.

Treatments for Urinary Incontinence

Penn's Feeling Well, Healing Well Program focuses on pelvic floor disorders women may experience as a result of pregnancy and childbirth.

“The post-partum time period can be challenging for new moms,” says Dr. Levin. “They might not feel comfortable talking about the issues they are experiencing. We want them to know that we specialize in these disorders and are here to help.”One in six women over age 18 have symptoms of overactive bladder

It’s estimated that nearly 50 percent of women suffer from bladder and pelvic floor disorders at some point in their lifetime; however, there are options so that women don't have to live with their symptoms.

Stress incontinence can be treated with physical therapy, including Kegel exercises, physical therapy, or the use of a pessary, a removable appliance similar to a diaphragm that is inserted into the vagina or rectum to strengthen the pelvic muscles. Collagen injections may also be used to help minimize urine leakage from the bladder.

“In some cases, we recommend surgery to place a hammock or sling under the urethra to provide more permanent support,” says Dr. Levin. During the operation, a sling created from FDA-approved mesh is inserted behind the urethra to support the weakened pelvic muscles.

Women who have vaginal pain after delivery or pain with intercourse may experience muscle spasms or have painful scar tissue that narrows the opening of the vagina.

“Once we learn what is causing the pain, we can determine if a woman needs surgery, physical therapy or both to address the issue,” says Dr. Andy.

Depending on the issue, surgery may be deferred until a woman decides not to have any more children. This decision would be made in collaboration with the patient after a full consultation and discussion about the risks and benefits.

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