I’m a new mum and I keep weeing when I laugh or sneeze – is this normal?

Stress incontinence (leaking of urine with laughing, coughing, sneezing, running) is extremely common in women during the child-bearing year. Up to 60% of women suffer from urinary incontinence during pregnancy, and up to 1/3 of women continue to suffer from stress incontinence post partum – so if are experiencing this, you are not alone.  However, it should never be considered “normal” – especially when, with the correct advice and exercises these symptoms can completely resolve.

The pelvic floor muscles cover the whole bottom of your pelvis – stretching from your pubic bone to your coccyx. During pregnancy these muscles can become stretched and weak from the weight and pressure of your growing uterus and your baby sitting above them. During a vaginal delivery they will have to stretch even further to allow your baby out, and episiotomies or perineal tears into the muscles will further weaken this area.   Your pelvic floor muscles also wrap around the entrance to your bladder and bowel, and when they are strong and working well they prevent anything leakage from these organs during the day. The muscles relax to allow you to go to the loo when you want. Weakness and reduced control in these pelvic floor muscles can therefore lead to incontinence (as well as pelvic organ prolapse, and a reduction in sexual pleasure).

The good news is that extensive research on this topic has shown that strengthening your pelvic floor muscles with some simple exercises during your pregnancy and/or post-natally can cure up to 70% of cases of stress incontinence.

Pelvic Floor (Kegal) Exercises:

Try to work on squeezing your pelvic floor – imagine you are trying to stop yourself from passing wind and trying to stop the flow of urine at the same time – the feeling is one of squeeze and lift.  Your buttocks, legs or back should not move when you contract your pelvic floor. There are two exercises you should work on:

  • SLOW: squeeze and lift the pelvic floor and hold the contraction for as long as you can (up to 10seconds) then relax completely. Try not to hold your breath as you do this. Repeat x10
  • FAST: squeeze and pull up the pelvic floor muscles strongly, then let go straight away. Repeat x10

You should aim to do these exercises 3-5 times a day during and following pregnancy.  They can be done in any position lying, sitting or standing (although do not do them on the toilet when you are passing urine).

As you get better at doing them try and hold the slow ones for longer, or increase the number of repetitions you do in a set. Try to also squeeze your pelvic floor muscles functionally during the day – when you cough sneeze or lift to prevent the pelvic floor from straining and protect you from stress incontinence.

Post-natally these muscles can take up to 3-4 months to strengthen fully with daily exercise – so keep at them.

If having read this, you are still unsure how to contract and exercise your pelvic floor muscles or are experiencing stress incontinence and would like some individualised advice please contact your local Women’s Health Physiotherapist – Don’t suffer in silence!

Specialist Women’s Health Physiotherapist at Mermaid Retreat, Kings Road, Chelsea.

Click here to read David Kingsbury’s article and exercises for Pelvic Posture and Back Pain throughout Pregnancy.