After birth your midwife may explain the importance of pelvic floor muscles and check for diastasis (the splitting of the abdominal muscles) and/or you may receive a visit from a physiotherapist. Pelvic floor health may be followed up by the GP at the routine 6 week post-natal check. Information may be included in the new mum course running at the Maternal Child and Health Nurse.
Or then again, it may not.
One third of all women who have children will suffer from either stress or urgency incontinence (or a mixture of both). 50% of women aged under 50 will suffer from incontinence. Fitness professionals will learn about gluteous maximus, abdominal recti and biceps brachii, but pelvic floor as a muscle will be missing from their training manual. Group fitness instructors may give exercise options for dodgy knees or lower back pain, but not for the case where you leak urine.
Everyone who leaks urine will feel embarrassed and most will suffer in silence; fewer still will get help. In the 1900’s, society felt uncomfortable about having a conversation about birth control and sexuality. Today we still feel uncomfortable talking about incontinence and many want to continue believing that it is only an issue for the old folks home. A hundred years later and we still live with pelvic floor myths that need debunking.
Performing crunches not only trains the superficial abdominal muscles to be convex rather than concave (so your tummy will stick out, rather than get flatter), but will also increase abdominal pressure to bear down on the pelvic floor. If the pelvic floor has already been compromised through pregnancy, pelvic floor dysfunction or prolapse is one step closer. Performing crunches will further split or stop the abdominals from healing back together if rectus diastasis (DRAM) has been diagnosed. The way to get a flat tummy is by starting with a pelvic floor contraction and working north (more about this later!)
Perhaps this is true, but it doesn’t need to be so! In most cases correct pelvic floor exercise training will fix the problem of leaking, improve pelvic and lower back pain and increase your sexual enjoyment.
Statistics are showing that surgery may improve the immediate issues of pelvic floor function, but without necessary changes of behaviour combined with surgical nerve damage, the operation may have to be repeated. Correct pelvic floor function will still need to be performed after surgery and for life.
Delivery is only half of the story. Carrying the weight of a growing child for nine months creates stress on the pelvic floor. However, when a woman reaches 45, she has the same chance of leaking—regardless of whether she has had children or not. Pelvic floor muscle training is important for all women and needs to be a routine part of their lives, like brushing teeth.