After a baby
Most Women accept that they might get a vaginal tear during childbirth, but having a bladder or bowel problem after giving birth to their baby is rarely in the minds of expecting mothers.
We cover on this page some possible problems that might occur. The main thing to remember is that most of these problems are usually treatable and some, perhaps, can even be avoided by following the health professional’s advice.
A weak bladder usually occurs when the muscles in the pelvic floor or sphincter have been damaged or weakened. These muscles can be weakened during pregnancy by the extra weight and natural hormonal changes.
A weak bladder is also referred to as stress urinary incontinence (SUI) which is defined as a sudden loss of urine during normal day to day activities such as;
- Or lifting something.
Third or Fourth Degree Tears
Third or fourth degree tears involve the two circular muscles that control the anus (may be referred to as Anal Sphincter tears). A third degree tear may involve damage to one or both of the circular muscles and a fourth degree tear will also include the lining of the anus. When this occurs, it is necessary for the tear to be stitched in theatre and that an epidural or spinal anaesthetic will be required.
At the time of discharge the following advice will be given to help with the healing process and reduce the risk of problems:
- Shower or bath at least once a day to keep the area clean and dry.
- Drink 2-3 litres of fluid every day and eat a healthy well balanced diet, including breakfast, to achieve a normal consistency stool.
- Do pelvic floor muscle exercises as soon as you can after birth. This will increase the circulation of blood to the area, reduce the swelling and ease discomfort. Establishing a routine of practicing pelvic floor muscle exercises whilst sitting feeding the baby and having a glass of fluid at hand to satisfy thirst, makes the most of the time available.
- Follow the programme of pelvic floor muscle exercises given to you by your midwife or physiotherapist to strengthen the muscles which will have been affected during pregnancy and delivery.
- Many women find that they have to rush to the toilet to have their bowels open or have problems controlling wind from the bowel during the first few weeks after delivery, but this control gradually improves. It can be helped by practicing anal sphincter exercises and bowel habit training will help to resist urgency and gradually increase the time between feeling the sensation and the need to empty the bowel.
- Whist the area is healing laxatives should be taken to make it easier to empty the bowel and to prevent constipation.
You can find more detailed information on episiotomies and managing tears following pregnancy in our download sheet, plus advice on preventing tears in the future.
Difficulty passing urine or urinary retention, as it is known, is a common problem in the first day or two following childbirth, but with careful management this should resolve without long term consequences. The small numbers of women, who are unable to pass urine, experience the discomfort of a very full bladder and may need to self catheterise or use a temporary indwelling catheter . Recent research indicates that approximately 1 in 500 women may have a problem with bladder emptying which lasts longer than 3 days.
For more information on the possible problems listed on this page, please read our After a baby advice sheet.
If you are concerned about your problem and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems.