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Talk about embarrassing: there you are, laughing and bouncing your baby on your lap during a mommy and me music class when -- yikes! -- you feel some urine leaking onto your skivvies. Sure, you kinda knew that having a baby might be rough on your nether regions, but this rough? If it's any consolation, many women experience urinary incontinence after giving birth -- and there's plenty you can do to stem the flow.
According to Cynthia Brincat, MD, a urogynecologist at Loyola University Health System and co-director of Loyola’s Mother’s Pelvic Wellness program, urinary incontinence affects anywhere from one in three to one in five women.
There are actually two different kinds of incontinence. "Urge incontinence" is where when you've gotta go, you've gotta go -- and if you can't find a bathroom, you're in trouble. It's typically experienced in the elderly.
Women who give birth, on the other hand, typically experience "stress incontinence" where they leak urine when they cough, sneeze, or laugh.
The reason for these mini-accidents have to do with your pelvic floor muscles, which get stretched and strained as they support the baby growing in your belly. Then these muscles can suffer way more damage once you give birth, especially if you give birth vaginally.
"When we look at vaginal delivery versus c-section, vaginal delivery has about 10 times the rate of stress incontinence as a c-section," says Dr. Brincat.
The good news? Stress incontinence often fades by six months, or at the very least tapers down enough that it's negligible and doesn't make women feel uncomfortable. But in case your problems persist, there are many things you can do about it.
A doctor's usual first-line Rx? Kegel exercises.These are exercises for your pelvic floor that will whip these muscles back into shape. In case you've never done them before: you squeeze the muscles that would stop the flow of urine. Try squeezing 10 times for 3 sets, then work your way up from there. The nice thing is that you can do this exercise anywhere and no one would even know -- so try it while you're killing time waiting in line at the grocery store or while sitting home watching TV with the hubby.
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If you're a Kegel pro, you can also try vaginal weights. Basically you insert one of these in your vagina, then try to keep them there by squeezing your pelvic floor. The heavier the weights, the harder they'll be to keep put. Or, if you'd rather a machine do your Kegel exercises for you, try the Apex automatic pelvic exerciser, a probe which will use electricity to actually stimulate contractions in the pelvic muscles for you (and don't worry, it doesn't hurt).
Another option is a pessary -- a device that looks like a diaphragm. "But it actually goes in the vagina and provides some extra support of the pelvic floor, which can alleviate stress incontinence," explains Oscar Aguirre, MD, a pelvic surgeon, OB/GYN, and urogynecologist in Denver, Colorado.
If all else fails, women can also consider surgical treatments, like a mid-urethral sling, a mesh strip surgically placed between the urethra and the vagina. While these have been FDA-approved, you'll want a qualified surgeon performing the procedure, so search for a surgeon board-certified in female pelvic medicine. To find a specialist or more information, check out the American Urogynecologic Society for guidance.
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