Preventing Urine Leakage Before and After Pregnancy

Women who receive one to one instruction on how to contract the pelvic floor muscles and practice pelvic floor muscle exercises with health professional supervision are less likely to suffer urine leakage during or after pregnancy. A systematic review from The Cochrane Library suggests that these exercises are effective for preventing and treating incontinence.

A third of women are known to leak urine following childbirth, while 1 in 10 leak faeces, although due the obvious embarrassment and distress associated with incontinence, it is possible that rates are underestimated. To avoid giving medication during pregnancy and breastfeeding, pelvic floor muscle exercises are widely recommended for strengthening the muscles supporting the pelvic organs and helping women to gain greater urine control. This systematic review shows these exercises can markedly decrease rates of incontinence.

“With good one to one teaching and supervision, these exercises are safe and will benefit many women,” says lead author, Jean Hay-Smith, who works at the Wellington School of Medicine and Health Sciences at the University of Otago in Wellington, New Zealand.

The review team found 15 relevant studies involving a total of 6,181 women. They discovered that those with no prior history of leakage who are taught the exercises on a one to one basis and practice pelvic floor muscle exercises with supervision from a health professional are half as likely to report urinary incontinence in late pregnancy, and a third less likely up to six months after birth, than those who receive usual antenatal and postnatal care. Exercises are also an effective treatment for women with persistent urinary incontinence after childbirth.

The authors also say that exercises might be particularly beneficial for certain groups of women. “Those who give birth to large babies or who have forceps deliveries run a higher risk of incontinence and may benefit more from intensive pelvic floor muscle exercises,” says Hay-Smith.

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