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Incontinence / Leakage

What is Incontinence?

Incontinence is when you experience leakage of urine, faeces or both unintentionally. It happens when there is an increase of intra-abdominal pressure inside you and the pelvic floor is not strong enough to withstand this increase in pressure. Common activities that increase pressure inside of you which can cause leakage are

  • Sneezing, coughing, laughing
  • Impact exercise – exercise where you lift off the ground and land
  • Certain abdominal exercises such as ab curls, planks, jack knives
  • Lifting Weights

What Happens To the Pelvic Floor During Pregnancy?

The video below explains the changes that happen and why they happen.

The pelvic floor is a group of muscles and fascia that makes up a sling on the bottom of your pelvis. It’s made of a superficial layer and a deep layer. That deep layer, which we can see inside here, has a group of muscles called the levator ani. In that levator ani, there is an area for the anus, vagina, and urethra to pass through.

The U-shaped area, is known as the genital hiatus. When you’ve given birth or have been pregnant, this can increase in size.

Now, previously, this genital hiatus may have been sitting at a higher tone or closer together giving support, like a shelf, to all of your organs inside. When you would do something like sneeze, your pelvic floor would naturally lift up and kink off your urethra, which is what’s connected to your bladder and where your urine comes out. This increase in pressure and this increase in lift and support meant you didn’t leak.

However, if through pregnancy your hiatus has increased in size and the tone of your pelvic floor has dropped down, that means that instead of the contraction starting where it should to kink off your urethra, the contraction may start lower down, which means that as that intra-abdominal pressure, i.e. that sneeze, cough, or laugh, comes down onto the pelvic floor, it no longer can kink off your urethra effectively, as it’s starting from the lower position. It will try to get there but, in that attempt, may not fully cut off urethra, and therefore, you will leak.

This is known as Stress Incontinence.

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