Bladder, bowel and vaginal care

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Constipation is common in pregnancy and after having your baby.  It's very important to look after your pelvic floor and not strain.  

Here are some tips which may help:

• Drink between one and a half to two litres of fluid a day or two and a half litres if you're breastfeeding.
• Eat plenty of fibre and try to include five portions of fruit and vegetables every day.
• The best time to empty your bowels is often 20 to 30 minutes after eating.
• When opening your bowels, sit fully on the toilet with your feet raised on a stool and lean forwards with your arms resting on your legs.
• Don't tighten your stomach muscles and keep your breathing relaxed.
• Support any stitches around the vagina or lower tummy by gently pressing a clean pad against the area as you open your bowels.

Should you have any issues during or after pregnancy please speak to your midwife or GP for advice. They may refer you to physiotherapy.

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Stress urinary incontinence

The leakage of urine during activities such as coughing sneezing lifting laughing or exercising is common and affects one in three women. The first line treatment is to do your pelvic floor exercises up to three times a day.

It can take three to four months to see change in your symptoms so keep going.  When doing a task where you might leak, lift your pelvic floor muscles just before to help reduce the chance of a leak. This helps to train the muscle to work at the right time and can start to help your symptoms straight away.

Urge urinary incontinence

This is the leakage of urine when you feel the urgent need to go to the toilet. People often find they go to the toilet more frequently when they have this too.  For these symptoms it's important to do your pelvic floor exercises.

You should only go to the toilet when your bladder needs emptying, not just in case. You may also benefit from bladder training. For this you should speak to your GP to see a physiotherapist or incontinence nurse.

Pelvic organ prolapse

This is when the womb bladder or bowel pushes into the vagina. It may feel like a heaviness something coming down in the vagina, or a lump at the vaginal entrance. This affects one in 12 women. In most cases the first line treatment is to do your pelvic floor exercises and to lift your pelvic floor muscles before any activity that puts more pressure on your pelvic organs.

It can take up to three to four months to see a change in your symptoms. It's also important to reduce any activities that make your symptoms worse, such as straining on the toilet, heavy lifting and high impact exercise for example.

It's safe to have sex with a prolapse and a good lubricant is often helpful. Should you have any of these symptoms in pregnancy or following birth please speak to your midwife or GP for advice. They may refer you to physiotherapy.