I was 8 months pregnant with my second and impatiently standing in line at a local store because my 2-year-old was melting down and I was exhausted. That’s when all of the sudden I sneezed so hard that I felt a small warm trickle down my leg and my pelvic floor caved under pressure.
Sheer horror overtook me. Would anyone notice? Should I hop out of line and go snag another pair of pants? Did I have anything stashed away in the car?
I waddled out of line with my toddler and went to grab a package of underwear and a skirt hoping that no one would notice or ask questions… or heaven forbid… accuse me of stealing as I swapped out my shame in the dressing room.
Jenn and I squeezed into the tiny fitting room and as I went to change, I sneezed again. This time instead of a small trickle, a gush happened.
It was so forceful that I legitimately thought my water broke as I stood in a puddle of my own urine inside of a department store dressing room. After changing, paying, and explaining what happened with bright red cheeks of embarrassment to a store employee, I rushed home from the singular most traumatizing moment in my adult life.
And I thought the troubles would subside after delivery.
But now after three babies, it hasn’t. And the fear of bladder leakage in public is so strong, my van has been stocked with extra undies and a pair of pants ever since.
Why stress incontinence happens in postpartum women
Nine long months of carrying a baby does wonders to the body. Place a head on the pelvic floor muscles coupled with a kick to the bladder, and you might just experience what it’s like to pee your pants as an adult.
Have more than one kiddo and you’re bound to know what it’s like to have a loss of bladder control even after having a baby.
The reason it happens in pregnancy is a mixture of hormones relaxing the ligaments and muscles as well as pressure from the uterus and baby. Unfortunately, that doesn’t just all bounce back after baby and requires some training and exercising.
“In France, all postpartum moms get pelvic floor physical therapy after delivery,” explains Dr. Heather Bartos, OB/GYN. That’s just really not the case in the United States, meaning many women have to go about finding the cure for that sneaky leak on their own.
Why focus on the pelvic floor to beat the leak?
“The pelvic floor is comprised of the muscles that form a figure eight from the pubic bone to the tailbone,” pelvic floor expert and postnatal fitness educator, Tori Levine says. Therefore, doing a Kegel, also known as pelvic floor contractions, strengthens the pelvic floor, activates the muscles, and draws blood circulation to the area to help heal any tearing or episiotomy damage even you performed perineal massage prior to birth.
Boiled down, it means that if you strengthen your pelvic floor you can have better bladder control.
How to do kegel exercises to strengthen the pelvic floor after birth
First and foremost when doing Kegels is remembering to do them. Second is doing them correctly.
As the mom of 12 kids, Varda Epstein said she put up purple K stickers all over her house to remind her to work on her Kegels. So whether it’s a visual cue or you make it a habit to do at the same time every day, that’s the first step.
But how do you actually do a Kegel correctly?
I know I struggle with this. In fact, I hate Kegels, but it’s one of the most popular pelvic floor exercises.
It’s pretty self-explanatory and involves both clenching and relaxing (yes both) of that figure 8-shaped muscle. Front and back Kegels utilize the muscles used to stop the flow of urine or gas.
But that’s the problem, right? Stopping the leak?
So target those muscles and learn to both contract and slowly release. And then do them both in correlation with and even during the following training exercises.
5+ Simple, but effective pelvic floor exercises
Unlike my public faux pas, working on strengthening the levator ani muscle that supports the bladder can be done in the privacy of your own home without embarrassment.
Once you’re given the all clear to exercise, typically around 6 weeks, it’s time to work on training the pelvic floor daily, just like staying active keeps you healthy. You can work to restore the area and use exercises for long-term strengthening.
Squatting stretches the pelvic floor into the correct position. In fact, implementing a stool for your feet while using the bathroom is a great practice because of how it aligns to organs and muscles in the pelvis.
Alex Samet, Registered Yoga Teacher, recommends doing this pose because “lengthens the pelvic floor, allows it to contract, helps control the bladder and resists the urge to urinate.”
How to do Malansana
- Place your feet wider than your shoulders with your feet pointing out and away from the body.
- Place your hands together at your chest to with elbows near the inner thigh
- Keep your tailbone tucked and breath deeply in and out.
- Feel the way the pelvic floor is pulled
Reclining Bound Angle Stretch
Samet also recommends this yoga pose for postpartum women because “You are stretching your inner thighs which helps to stabilize your pelvic floor.”
How to do the Badakanasa pose
- Sit with your legs straight in front of you.
- Raise your pelvis with a block or a blanket if your hips are tight.
- Bring your heels in close to the pelvis and hold feet with hands
- Make sure the pubic bone and tailbone are equidistant from the floor. The perineum then will be approximately parallel to the floor and the pelvis in a neutral position.
- Pull your body towards the floor, but don’t force knees down.
A modification to this would to go the opposite direction and to place an exercise ball against and wall for back support to do something similar to the picture below.
While I completely understand that may be the last thing you want to do if your nether-region is suffering, but the reality is you can engage those muscles as you jump and release as you bring your legs back together. It’s a great way to get in more vigorous exercises beyond stretching.
The benefits of doing the Bandhasana pose is that it strengthens the back of the pelvic floor, including the coccygeus muscle. If you’re going to work on the front, you’ll also need to work out the back and is is one way to do it!
Plus, if you got sciatica in pregnancy, this could be the ticket to helping alleviate that pain.
Calli De La Haye, yoga instructor & new mom explains how to do it:
- Lay on your back and place the feet on the floor at hip width apart, draw the feet close to the body
- Press into the feet and lift the back off the floor, at the same time lift the arms up and above the head
- Slowly roll the back down onto the mat, press the lower back into the mat, lift only the bottom and tilt the pelvis by drawing the pubic bone towards you
- Repeat four times
Implementing this exercise will ease the low back and allow the pelvic floor to stretch and expand, making this a great prenatal exercise as well as postpartum recovery exercise.
How to do Balasana:
- Position yourself on the floor on your hands and knees.
- Allow your big toes to touch while spreading the legs and knees to be approximately hip width
- Sit up on your heels.
- Exhale and lay your torso down between your thighs with your arms extended and forehead on the mat.
Sit on an exercise ball
Using the right size exercise ball as a chair will help train you to sit correctly and aligns your pelvis into the right position. Ultimately it keeps your back straight and pelvis aligned to help engage all of the muscles weakened by pregnancy. You can also do “wall sits” with your exercise ball.
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