Did you know that one in three women who have ever had a baby wet themselves?
When the baby moves down through the birth canal the canal was stretched
and the muscles and nerves that keep the bladder quiet called the pelvic floor muscles
were also stretched.
Now even if you had your baby through cesarean section
the pregnancy itself can cause pelvic floor problems and over time they can become weak
and they're not able to keep the bladder from leaking.
Now this leaking often happens when you cough, laugh, sneeze or exercise
and if you do start to leak, it's not going to go away unless you start some pelvic floor exercises
to help those muscles get their strength back again.
As you get older these muscles are going to get weak
so after every baby you have to get them back into top condition.
When you go through the menopause you're also likely to have a higher risk that you'll wet yourself.
So the bladder itself is a hollow muscular pump that fills slowly from the kidneys above.
Now you should be able to hold on to at least 300 to 400 mills inside your bladder
and then when you're ready to go, your pelvic floor muscles relax when you sit on the toilet
the bladder actually squeezes the urine out and the cycle begins again.
Now the pelvic floor muscles help to close off the front passage, the bladder, the vagina and the back passage.
So they help you control your wind as well as your urine
and they also help to keep your womb, your uterus, right up high nice in the proper position
and so they're not going to cause any problems by falling down into the vagina.
This diagram shows you where the pelvic floor muscles are.
This is a model pelvic showing you where the pelvic floor muscles sit, right at the bottom of the pelvis
and you can clearly see that they wrap around the urethra, the outlet from the bladder in the front,
the vagina, as well as the back passage.
So if you've got problems with your pelvic floor muscles, you might leak urine,
you might have problems controlling your wind or your bowel
or you might have what we call pelvic organ prolapse.
When you have a problem with your pelvic floor muscles,
you're likely to have trouble controlling your urine when you cough, sneeze or laugh.
You may be problems controlling your wind.
You may have a sense of urgency where you don't feel you can hold onto your urine
as long as you'd want to or even your bowels, and you have to rush to the toilet
The other job that the pelvic floor muscles have is to actually hold your pelvic organs -
your bladder, your womb and your bowel - in the proper place.
When these sag down into the vagina, it's called a pelvic organ prolapse.
It's very common. 1 in 10 Australian women actually have this.
They get a feeling that something's coming down.
If you think you have a prolapse, you really should talk to your doctor about that.
What we need to do now is to get you started on a good pelvic floor exercise program.
But the first thing we've got to do is to make sure you're using the right muscles.
So let's start in sitting.
What you need to do is to squeeze, lift and hold
as though you're trying hard not to pass embarrassing wind
and then relax.
Can you feel your pelvic floor lift?
If your muscles are really weak, you may not feel much at all.
You may need to actually use the lower part of your tummy muscles
to pull in at the same time as you lift up.
Make sure that you don't have any downward movement at all.
The movement should be up and in. No movement down at all.
You know, you have to get started on these exercises
but it's important to find out what your level is
so that you can start an exercise program designed for your muscles and that's really important.
A proper pelvic floor squeeze should lift up hard and hold.
Every squeeze should be done as strongly and as tightly as you can.
You need to squeeze hard and hold for as long as you can.
1 potato, 2 potato, 3 potato, gone.
This is 1 set
and you need to find out what your muscles can do
and then you need to do your set 3 times, 3 times a day.
As your muscles get stronger, you may actually find that you can hold for longer.
You're aiming to do 6 big squeezes, held for 6 seconds, 3 times a day.
But you need to start where you're at now and so it's up to you to find out
how your pelvic floor muscles are working now.
If that's a problem you might like to visit your local physiotherapist or nurse continence adviser
so they can give you a baseline so you can base your exercise program
on what your muscles can do now.
It's not just important for you to have an exercise program for your pelvic floor muscles,
it's also important for you to know to know when to use them properly.
We call this 'having the knack'.
Getting the knack means that you know to squeeze up hard before you cough, sneeze or laugh
and you can actually incorporate this into your exercise program
to make sure your muscles are going to be able to work when you want them to.
So the other hard thing about pelvic floor exercises is remembering when to do them
and you know there are quite a few ideas about what might work best for you.
You have to make the choice of what would fit into your lifestyle
but it's always a good idea to do 1 set of pelvic floor exercises every time you finish going to the toilet.
You can do it when you are having a drink.
You could do it when your breast feeding.
When your changing the baby.
Another good place to practice the knack is actually in the shower.
You can buy red stick up dots at your local stationary store.
Put them in special places around the house, even on the phone
so that when you are on the phone, you notice the dot,
oops. That's a good time to do you pelvic floor exercises.
But you must remember to brace your pelvic floor before every cough, sneeze or lift
actually use the lift and remember doing your pelvic floor exercises is for life.
We need to talk just briefly about good bladder habits
because it is important that you should know that you should really only go to the toilet
about 6 to 8 times through the day.
Passing about 300 to 400 mills remembering that a can of drink is about 300 to 400 mills.
It's okay to get up once a night to go to the toilet but any more than this for a young woman
you should really be talking to the doctor.
For good bladder habits it's also good for you to try to drink at least 2 litres of fluid a day
now this includes the fluid that's contained in food as well.
You shouldn't really drink very much coffee or anything that contains caffeine
as these can irritate the bladder if you've got a bit of an irritable bladder.
But if you've got any leaking of urine, needing to rush to the toilet for your bladder or your bowels
you need to get started on a pelvic floor exercise program
and you can speak to your GP about this. You can speak to a continence nurse.
A pelvic floor physiotherapist. All these people are there to help you.
But easiest of all is to call the National Continence Helpline 1800 33 00 66.
There are people there all day, every day to help you with any of the problems you have
with pelvic floor or bladder control.
All the information I've given you and any information you want about your pelvic floor muscles
and having a baby is contained within this little pamphlet.
This will take you step by step right through how you might care for your pelvic floor
during and after your pregnancy.