Nappies for Baby, Pads For You?
Is it possible that in a civilised nation we accept that approximately one in three new mothers will become incontinent of urine and may remain so for
decades? (Brubaker 2002)
Urinary incontinence (UI) means the unintentional leakage of urine. It is often termed 'bladder weakness' which is a misnomer as it rarely involves a
problem with the bladder at all.
It remains a 'taboo' subject that is not openly discussed even with a partner; less so with a doctor, other health professional or friend. Stress
incontinence is the most common form, and is caused by physical exertion such as exercising, laughing or sneezing. Urge incontinence is another
form where the woman feels a strong urge to urinate and cannot stop herself. (NICE 2006) Whatever the type: it is distressing. The situation is only
managed by the wearing of pads at considerable cost to the pocket and, more importantly, self-esteem.
Antenatal advice, mainly given by midwives, is to regularly practice pelvic floor exercises, otherwise known as Kegel exercises to avoid the leakage of
urine occurring. In a study summarised by Sue Dwyer (2006) of 3204 women, over a third of women practiced pelvic floor exercises from the
beginning of their pregnancy to two years after the birth.
Why is it then that almost half these women still suffered with UI?
Possibly, the exercises are being performed incorrectly due to a lack of adequate initial supervision when identifying the correct group of muscles or
not often enough. One study states it is necessary to exercise these muscles 80-100 times each day (Glazener, Herbison, Wilson, MacArthur, Lang,
Gee, Grant 2001). Even on a more reasonable level it should be 8-12 times three times daily (Jozwik 2007) preferably in each position of lying, sitting
So, what else could be done?
Studies have shown that an intensive programme of pelvic floor exercises overseen by a qualified physiotherapist (Chiarelli & Cockburn, 2002) or
specialist nurse (Glazener et al, 2001) can help to reduce UI.