[ozmidwifery] pelvic floor / incontinence

[Maxine Wilson]

Hi - I have recently returned to the list after several years absence.  I am interested in the discussion sparked by Sue following her visit to the incontinence clinic.  I have had some conversations recently with a physio who specialises in pilates and has a specific interest in pelvic floor function.  I had assumed that the increase in incontinence pad advertising was aimed at an older or elderly age group but apparently she is seeing a significant portion of her practice being young (seemingly) fit women after their first babies who are suffering from incontinence. She feels that this is a problem that has been hidden or taken as normal by women and perhaps as a "normal" consequence of childbirth.  I bought a booklet called Women's Waterworks by Dr Pauline Chiarelli which quotes that36% of women over 45 suffer incontinence and apparently 60%of all nursing home admissions are due to incontinence.  This little booklet is aimed at teaching women how to regain bladder control and goes  into detail about the role of hormones and various muscle groups in the contraction of the bladder and pelvic floor.  I found it well written and informative. Anyway my take on the whole issue is that the majority of people are now very sedentary compared to our previous history and also use furniture and sitting toilets.  I don't think these things can be good for your pelvic floor.  I don't believe forceps or epidurals or instructed pushing can be good either.  I think it probably takes much more effort to keep this part of our body healthy in this age of TV and couches than most of us realise and so the consequence is that it becomes weak following the physical, hormonal and neurological changes following childbirth.  I am thinking now that perhaps "are you doing your pelvic floor exercises?" needs to be an issue that I spend a lot more time on in education and follow-up.    Maxine