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WHY do I still leak when I sneeze after baby? Understanding Your Core’s Pressure System

Let’s face it, having urinary leakage while you cough, sneeze, and exercise is no fun after baby. Needing to purchase depends or pee proof panties only does so much for "helping" the situation.

And let’s be honest, those depends came in handry right after baby (one of my top recommended postpartum products) but STILL needing them months to years after you’ve had your baby is just embarrassing and defeating.

According to a 2010 systematic review, 1 in 3 women who have a vaginal delivery will experience urinary incontinence during the first three months postpartum with small changes over the first year. This number is cut in half for women who delivered via cesarean section.

So WHY is incontinence so common postpartum?

Growing a baby over 9 months fundamentally changes your body to accommodate your growing baby.

  • Your abdominal wall stretches out

  • Your diaphragm gets restricted

  • Your ribs expand

  • Your pelvic floor muscles become stretched

  • Your ligaments and joints loosen to allow for the baby to move down and out of the vaginal canal

Additional contributors to incontinence postpartum include:

  • Your delivery

  • Activity level early postpartum

  • Body mechanics

  • Posture

  • Nutrition

  • Stress

  • Lifestyle factors

And I’m taking a wild guess here...but you’ve probably been told by your doctor, another provider, or friend to just do kegals and it will get better.

Here is the problem…

Kegals are one small part of the picture, and in many, if not most women postpartum, kegals can actually contribute to more urinary leakage.

So while the advice to do kegals was well meaning... you might actually need to be working on learning to relax your pelvic floor.

Birth and the early postpartum period can be traumatic and stressful. High stress and trauma are just two things that can contribute to a tighter pelvic floor postpartum.

And the pelvic floor is just one part of the pressure system that is your abdominal canister and core.

This pressure system or abdominal canister is made up of your diaphragm, your abdominal muscles, your pelvic floor, and your back muscles.

Fun fact---this pressure system links up into your throat and glottis too. So vocal changes postpartum can be related due to improper imbalance of the abdominal canister.

In a “normal” pressured system the diaphragm and pelvic floor muscles move together with each in and out breath to maintain even pressure. Your abdominal muscles and back muscles work together along with your pelvic floor and diaphragm to create the power and stability you need for your daily activities.

After baby the stretching out of your abdominal muscles, your pelvic floor muscles, restrictions in your diaphragm and compensations in your back muscles can contribute to alterations in this pressure system that put more pressure down on your internal organs, including your bladder. This is one of the most common factors contributing to incontinence postpartum.

Regaining balance, flexibility, and strength of the abdominal canister is essential for managing your internal pressure system and postpartum healing including incontinence.

Resilience of your core (Resilience = strength + flexibility + balance) can help reduce:

  • Urinary Leakage

  • Diastasis Recti

  • Pelvic heaviness or prolapse symptoms

  • Hemorrhoids

  • Constipation

  • Vocal changes

  • Neck and Jaw pain

  • Rib, hips, back pain

  • Anxiety and depression (due to the role of the diaphragm in calming the central nervous system and the role of the diaphragm in gut health ie the gut-brain axis)

  • Stress and Overwhelm (same reason as above…)

Building resilience within your core after baby shouldnt be an option, is should be the standard postpartum care. Here in the US we are lacking where other european and scandinavian countries automatically refer a new mom to pelvic floor physical therapy.

An integrative approach, one that not just addresses strength and flexibility, but one that address WHOLE person health including stress management, nutrition, and lifestyle factors can also affect the quality of your postpartum healing in body, mind, and spirit.

If you are seeking the whole person approach to postpartum recovery that you deserve, I invite you to book a call with me today and let’s get you out of those pee proof panties and on your path to feeling resilient in body, mind, and spirit.

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