- Kegels have been proven to help mothers with urinary incontinence
- But a study found that there’s a lack of awareness and education around this useful treatment
- They believe women need more encouragement to continue with this regime in the months after pregnancy
Pregnancy can cause havoc with your bladder control – and the problem can stick around postbirth. One sneeze and you find yourself running for the bathroom.
Many women struggle with urinary incontinence (UI) during and after pregnancy, which can have an uncomfortable impact on their daily lives.
There are ways to deal with this, but a recent study published in the Journal of Women’s Health advises that Kegel exercises are underutilised as an effective treatment for urinary incontinence.
What are urinary incontinence and Kegels?
Urinary incontinence normally starts presenting itself during pregnancy and sticks around even after birth, where any form of exertion can lead to an involuntary release of urine. It affects around half of pregnant women, while a third may struggle with it for years after birth.
The researchers aimed to gather more information on women’s experiences with UI and Kegel exercises. Kegels are exercises to strengthen the pelvic muscles – and have been proven many times to reduce the severity of UI. Experts normally recommend a series of 30 Kegels one to three times a day for a minimum of three months to treat UI.
Kegels entail sitting or lying down, tightening your pelvic muscle, counting up to five seconds and then releasing for another five seconds, with as many repeats as needed. It’s important to ensure your bladder is empty to avoid any accidents.
Doing these exercises during pregnancy also helps with any post-birth UI issues.
Not enough advocacy
The study, however, found that UI is still fairly common and that education on Kegels is limited. The number of women using Kegel exercise also hasn’t increased significantly since the 50s. They also report that women aren’t performing Kegels properly, or doing too few.
It shows there’s a need for better educational materials and ways to make it less of a hassle for new mothers who have many other concerns and don't pay enough attention to their UI.
“UI during pregnancy and postpartum is a significant health concern.” explain the researchers.
“Thorough knowledge about how women learn, perform, and are motivated to integrate Kegel exercises into their daily routine is important to discover. From this discovery, providers and nurses can plan and implement programmes to educate and encourage women toward healthy pelvic muscles.”
They explored the issue using a sample of 368 US women from four different state hospitals and birthing centres who were asked about their pregnancy, their UI, what they know about Kegel exercises and how diligently they used it. Follow up was done after three months and again after six months.
Most of them were multiparous, meaning they have had more than one child.
About 19.8% of the women suffered from UI before the pregnancy, and these tended to be women who weren’t on their first pregnancy and whose UI tended to be more severe. About 62% of the sample size suffered from urine leakage during pregnancy, many of whom suffered from UI after three to six months post-birth.
They also found that those over the age of 35 and those who had a high pre-pregnancy body mass index had higher incidences of UI during pregnancy.
Caesarean vs. vaginal births
After assessing their UI status, the researchers analysed how the women sourced information on Kegel exercises. Just more than 40% got information from a medical provider (nurse or doctor) and almost 60% got it from written materials like books and online content.
In total, 65.5% of the women did Kegel exercises during pregnancy with an average of about 27 Kegels a day. However, about a third performed fewer than 30 Kegels a day.
Women with Caesarean births were less likely to do Kegels, despite having the same rate of UI and severity as those with vaginal births.
Almost all the women said they planned to continue Kegels after birth, but only about 76% of them still did it at the 3-month mark and only 36.4% at the 6-month mark, despite still complaining about UI.
“Planning to do Kegels postbirth was associated with a history of vaginal birth, Kegels during pregnancy, and reporting that UI is not a normal life change.”
Most of them also didn’t seek professional help with UI despite moderate or severe leaking, and about 66% of them saw this leakage as the new normal after giving birth.
“One in five women presenting to pregnancy already experiencing UI is high and unnecessary. Women who present during pregnancy with a history of UI or current symptoms need to begin a Kegels regimen or a referral to physical therapy dependent upon their previous commitment or success with Kegels.”
The women preferred to get information on Kegels from midwives or physical therapists, even though almost all of them had some knowledge of Kegels beforehand. This provides an opportunity for better, tailored education and awareness for pregnant women from their health providers to improve their lives. This can include better guidance, referrals to approved websites, Kegel apps and motivational support groups.
The researchers also suggest that national health organisations should promote the use of Kegel exercises in mainstream media.
“With less than one in three women continuing Kegels at six months postpartum, the opportunity to initiate life-changing routines and change the attitude toward valuing Kegels and pelvic health exists and should be seized.
“The misconception that Kegels are only necessary for women with vaginal births should be eradicated. Providers should guide postpartum women to engage in continuation beyond the motivators noted in this study.”
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