Postpartum incontinence

[Anonymous]

So sorry OP. Thought I’d also mention here that prolapse is most common in women in their 70s. My mom had zero issues after having two children and at 65 is now experiencing prolapse. There is a genetic component/it runs in families, which she learned after experiencing prolapse. She warned me that it may be in my future, but I feel like I can do nothing about it. Risk factors are multiple vaginal births, having babies that are 9+ pounds, being white/Hispanic, and having a family history.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op, pelvic floor physical therapy can help but it isn’t always a cure. A Post partum body will be forever postpartum it’s not gonna be the same as before. I have stress incontinence and a very mild prolapse. None of it was bad enough to warrant surgery per two Urogyns. I saw some improvement with two rounds with certified physical therapist specializing in pelvic floor disorders at VHC. They were very good and it’s an excellent program. However I still need to wear a liner every day just in case I have an unexpected cough or sneeze and I do not run/jump if I can help it. I just want to put that out there because sometimes I feel like pelvic floor physical therapy is presented as a cure all for this issue and it will certainly help but it is not always a cure-all for all women

Agree with this…but my question continues to be, why don’t ob gyns warn about all of the permanent negative body changes beforehand? I knew all about post partum hair loss, stretch marks, etc, but never knew about prolapse or dreamed I’d have bathroom issues like an 80 year old man in my 30s. Had I known, I would have made a different choice about delivery method and may have decided not to have kids. I doubt many women are in my boat on the second point, but running was my life before my kid and I wanted it to be a large part after. I also didn’t want all of my toileting organs gathered together in my vagina, which seems like a reasonable ask.

To the OP — I’m sorry; this sucks. I wish there were better answers.

I think 1) doctors just aren't trained in this yet, and 2) a lot of common birth practices really aren't healthy for the pelvic floor (like pushing forcefully on your back), so thinking about the pelvic floor would really call a lot of other common birth practices into question. Even c sections can lead to problems in the pelvic floor, which nobody really talks about.

Also, it's not just the birth itself that causes the issues. A lot of times it's poor habits pre-pregnancy, during pregnancy, and post-partum. All kinds of things like how your posture is, how much you sit, what kind of exercise you do, etc.

The most widespread pelvic floor health advice we have right now is "do kegels," but even in that case, a lot of people do them incorrectly (like they push down instead of pulling their pelvic floor up, in which case they are making something like prolapse WORSE), AND a lot of women actually have a hypertoned pelvic floor, which can ALSO cause incontinence, and kegels just make that worse too.

[Anonymous]

Sorry OP, I have the trifecta of prolapses and was rectally in continent for 6 months post birth. The midwives congratulated me for having forceps and avoiding a C section because apparently that is their worse case scenario. No, not even close. Worst case scenario is a dead or injured baby. Second worst case scenario is a dead or injured mom. Nowadays I’m mostly rectalky continent but can’t run and my rectocele is so bad I can’t empty my colon fully without using an enema or digging stool out with gloves. I do this most days and it’s disgusting and I have so much rage I never knew about these things until they happened to me and it was too late.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, pelvic floor physical therapy can help but it isn’t always a cure. A Post partum body will be forever postpartum it’s not gonna be the same as before. I have stress incontinence and a very mild prolapse. None of it was bad enough to warrant surgery per two Urogyns. I saw some improvement with two rounds with certified physical therapist specializing in pelvic floor disorders at VHC. They were very good and it’s an excellent program. However I still need to wear a liner every day just in case I have an unexpected cough or sneeze and I do not run/jump if I can help it. I just want to put that out there because sometimes I feel like pelvic floor physical therapy is presented as a cure all for this issue and it will certainly help but it is not always a cure-all for all women

Agree with this…but my question continues to be, why don’t ob gyns warn about all of the permanent negative body changes beforehand? I knew all about post partum hair loss, stretch marks, etc, but never knew about prolapse or dreamed I’d have bathroom issues like an 80 year old man in my 30s. Had I known, I would have made a different choice about delivery method and may have decided not to have kids. I doubt many women are in my boat on the second point, but running was my life before my kid and I wanted it to be a large part after. I also didn’t want all of my toileting organs gathered together in my vagina, which seems like a reasonable ask.

To the OP — I’m sorry; this sucks. I wish there were better answers.

I think 1) doctors just aren't trained in this yet, and 2) a lot of common birth practices really aren't healthy for the pelvic floor (like pushing forcefully on your back), so thinking about the pelvic floor would really call a lot of other common birth practices into question. Even c sections can lead to problems in the pelvic floor, which nobody really talks about.

Also, it's not just the birth itself that causes the issues. A lot of times it's poor habits pre-pregnancy, during pregnancy, and post-partum. All kinds of things like how your posture is, how much you sit, what kind of exercise you do, etc.

The most widespread pelvic floor health advice we have right now is "do kegels," but even in that case, a lot of people do them incorrectly (like they push down instead of pulling their pelvic floor up, in which case they are making something like prolapse WORSE), AND a lot of women actually have a hypertoned pelvic floor, which can ALSO cause incontinence, and kegels just make that worse too.

This post is some straight up victim blaming. And many younger women get prolapse, not just older women. The major modifiable risk factor is vaginal delivery with forceps but sure, blame women for poor posture FFS

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op, pelvic floor physical therapy can help but it isn’t always a cure. A Post partum body will be forever postpartum it’s not gonna be the same as before. I have stress incontinence and a very mild prolapse. None of it was bad enough to warrant surgery per two Urogyns. I saw some improvement with two rounds with certified physical therapist specializing in pelvic floor disorders at VHC. They were very good and it’s an excellent program. However I still need to wear a liner every day just in case I have an unexpected cough or sneeze and I do not run/jump if I can help it. I just want to put that out there because sometimes I feel like pelvic floor physical therapy is presented as a cure all for this issue and it will certainly help but it is not always a cure-all for all women

Agree with this…but my question continues to be, why don’t ob gyns warn about all of the permanent negative body changes beforehand? I knew all about post partum hair loss, stretch marks, etc, but never knew about prolapse or dreamed I’d have bathroom issues like an 80 year old man in my 30s. Had I known, I would have made a different choice about delivery method and may have decided not to have kids. I doubt many women are in my boat on the second point, but running was my life before my kid and I wanted it to be a large part after. I also didn’t want all of my toileting organs gathered together in my vagina, which seems like a reasonable ask.

To the OP — I’m sorry; this sucks. I wish there were better answers.

Completely agree, PP. It is irresponsible for doctors to push vag delivery at all costs and not warn about consequences. (4.5h pushing time here; I wouldn't have tried to be a hero if I had known about pelvic floor health.) I ended up lucky with no permanent symptoms but I had to have PT.

[Anonymous]

Anonymous wrote:

To the OP — I’m sorry; this sucks. I wish there were better answers.

I think 1) doctors just aren't trained in this yet, and 2) a lot of common birth practices really aren't healthy for the pelvic floor (like pushing forcefully on your back), so thinking about the pelvic floor would really call a lot of other common birth practices into question. Even c sections can lead to problems in the pelvic floor, which nobody really talks about.

Also, it's not just the birth itself that causes the issues. A lot of times it's poor habits pre-pregnancy, during pregnancy, and post-partum. All kinds of things like how your posture is, how much you sit, what kind of exercise you do, etc.

The most widespread pelvic floor health advice we have right now is "do kegels," but even in that case, a lot of people do them incorrectly (like they push down instead of pulling their pelvic floor up, in which case they are making something like prolapse WORSE), AND a lot of women actually have a hypertoned pelvic floor, which can ALSO cause incontinence, and kegels just make that worse too.

This post is some straight up victim blaming. And many younger women get prolapse, not just older women. The major modifiable risk factor is vaginal delivery with forceps but sure, blame women for poor posture FFS

I wasn't trying to blame women. I was talking more about how we're set up to fail in multiple ways, including before birth even happens. In talking about posture, I just meant that women are taught and/or forced into bad posture that is really bad for our pelvic floor health and can contribute to incontinence, etc. Like all the exercise classes that tell us to "tuck your pelvis" - terrible for your pelvic floor! Or being forced to sit in a crappy office chair all day. Or how we're all told to "do kegels," but a lot of us do them wrong, or shouldn't be doing them at all, and that can definitely make prolapse and incontinence worse. Yea, if someone had a forceps delivery, I'm not saying their office chair is the cause of their prolapse vs. the forceps. But even those of us who didn't get forceps have problems, and those problems often have roots in lifestyle stuff that we're never taught about.

[Anonymous]

I don’t know of any childless women with incontinence. Do you honestly think having babies won’t result in some damage to the human body?

[Anonymous]

Anonymous wrote:I don’t know of any childless women with incontinence. Do you honestly think having babies won’t result in some damage to the human body?

So I guess it’s women’s faults for furthering the human race and bearing the next generation or workers and tax payers? Go away.

[Anonymous]

Anonymous wrote:I don’t know of any childless women with incontinence. Do you honestly think having babies won’t result in some damage to the human body?

Just because you don’t know them doesn’t mean they don’t exist. Prolapse can and does occur in women who don’t have children (hyper mobility is another big risk factor).

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t know of any childless women with incontinence. Do you honestly think having babies won’t result in some damage to the human body?

Just because you don’t know them doesn’t mean they don’t exist. Prolapse can and does occur in women who don’t have children (hyper mobility is another big risk factor).

Yep - plenty of women with Ehlers Danlos syndrome in my prolapse groups have never have kids and have prolapse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t know of any childless women with incontinence. Do you honestly think having babies won’t result in some damage to the human body?

So I guess it’s women’s faults for furthering the human race and bearing the next generation or workers and tax payers? Go away.

To what end? The human race is not going to be able to sustain itself. The world is overpopulated as it is with the overconsumption.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don’t know of any childless women with incontinence. Do you honestly think having babies won’t result in some damage to the human body?

So I guess it’s women’s faults for furthering the human race and bearing the next generation or workers and tax payers? Go away.

To what end? The human race is not going to be able to sustain itself. The world is overpopulated as it is with the overconsumption.

So what is your point, victim blamer? I guess women who are incontinent from birth (whether urinary, flatally, or rectally) or have their pelvic organs falling out of their bodies due to childbirth don’t deserve sympathy and high quality health care and treatment options? I’m gonna go out on a limb and guess you are childless and can often be heard saying things like, “well you choose to have kids.”

[Anonymous]

Anonymous wrote:OP you can also go see a urogynecologist. You may benefit from a stress incontinence pessary. And there are surgical options like a sling if pelvic PT and a pessary don’t help and you exhaust other options. A urogyn would fit you for this and educate you about options. Obviously they are predisposed to surgery but they can give you a good sense of how serious your incontinence is relatively speaking and what options are for managing it from conservative to surgical.

+1 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP you can also go see a urogynecologist. You may benefit from a stress incontinence pessary. And there are surgical options like a sling if pelvic PT and a pessary don’t help and you exhaust other options. A urogyn would fit you for this and educate you about options. Obviously they are predisposed to surgery but they can give you a good sense of how serious your incontinence is relatively speaking and what options are for managing it from conservative to surgical.

+1 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

Is he going to do surgery for you? He’s not my favorite urogyn, and I’ve seen a lot of them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP you can also go see a urogynecologist. You may benefit from a stress incontinence pessary. And there are surgical options like a sling if pelvic PT and a pessary don’t help and you exhaust other options. A urogyn would fit you for this and educate you about options. Obviously they are predisposed to surgery but they can give you a good sense of how serious your incontinence is relatively speaking and what options are for managing it from conservative to surgical.

+1 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

Is he going to do surgery for you? He’s not my favorite urogyn, and I’ve seen a lot of them.

Different poster — do you mind elaborating? I have an appointment coming up with him.