Sneeze and Cough without Leaking


While pregnancy brings an abundance of joy and happiness to families all around, this life changing event also introduces women to certain physical changes they may, or may not, be prepared for. For instance, not many women talk openly about their struggle with diastatis recti, a separation of the abdominal muscles that affects up to 90% of child-bearing women, resulting in the dreaded “mummy tummy” and contributing to a host of health problems, including back pain and incontinence. Most women also do not openly share their embarrassing experiences with urine leakage or pelvic organ prolapse, all symptoms that are very common for pre and postpartum women. For so many moms, they truly believe that this has to be the new normal. That they are helpless and alone in a body they no longer recognize. Fortunately though, for any woman in her journey through motherhood, these conditions are completely preventable, and are even reversible, through correct core training and activation.

Sneezing and coughing are two events, experienced by anyone, which exert significant pressure on our abdominal muscles. This is especially important to be aware of during pregnancy and postpartum. While for many of us sneezing comes as an “involuntary” reaction which is sometimes difficult to control, it is crucial to learn how to control it and to sneeze in a way that does not cause more harm to our bodies. By making conscious changes about how we sneeze, women can minimize the toll that sneezing and coughing typically take on the core, and they can stop the leaking, back strain and risk of worsening or re-opening diastasis recti (if resolved) with every cough or sneeze.

Here are a few tips on how to sneeze and cough safely:

Prepare for a sneeze: Each sneeze or cough presents an opportunity to improve core health, function and integrity – it doesn’t have to be a stressor that worsens a weak or overstretched pelvic floor. The key is to anticipate the sneeze or cough, and prepare for it with both breath and muscle awareness, and then engage the muscles properly as you sneeze or cough. What does that look like? Click here for a video demonstration. The first step is turning your attention to your body the moment you feel a sneeze or cough coming on. Prepare by taking a diaphragmatic breath – think of this as an expansive, relaxed breath that gently fills the torso with air. Then, as you emit the sneeze or cough, firmly squeeze your abdominal muscles AND your pelvic floor in an upward lift toward the spine.

Eliminate forceful, involuntary exhalation: Sneezing and coughing both involve a forceful, involuntary exhalation. When you harness that exhalation with proper core muscle activation, you can use each sneeze/cough as an opportunity to strengthen and protect your core and pelvic floor. This conscious muscle engagement eliminates the bulging pressure that normally occurs- an outward bulging of both the pelvic floor and the abdominal wall – when we sneeze/cough without conscious control. By pausing to sneeze or cough with awareness, we not only mitigate the stress on those tissues in that moment, but we also actively improve function and integrity.

Provide manual support: For even greater protection, place your hands on your belly when you feel a sneeze or coughing fit approaching. This manual support provides physical feedback that you have relaxed the belly for an expansive diaphragmatic breath, and then as you sneeze or cough your hands can offer external support in addition to engaging your deep core muscles in an upward squeeze toward the spine.

Empty your bladder frequently: It’s much easier to correctly engage your deep core and avoid a sudden leak of urine while sneezing or coughing when your bladder is not full. So especially if you have a head cold or it’s the middle of an allergy season, empty your bladder completely and often so minimize the risk of a “whoops!” moment.

If sneezing/coughing does not abate: If it seems you can’t shake a bad cold, or those pesky allergies are worse than ever, you don’t need to suffer endlessly! Reach out to your doctor. He or she may be able to recommend some remedies, including acupuncture, that are safe for pregnancy and breastfeeding.

While leaking urine, abdominal separation and back pain are common, they are not normal. You do not need to live with dysfunction or accept it as “life, now that I’m a mom.” You absolutely can restore your body and health through simple, accessible exercises and embrace a much improved quality of life.

By Leah Keller, Creator of the EMbody Program. Learn more about Leah here.

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