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 diastasis recti, the separation of the abdominal muscles that affects up to 90% of child-bearing women, resulting in the dreaded “mummy tummy” and a host of health problems, including back pain and postpartum urinary incontinence.
Urinary incontinence after childbirth is often a direct result of the physical stress pregnancy and labor exert on “the supporting tissues that hold the uterus, bladder, and rectum in their proper place.” Urine leakage and pelvic organ prolapse, are symptoms common for both pre and postpartum women. And, for so many new moms, the lack of transparency around these symptoms leaves them feeling embarrassed, hopeless, and alone in a body they no longer recognize. They truly believe that this has to be the new normal, but fortunately, for any woman on her journey through motherhood, these conditions are completely preventable, and even reversible, through correct core training and activation.
You do not need to live with dysfunction or accept it as “life, now that I’m a mom.”
There are, however, certain events that exert significant pressure on our abdominals, and sneezing and coughing are two women should pay special attention to during pregnancy and postpartum.
While for many of us sneezing and coughing are “involuntary” reactions that feel difficult to control, it is crucial to learn how to manage them and to sneeze and cough in a way that does not cause more harm to our bodies. By making conscious changes about how we sneeze and cough, women can minimize the toll these responses take on their core and reduce leaking, back strain, and the risk of worsening or re-opening their diastasis recti.
Here are 5 tips on how to sneeze and cough safely when suffering from diastasis recti and postpartum urinary incontinence.
1.Prepare for a sneeze/cough:
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.
2. 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 at that moment but we also actively improve function and integrity.
3. 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.
4. 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 allergy season, empty your bladder completely and often to minimize the risk of a “whoops!” moment.
5. 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, like 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 (like our EM Body Reclaim Program) and embrace an improved quality of life. So, say goodbye to postpartum urinary incontinence and hello to the new you!
To learn more about stress incontinence check out this article.