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When you have urinary incontinence: MedlinePlus Medical Encyclopedia

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You have urinary incontinence. This means you are not able to prevent urine from leaking from your urethra. This is the tube that carries urine out of your body from your bladder. Urinary incontinence

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Postpartum belly wraps are a type of abdominal binding. Learn about the risks and benefits of wearing them, what to expect, and more.

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Years ago, before I started working as a doula, I taught antenatal classes.

When I was asked about using a girdle after the postpartum I told women I thought this wasn't a good idea.

You see my grandmother wore a corset most of her life. Due to this she had her stomach or back muscles weren't strong enough for her to be able to function without it.

It made me believe that this kind of support would only cause weakness.

Fast forward several years later whilst working as a doula, teaching closing the bones and generally asking everybody I meet about their culture's postpartum practises, I came to realise that postpartum binding is a worldwide practice.

It challenged my belief massively because surely if the whole world does something similar, there is bound to be some wisdom being it, right?

Whilst developing my rebozo course I asked my super knowledgeable osteopath friend, Teddy Brookes, what his opinion of it was. He said it was definitely a worthwhile treatment as long as it was only done mindfully (i.e. not 24/7) and only during the first few weeks postpartum.

To me, now, it makes complete sense.

I have given the closing the bones massage to hundreds of new and not so new mothers.

Therefore I have laid my hands on the abdomen and hips of all these women, and wrapped their bodies with rebozos.

How changing and open their body is post birth is truly mind-blowing.

The whole body changes to accommodate the growing baby: the pelvis tilts and widens, the spine curvature increases, the abdomen stretches to accommodate the growing uterus, which in turn also pushes all the internal abdominal organs up.

Then after the birth all of this has to happen in reverse.

In particular, as the uterus shrinks back to its pre-pregnancy size, then the abdominal organs descend back into place.

New mothers, whilst going through the transition that giving birth to a baby and being born as a mother requires, are very open, both physically, emotionally and spiritually, and therefore the wrapping is part of the nurturing support to bring them back to their centre.

To cite an extreme example, when mother of triplets Rowena Hazell had just given birth (vaginally at that!) she couldn't breathe properly:

" As I tried to get back out of the pool, I had a weird sensation of not being able to breathe, as if all my body was suddenly too heavy. That was odd. On the postnatal ward I couldn't sit up or stand for more than five minutes without finding breathing difficult. I was having to be wheeled across to NICU in a wheelchair because I couldn't walk far. The midwives didn't know why, didn't take it seriously, and looked at me quite oddly when I said I needed to use a wheelchair. One of the other mums I met had brought a corset in, because she said that she had had severe diastasis recti before. This is when the stomach muscles have separated so much that for a while after birth they simply don't hold your organs properly in the right place. The mum described it to me as your diaphragm not holding everything in, so it falls out of the bottom of your tummy. This was exactly what it felt like was happening to me! The midwives on the ward didn't seem to have heard of this, but they did send a physio to see me. The physio made a corset out of a double layer of their largest Tubigrip, and immediately I could breathe, sit up, and walk again with ease". (you can read her whole birth story here)

I think this illustrates very well how important postpartum wrapping can be!

I'm not saying that every mum should wrap herself by the way, because I'm a staunch supporter of informed choice.

I'm also certainly not advocating that new mums wrap themselves to look slimmer either, because this is the wrong focus.

If you follow this blog you'll know that I have written several times about how I'd like to see the focus of postpartum gifts and support to be focused on the new mother and her well-being and support, rather than on the baby.

So I see postpartum wrapping as a source of comfort, support and warmth.

Done right, in accordance with the mother's preferences, it can feel very good indeed.

So what can we use, and how can we do it?

There are quite a few blogs around, one kind that seems to be especially popular is an indonesian type of binding called bengkung belly binding. It seems, and I've been guilty of this too, that many see this as the gold standard.

However, I'm also a babywearing consultant. If I have learnt one thing in my 8 years in this capacity it is that slings are like jeans: you cannot be prescriptive about what fits one person, and you have to try before you buy.

These days I see my job as providing a buffet of choices, but not as being the one who chooses the dish for you.

I may like the versatility of wraps but if you think this feels like impossibly origami to you, it's not going to the right kind of carrier for you.

So when it comes to postpartum wrapping the same is true.

I used to believe that soft fabric was best, until I realised it was the same as slings: some people prefer wraps, some prefer buckle carriers.

So as well as my rebozos, wraps and belly binds fabrics, I added velcro type belts and girdles to my ever expanding collection.

Earlier this year, I was supporting a new mother who had given birth to twins. She was already an experienced user of woven wraps, having carried her first child. She asked me to show her how to wrap her belly post birth using a rebozo or a woven wrap.

The problem was, she couldn't do it tight enough on herself. We tried and couldn't make it work. She did love my velcro postpartum girdle, however, so she ordered one for herself.

There is a plethora of tools to use-from simple pieces of cloth, scarves, rebozos, pashmina, babywearing wraps (both stretchy and woven ones) and more. There are also many different velcro belts and girdles.

This year I learnt to use a very long woven wrap to support a pregnant woman's body (I took a course from this German babywearing school), and I'm pretty sure the techniques can be adapted to support the postpartum too.

Some cultures wrap the hips, some wrap the abdomen, and some wrap both the hips, abdomen, and lower ribs.

Some velcro belts are just for the waist or hips, some are designed to bind the whole abdomen and hips.

Here is a collection of types of binding that I have tried:

You can simply wrap your abdomen or hips by wrapping the fabric around you and either twisting and tucking the fabric, or twisting and knotting it, depending on how much tension you prefer. You can see a video of me wrapping my hips this way here

With a long enough cloth, you can wrap your belly, twist at the back, then wrap your hips and tie a knot at the front, wrapping your hips as well as your belly.

You can use babywearing wraps to wrap your belly and hips after the birth too as shown here

With a very long, narrow cloth (about 15cm wide and 7 m long) , you can do the bengkung style binding, which goes from the hips to the ribs. Here is a tutorial for it

In Holland you can find a range of postpartum girdles, known as sluitlakens, some of which look uncanningly like the Indonesian binding (which is perhaps not surprising given the Dutch colonisation history).

Finally there is a plethora of velcro belts and girdle both online and in stores. From what I have experienced, you really get what you pay for: cheap ones are made of scratchy and/or uncomfortable material.

The more expensive ones also often have a double velcro system that allows you to tighten the belt/girdle a second time towards the back which makes tightening effortless (and important point when one has weak core muscles).

To give you an idea a good hip belt such as the Serola costs about £35/£40 and a good hip to waist girdle such as the Belly bandit will be about £50/£70 depending on the model.

Another simple garment to use is compression pants/shorts. Again different types are available only, including in leading maternity brands like Mothercare or Jojomamanbebe (so it might be worth a visit to an actual brick and mortar shop, though choice maybe be more limited than online)

How to choose?

Like jeans, it's best to try before you buy. Difficult with online stuff I know but you can return items if needed.

Only you can tell whether it is comfortable and right for you, so it's worth trying a couple of options. You cannot go wrong with simply going with your gut or what you like the look of for you first, then trying and see how it feels.

Recently we had a discussion thread on the Facebook group for closing the bones practitioners about it.

A new mum said this about bengkung: "I tried it few times and every time it felt like my organs were falling down. It just felt wrong and seemed to add too much pressure on my already weakened pelvic floor."

My friend Rosie Dhoopun who teaches alignment for pregnancy, said that "bengkung is so tight, proper binding, there is more chance of damage from intra abdominal pressure and pelvic floor damage. I personally wouldn't recommend it"

I'm not saying bengkung is wrong for everybody, just giving this as an example that some types of binding (heck sometimes even any binding at all) may not be right for some mothers.

So trust your comfort, your instincts and your feelings and maybe try a couple of different wrapping methods and see what makes you feel good 🙂

PS: I have been working with wraps, rebozos, shawls and scarves for several years now and I see them as something that has a lot of use beyond the childbearing years. When it comes to wrapping for example, I now see my period as a mini postpartum time with similar needs, and I find that wrapping my hips or my abdomen or both during this time is extremely comforting. Try it and tell me what you think.

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The lost art of postnatal wrapping | Sophie Messager

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Years ago, before I started working as a doula, I taught antenatal classes. When I was asked about using a girdle after the postpartum I told women I thought this wasn't a good idea. You see my grandmother wore a corset most of her life.

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Busting taboos about leaks & lumps after childbirth. A community, book and kick ass podcast about incontinence, prolapse and pelvic pain.

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This is from the Physiotherapy department at Cardiff Hospital

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Cardiff and Vale University Health Board

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Help recover from your caesarean section with these gentle exercises. Read now.

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You will probably need some help to start with at home after your caesarean section (c-section). But you can start your usual activities when you feel ready.

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This sequence of exercises, we're going to do lying on the floor. But to get to the floor, I want you to be really careful. Put one hand round your tummy, turn onto your side, and then lower down and lie on your back.

The reason I want you to do that is that sometimes, during pregnancy, your tummy muscles can separate. This is completely normal and natural. But to help bring those tummy muscles in, it's really important to do exercises like the ones we're going to do.

To check if you've got a gap in your tummy, you can do this: get two fingers, place those fingers just above your belly button - so find your belly button, just place them a little bit above your belly button. Take your other hand back behind your head and, just once, lift up. Then just feel between the ridge in your tummy, and you can feel if there's a gap there or not.

If you can sink your fingers in and the gap is wider than two finger-widths, then you need to be a bit careful. Just do the exercises in this video for tightening your tummy, and avoid any kind of curling actions, because that won't help your tummy right now. Just stick to the ones in this video.

So, making sure that your tailbone is on the floor, with a little gap in your back here, so you can get your fingers part-way underneath, we're going to really connect to the inner core muscles. So find your pelvic floor, draw up through your centre. As you exhale, slide your leg out, keeping all of this area completely still and pulling up into your tummy.

One way to remember this is to think of a line, a zip-line from your tail to your pubic bone, up into your belly. You zip up through that line as you extend your leg out.

Take another breath to bring your leg back, and again pull up through the zip-line as the leg comes back. Don't allow anything to move.

So you take a breath, you inhale, slide your leg out, zip up through, pull up through your pelvic floor, pull your tummy in. Then take another breath, zip up through again, and we're going to slide the leg out, pull up through, and make sure that there's no movement in your pelvis. You're concentrating on that zip line, pulling up through your pelvic floor.

If you were to do this every day, and if you've got a gap, this will really help to bring that gap in. It's really good to do anyway, but good if you've got a gap as well.

The next exercise again is going to help - perfectly safe for you to do. So you're going to now go into what we call a bridge, but this is going to really work your bottom muscles as well as your tummy.

So, from that neutral line - which is where you've got that little gap in your lower back - you're going to tuck your tail, suck your tummy in, and start to lift your back up off the floor, one vertebrae at a time. Go up to a position where you can really tuck your tail.

I'm going to do this wrong for a second. I'm going to push my back through - now that's not good for your back. You've got to make sure that you're tucking your tail, squeezing your bottom, sucking your tummy in. So your bottom goes high, your back doesn't. If you feel any pain in your back, you need to come out of the position.

Squeeze your buttocks really tight, and then roll back down, tucking, tucking, tucking, trying to get each vertebrae back down to the floor like links in a chain, one at a time, until you're back in that neutral line, and then you can lift up again.

So from neutral, tail on the floor, tuck your tail, suck your tummy in, lift up. When you're up here, find your pelvic floor again. Lifting through your centre, squeeze your buttocks and then roll back down, really making sure you're feeling it. So this is a really great exercise for your bottom.

We're now going to work into the upper body. So you're going to take your hands up behind your head. We're going to use one arm against the other, and this is brilliant for toning the backs of the arms, the old "bingo wings", this tricep area here.

So you're going to press and push one hand against the other. This really works the bicep muscles, and the tricep muscles, which are the ones that go down the back of the arm here. If you've got some hand-held weights, you can use those instead.

Then you're going to swap hands and do it the other way as well. Just push and pull, and then really feel the backs of the arms, and also the biceps, the fronts of the arms working.

We're just going to finish off with a stretch for the bottom that you worked in that bridge exercise. So take your knee out to the side, hold that position there, pushing your knee out to the side and lifting this leg in. You should feel a lovely stretch going down the side of your leg. And on the other side, making sure your knee is out to the side.

This is a lovely sequence of exercises to do with your baby lying by your side.

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Postnatal exercises: tightening those abdominals (Video)

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This sequence of exercises, we're going to do lying on the floor. But to get to the floor, I want you to be really careful. Put one hand round your tummy, turn onto your side, and then lower down and lie on your back.

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Days after giving birth

As soon as you feel up to it, it's safe to go for walks and do pelvic floor exercises and gentle stretches (NHS Choices, 2016a). Don't worry if you can't quite manage those pelvic floors just yet. You'll know as soon as you've healed enough when to give them a go.

Pelvic floor exercises

Pelvic floor exercises help to strengthen the muscles of the pelvic floor. These muscles come under massive strain during pregnancy and when you give birth.

If your pelvic floor muscles are weak, a bit of wee might sneak out when you cough, sneeze or strain. This is known as stress incontinence, and - you may have discovered during a natter with your mum mates - it's super common following childbirth (NHS Choices, 2017).

To get your pelvic floor muscles strong again, exercise them lying down, sitting or standing. After a while, you'll be able to do these exercises anywhere. You'll soon be doing them on the bus, in a meeting or while waiting in the queue for a coffee (NHS Choices, 2016b).

Here's how you do them:

First, squeeze and draw in your back passage as if you are holding in wind.

Squeeze as if you're stopping a wee.

Now relax. This is a short squeeze. Rest for a second, then repeat until you feel the muscles get tired.

After a short rest, squeeze again as above. This time, hold the squeeze for as long as you can, but no longer than 10 seconds, then relax.

It's important to keep breathing normally while you do these exercises. Make sure you don't pull in your stomach or squeeze your buttocks.

Aim to build up to 10 repeats of each exercise, four to six times a day.

(NHS Choices, 2016b)

For more information on how to start practising pelvic floor exercises, click here (Bladder and Bowel Foundation, 2008).

Abdominal muscle separation

The two abdominal muscles (rectus abdominis) that run down the middle of the abdomen often separate during pregnancy (NHS Choices, 2016c). How much they separate varies between women.

These muscles separate because of your growing womb pushing them apart. This makes your abdominal muscles longer and weaker (NHS Choices, 2016c).

Here's how to check the size of your separation, after you've had your baby:

Lie on your back, bend your knees and have your feet flat on the floor.

Lift your shoulders off the floor a bit and look down at your belly.

Feel with your fingertips between the edges of the muscles, above and below your belly button. Check the number of fingers you can fit between your separated muscles.

Check this regularly to see that the gap is decreasing.

If you go to a postnatal pilates or yoga class, trained instructors might also be able to help you check your separation.

(NHS Choices, 2016c)

Once your baby is eight weeks old, your muscles will usually have returned to normal. If the gap is still obvious, you could be risking back problems. So speak to your GP and they can refer you to a physiotherapist (NHS Choices, 2016c).

Swimming

Swimming is great exercise. It's low-impact and good for some chill-out time for you too. You'll need to wait until seven days after your postnatal bleeding (lochia) has stopped to hop (or maybe step tentatively) into the pool.

Six weeks after giving birth

Generally, to get back to proper, high-impact exercise like running or your much-loved zumba class, it's best to wait until your six-week postnatal check-up (NHS Choices, 2016a).

It will also depend what type of birth you had. For example, if you had a caesarean section, your recovery time might be longer. It might also depend on how much exercise you did before you were pregnant.

Certain types of exercise might be better if you have weak pelvic floor muscles too. If you've got any doubts or questions about whether the exercise you're doing is ok, talk to your midwife, health visitor or GP (NHS Choices, 2016a).

But generally, don't be too nervous about it - it's great to get back to exercise after having a baby. There are loads of reasons to exercise, including your mental and physical health. So go for it and have fun.

Buggy fit, postnatal yoga and other postnatal exercise classes

Some postnatal classes let you do the exercise class with your baby at your side, which isn't as ridiculous as it sounds. Especially with a newborn who'll often snooze through the whole thing.

Some even include your baby and their pram or buggy as part of the workout. Plus they're often outdoors in local parks, which is a nice bonus.

If you're going to a class that isn't a special postnatal class, make sure you tell the instructor that you've recently had a baby.

Postnatal exercise tips

Your ligaments and joints are much more supple in the months after you give birth, so just be aware of that. It's easier than before pregnancy for new mums to injure themselves by stretching or twisting too much (NHS Choices, 2016a).

You're more likely to get injured because of a group of hormones called relaxin (The Guild of Pregnancy and Postnatal Exercise Instructors, 2018). Your body produced relaxin in early pregnancy to make the ligaments in the body more elastic.

The downside of relaxin is that it can cause back problems and injuries. Plus its impact on the joints might linger around for up to five months after you have your baby (The Guild of Pregnancy and Postnatal Exercise Instructors, 2018).

If you're in pain or your postnatal bleeding (lochia) gets heavier or changes colour (becomes pink or red) after activity, you might be doing too much (NHS Choices, 2016a; The Guild of Pregnancy and Postnatal Exercise Instructors, 2018).

Other postnatal exercise

If you're struggling for time to dedicate to specific postnatal exercise, there's still a lot you can do. Try the following:

Have a go at pushing the pram quickly. Try to keep your arms bent and your back straight, ensure the handles are at the right height for you and your elbows are bent at right angles.

Play some games with your older children that get you running around.

Build exercise into your day, for example you could walk instead of taking the car.

Bend your knees rather than your back when you pick things up. This'll strengthen your thigh muscles and avoid damaging your back.

(NHS Choices, 2016a)

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Postnatal exercise: how soon can I start again after a baby? | Life as a parent articles & support | NCT

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If you're keen to get back to your fitness routine but are not sure how safe it is, here's what you need to know.

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Advice about stitches, piles, bleeding and other physical changes after birth, plus tips to help you make a healthy recovery.
If you've had a caesarean, see recovering from a caesarean.

Stitches

If you've had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection. Have a bath or shower with plain warm water then carefully pat yourself dry.

If your stitches are sore or uncomfortable, tell your midwife.

Painkillers can help. If you're breastfeeding, check with your pharmacist, midwife or GP before you buy over-the-counter painkillers.

Stitches usually dissolve by the time the cut or tear has healed, but sometimes they have to be taken out.

Going to the toilet

At first, the thought of peeing can be a bit frightening - because of the soreness. Drinking lots of water dilutes your urine, which may make it sting less.

Tell your midwife if:

you're finding it really difficult to pee

you feel very sore

you notice an unpleasant smell

You probably won't have a poo for a few days after the birth, but it's important not to let yourself get constipated.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water.

If you've had stitches, it's very unlikely you'll break them, or open up the cut or tear again.

It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain.

Talk to your midwife or GP if you have constipation that won't go away. A gentle laxative may help.

Also tell your midwife or GP if poo is leaking or you're pooing when you don't mean to.

Bladder control

After having a baby, it's quite common to leak a bit of pee if you laugh, cough or move suddenly.

Pelvic floor exercises can help with this but tell your GP at your postnatal check if they aren't. They may refer you to a physiotherapist.

Piles

Piles are very common after birth but usually disappear within a few days.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water. This should make pooing easier and less painful.

Try not to push or strain - this will make the piles worse.

Let your midwife know if you feel very uncomfortable. They can give you a cream to soothe the piles.

Bleeding after birth (lochia)

You'll bleed from your vagina after the birth. It will be quite heavy at first, and you'll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards.

It isn't a good idea to use tampons until after your 6-week postnatal check because they could increase your chance of getting an infection.

See when you can start using tampons after birth.

You may notice the bleeding is redder and heavier when you breastfeed. This happens because breastfeeding makes your womb contract. You may also feel cramps similar to period pains.

The bleeding will carry on for a few weeks. It will gradually turn a brownish colour and decrease until it finally stops.

If you're losing blood in large clots, tell your midwife. You may need some treatment.

When will my periods start again after pregnancy?

It's hard to be exact about when your periods will start again, as everyone is different.

If you bottle feed your baby, or combine bottle feeding with breastfeeding, your first period could start as soon as 5 to 6 weeks after you give birth.

If you fully breastfeed (including at night) without any bottle feeding, your periods may not start again until you start to reduce breastfeeding.

How soon after giving birth can I get pregnant?

You can get pregnant as little as 3 weeks after the birth of your baby, even if you're breastfeeding and your periods have not started again yet.

Find out more about when you can use contraception after having a baby.

How soon can I use tampons after giving birth?

You should not use tampons until you've had your 6-week postnatal check. This is because you'll still have a wound where the placenta joined with the wall of your womb, and you may also have tears or cuts in or around your vagina.

Using internal sanitary products like tampons and menstrual cups before this wound has healed could increase your chance of getting an infection.

Use maternity pads or sanitary towels during this time while your body is still healing.

Breasts

To begin with, your breasts will produce a yellowish liquid called colostrum for your baby.

On the third or fourth day, they may feel tight and tender as they start to produce milk.

Wearing a supportive nursing bra may help. Speak to your midwife if you're very uncomfortable.

Read more about breastfeeding in the first few days.

Tummy

After delivery, your tummy will probably still be a lot bigger than before pregnancy. This is partly because your muscles have stretched.

If you eat a balanced diet and get some exercise, your shape should gradually return.

Breastfeeding helps because it makes your womb contract. You may feel quite painful period-like cramps while you're feeding.

You could also try these gentle postnatal tummy exercises.

Is it something serious?

Tell your midwife, health visitor or GP straight away if you get any of these symptoms.

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Advice about stitches, piles, bleeding and other physical changes after birth, plus tips to help you make a healthy recovery. If you've had a caesarean, see recovering from a caesarean. If you've had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection.

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Blood Loss after Birth

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Pelvic Floor Toner (You may get on prescription with a physio referral

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Take control of your pelvic floor with the PelvicToner™

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The PelvicToner™ pelvic floor exerciser offers a simple, quick and effective to strenghten your pelvic floor. Clinically proven and available on prescription through the NHS it offers a low cost treatment for stress incontinence, vaginal prolapse and poor

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Pelvic Floor