Posted December 4, 2012 in POSTPARTUM

Kegel Exercises after Childbirth

Kegel Exercises after Childbirth
Kegel Exercises after Childbirth

Vaginal delivery is one of the potential risk factor for developing conditions like urinary incontinence, fecal incontinence and uterine prolapse in middle aged women. The risk is significantly higher in women who have given birth multiple via vaginal mode.  After years of research studies, it has been concluded that performing some exercises that strengthen the pelvic floor are preventive against all these complications. These exercises are collectively referred to as Kegel’s exercise and must be performed after childbirth for maximum benefits.

Anatomy of Pelvic floor muscles:

In order to understand the physiology of the kegel  exercise, it is important to know the basic anatomy of pelvic floor muscles. Pelvic floor weakness is the most common cause of incontinence and prolapse like issues. Pelvic floor muscles are the muscles that form the base of the pelvis that encloses all major reproductive, urinary and gut organs in a bony cage to prevent against trauma. Due to openings or orifices in the base of pelvis to allow urination, defecation or child birth; there is always a potential risk of rectal and uterine prolapse.

The role of pelvic floor muscles is very important in preventing prolapsed viscera or organs. Along with these organs, the pelvic floor also protects major nerves and vessels that are required for effective functioning of these major viscera. The pelvic floor muscles are further supported and strengthened by connective tissue and fat pads to safe-guard potential openings. Since the pelvis in women is broad and further expansion occurs during childbirth due to stretching of ligaments and muscle fibers to allow the passage of baby, chances are fair that the muscles may get damaged and lose their strength. This is due to repeat vaginal deliveries, and often nerves undergo temporary stretching or damage that may affect the strength and power of these muscles.

How can Kegel exercises prevent complications?

A few pelvic floor strengthening exercises are also very helpful in preventing complications in the future. The exercises demand just a little concentration and you can repeat these simple exercises at any time of the day, even when you are in bed or while working in kitchen. The maneuver demands relaxing your abdominal muscles and contracting your pelvic floor muscles for at least 10 seconds.

You can perform these exercises at any age; however the importance and benefits are highest if women perform kegel exercises after childbirth to regain muscular power and strength of ligaments that undergo extensive stretching during the process of labor and birth.

Benefits of kegel exercises after childbirth:

A lot of doctors do not counsel post-partum mothers properly regarding the effectiveness of post-partum pelvic floor strengthening exercises resulting in low compliance. You must know that by performing kegel  exercises, besides the long term benefits discussed above, you can always achieve:

  • A better and early recovery that is not possible without the kegel exercise.
  • To achieve better control of bladder motility as a lot of mothers (especially those who have undergone long stages of labor or significant perineal injury) experience stress incontinence.
  • Stress incontinence is a common symptom reported after mismanagement of labor and is characterized by:
  • Urinary dribbling after coughing or laughing (or any activity that increases intra-abdominal pressure).
  • Mild to moderate urinary incontinence.
  • Partial fecal incontinence.

Although these are minor and temporary changes, it may be distressing or embarrassing for the mommy and can be avoided if mother perform kegel exercises after childbirth to regain the power and control of pelvic floor muscles.

Who should mandatorily perform kegel exercises?

Although, as discussed all women should perform who are pregnant or who are post-partum; however the following sub-groups should be especially counseled for performing the kegel exercises.

Advancing age:

Aging process is directly related to physiologic changes in the strength of muscles and tissues. It is hard to believe but more than 13% of all admissions in nursing home units are because of involuntary dribbling of urine.

The degree of damage to pelvic floor muscles is higher when you are multi-parous, giving birth to a baby in breech presentation or you are multi-parous. Besides the damage, the natural power of the body to heal muscles fibers that have undergone extensive tearing is also higher if you are above 35 years of age.

Difficult deliveries or poor management of labor:

Difficult or prolonged labor that may or may not be associated with giving birth to a large size baby is also a significant risk factor that increases the stretching of pelvic muscles and tearing of small nerve fibers.

Dr Rabia Sikandar MD is an OB/GYN and a Guest medical writer.