The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Shutting Off the Faucet
Though it might be tempting to schedule a C-section to lower your odds of incontinence, experts advise against this. For one thing, susceptibility is to some degree genetic, and a substantial number of women who choose C-sections end up leaking anyway.
What’s more, research shows, two decades after giving birth, women who delivered via C-section are no better off, leakage-wise, than women who delivered vaginally. “Things tend to equalize due to wear and tear and gravity,” Goldberg explains. Besides, C-sections pose their own risks, to both mom and baby.
If you’re leaking while pregnant, Kegel exercises may not be enough to stop the spritz; experts believe that the weight of the uterus combined with pregnancy hormones make for an overpowering combo. But it still pays to start getting your pelvic-floor muscles in shape: Research suggests that after delivery, Kegel exercises, if done properly, can help minimize both stress and urge incontinence (see “My Vagina Workout,” below). “You can Kegel immediately, right in your hospital bed,” says Missy Lavender, founder of the Women’s Health Foundation, a nonprofit group that educates women about pelvic health.
If your leakage is persistent, you can be fitted for a pessary, a small silicone ring that acts as a “speed bump” for the urethra; you place it inside the vagina in the morning and remove it at night. Some women use a pessary only when they jog or play tennis.
“Bladder sling” surgery, which has a 90 percent success rate for stress incontinence, may be the best option for frequent leakage as long as you aren’t planning any future pregnancies. In a quick, minimally invasive procedure, the surgeon inserts a U- shaped, mesh sling that permanently supports the urethra. What kind of treatment you seek depends on whether your activities are disrupted. Consider surgery, Mahajan says, “if you have to wear a pad every day or if you can’t live the way you want to. Don’t let your bladder rule your life.”
My Vagina Workout
As an occasional leaker, I’d likely benefit from strengthening my pelvic-floor (aka vaginal) muscles. The problem: Kegels bore the heck out of me, so I blow them off. So I was surprised to find that The Myself pelvic muscle trainer ($99; themyselftrainer.com), a battery-powered gizmo that offers visual feedback and three strength levels, makes a vagina workout kind of fun (no, not in that way).
Lying down, you insert a super-tampon-sized plastic sensor, then press a button to inflate a balloon inside it. A handheld device that resembles an oversized iPod, complete with screen, guides you through a five-minute workout, instructing you when to squeeze and relax. A series of bands indicates how strong your pelvic-floor muscles are. In my case, not very: Turns out, Kegeling is tough.
“Most women recruit their abs and buttocks instead of their vaginal muscles,” says Providence, R.I., urogynecologist Star Hampton, M.D. I found myself clenching my glutes and holding my breath— two big no-no’s—and I couldn’t hold the squeeze nearly as long as the device asked me to. With or without a pelvic-muscle trainer, your goal should be to do two sets of 10 Kegels twice daily; start by holding each for one second, and work up to five seconds.