November is Bladder Health Month - What the New York Times Got Right

To start off Bladder Health month, I thought a discussion about urinary incontinence, a bladder concern of many women, especially those who have undergone pregnancy, would be appropriate. Pregnancy and childbirth are known risk factors for urinary incontinence (unintentional and involuntary loss of urine). But despite the fact that more than one-third of women experience urinary incontinence in the second and third trimesters of pregnancy and about one-third leak urine in the first three months after giving birth, the topic is widely avoided.


In a recent New York Times (NYT) article under the In Her Words column, "‘We Don’t Have to Put Up With This’: A Candid Conversation About Bodies",1 the author noted that incontinence is rarely talked about, rather "it remains shrouded in shame, secrecy, and falsehoods" but that women "don’t need to put up with this". As a pelvic floor specialist, I have treated too many women who have suffered from incontinence for too many years before seeking treatment. Their stories weave along similar threads: "it started after having my son" or "after my first kid I started leaking", or "when I laugh or sneeze, I wet myself". 

As noted in the NYT article, there are treatments for incontinence including pelvic floor muscle (PFM) exercises (Kegel exercises). A recent Cochrane review noted that pregnant women without urine leakage who did PFM training to prevent leakage report less urine leakage in late pregnancy and the risk is slightly less at three to six months. Also, women who began PFM exercising during pregnancy probably have slightly less leakage in late pregnancy and this may continue up to six months after birth. So we need to promote a more open dialogue with women about the importance of the pelvic floor and encourage help-seeking behavior, especially if it occurs during or after childbirth.

Written by: Diane Newman, DNP, CRNP, FAAN, BCB-PMD, Nurse Practitioner (NP), Co-Director, Penn Center for Continence and Pelvic Health Director, Clinical Trials, Division of Urology, Adjunct Professor of Urology in Surgery, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Reference: 
1. Altman, Mara, and Luce Brett. “‘We Don’t Have to Put Up With This’: A Candid Conversation About Bodies.” The New York Times, October 26, 2020, sec. U.S. https://www.nytimes.com/2020/10/26/us/childbirth-bodies-stigma-incontinence.html.

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