The secret many moms keep

Pelvic health is not a topic most moms typically discuss. But there can be plenty of problems “down there,” such as bladder leakage, that are the direct result of going through pregnancy and childbirth.

Missy Lavender, the executive director and founder of the Chicago-based non-profit Women’s Health Foundation, was one of those moms. After delivering a son in 1999, she discovered a few problems.

“I was a classic postpartum mom,” she says. “I had a tough delivery and I wasn’t ready for everything.”

Almost immediately, Lavender began having problems with urinary incontinence. To her dismay, her doctor told her it was a common problem for new mothers. She told me to go home and just do some Kegels and everything would be fine in six months,” Lavender says. “Which is like telling an athlete with a torn ligament to go work everything out on their own.”

Lavender went on to have a second child and eventually had a reconstructive pelvic operation in 2001. While she was recovering, she says she began thinking about the lack of information for women about pelvic health.

“I couldn’t get over the fact that other women were experiencing similar or worse after effects,” she says. “It seemed all too common but it’s just not normal to leak when you sneeze and you shouldn’t have back problems.”

Her mission turned her into a “pelvic floor evangelist.” She approached Congress about the lack of research dollars for bladder disease and over a two-year period interviewed urogynecologists, nurse practitioners, pelvic floor physical therapists and exercise physiologists to find ways to help women.

Through her research, Lavender discovered the “pelvic pyramid,” three groups of muscles women often ignore—the pelvic floor (the ones focused on during Kegels), the transverse abdominals (under the six-pack abs everyone tries to achieve) and mulfidus (under the big back muscles, the erector spinae, that run from vertebra to vertebra starting at the sacrum and through the mid-thoraic spine between the shoulder blades.)

The muscles in the front, back and pelvic floor are all attached so they work together and hold everything up and in. When they are strong, Lavender says, they improve posture and help create a well-toned stomach, a better sex life, a stronger back and curb urinary inconsistence. After the stomach has been stretched out during childbirth, there is a traumatic opening of the pelvic floor and women start to have problems, she says.

“Would you ever just show up for the Boston Marathon?” Lavender asks. “No, but in pregnancy, we just show up and then we are like ‘why do my back muscles ache, why does my sex life suck’ and we just did the Boston Marathon of the pelvis.”

Spreading the word

A 2003 New England Journal of Medicine study found that 21 percent of women who deliver a baby vaginally have some degree of bladder issues.

To increase public awareness, Lavender founded the Women’s Health Foundation in 2004 and developed a medically based fitness and education program called the “Total Control,” a seven-week class designed to educate and provide exercise instruction on pelvic health and wellness. The program was tested in two clinical studies in 2004 and 2006 by Loyola University Medical Center, Northwestern Medical School and Evanston Northwestern. According to the initial pilot study of 23 women, the participants decreased their symptoms and improved their quality of life.

Lavender says one out of three women suffer from urinary incontinence, but it is a topic they are least likely to discuss. Instead she discovered women were more likely to discuss their sex lives. The Women’s Health Foundation began hosting one-day fund-raising events called “Sex, Chocolate and Your Pelvic Floor” in 2006 and now is offering them nationwide.

“It’s about giving power back to women,” Lavender says. “To take control of your body. You only get one shell. Even if you get a boob job or tummy tuck, you have to look under that shell at the foundation. If that foundation is weak or damaged and no one is attending to it, then your whole building is weak and you might have problems.”

Tips to try

The Women’s Health Foundation, 632 W. Deming Place in Chicago, offers a variety of tips to help curb urinary inconsistence.

Here are a few:

1. Do not anticipate going to the restroom, because anticipation becomes need. When you go, in your own time, walk.

2. Empty your bladder after intercourse and right before bedtime face.

3. Never indulge in “just-in-case peeing.” Some people go every chance they get, even when they don’t need to.

4. Distract your bladder. Count by threes, give it (and you) something else to focus on. Or apply your strongest Kegel squeeze and walk.

5. Don’t be a camel by trying to “hold it” for more than six hours.

6. Feel like you’ve “gotta go” right after you just went? Make sure it’s all out by rocking back and forth on the seat, side to side and front to back

7. Foods that are acidic, spicy or sweet are potential dietary triggers of incontinence. Culprits include ketchup, red pasta sauce, chilies, vinegar, mayonnaise, soy sauces and most salad dressings

8. Eat more fiber. Bladder-friendly foods include olive oil, garlic and green, leafy vegetables, bran and other items like oatmeal and prune juice. (A lack of fiber in a diet can lead to constipation, which, if chronic, can increase symptoms of an overactive bladder because constant straining and abdominal pressure weaken the support of bladder and pelvic organs.)

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