The pelvic floor is important for bladder and bowel control and for increased satisfaction during sex. Weak pelvic floor muscles do not support the pelvic organs correctly, which, along with bladder and bowel weakness, can lead to prolapse (the dropping of the uterus, bladder, or bowel).
Bladder care during labour
The most important thing for bladder care during labour is to stay well hydrated. Dehydration can lead to your labour slowing or stopping. To ensure you do not have too much or too little fluid in your system, you may be started on a fluid balance chart.
Also, your midwife will encourage you to regularly empty your bladder so your baby’s head can descend towards your pelvis. This also has the added benefit of reducing bladder trauma risk.
Fluid balance charts
These charts help track your fluid consumption levels and the amount of urine you pass. Your fluid intake includes both drinks and liquid medicines/IV fluids. The amount of urine you pass may be measured via a bedpan in the toilet, or a catheter if you have one in place. Achieving fluid balance using a chart can help avoid organ damage.
You may also need fluid balance if having a home birth. Your midwife may not able to measure your urine, so they will ask you if you feel you are passing a normal amount.
What if you can’t empty your bladder when pregnant?
If you can’t pass urine every 2-3 hours while pregnant, your midwife may encourage you to:
Drink more fluids if you aren’t having enough.
The midwife will gain your consent if they feel it would be advisable to use an in/out catheter, a small plastic tube that will be passed into your bladder. It will empty the bladder, then be removed.
Insert a urinary catheter, it will remain in place until your baby is delivered.
Bladder health support for a caesarean birth
If you have any form of caesarean birth, you will need a catheter to empty your bladder. Insertion is most commonly performed once your anaesthetic is working so that it is not painful and you cannot feel it.
The first 24 hours after the birth (or after your catheter is removed)
Empty your bladder every couple of hours. The feeling of wanting to pass urine may not return straight away. You must tell your midwife if you are unable to empty your bladder within six hours following delivery.
Do short pelvic floor muscle squeezes at first. It can help reduce swelling and help heal tears and stitches. Lying on your side is a comfortable position to start exercising
If you had stitches - Keep the perineum clean and dry until healed, using only warm water to wash it. Avoid using any creams, gels, or soaps in the area, as they can cause infection and irritation to the new skin. Stitches should dissolve within 10-14 days; discomfort should decrease daily. If not, please ask your midwife or GP to check them at your post-natal appointments.
Use medication as advised by your midwife or doctor if your perineum (the area between the vagina and back passage) is uncomfortable. This will help to keep you mobile, which in turn helps the healing process.
You could also try using an ice pack – this will help to reduce swelling and discomfort, as well as ease bruising. When you are at home, you can use a damp frozen pantyliner or a ready-made gel ice pack in a damp, clean flannel and place it on the perineum for 5 minutes, while you are lying down. Remember not to sit on the ice pack.
Caution: ice can burn, so do not leave it in place for longer than five minutes.
If you have difficulty controlling your bladder or bowels after delivery, please ask your GP/Midwife to refer you to Women’s Health physiotherapy.
You may feel worried about emptying your bowels for the first time. Using a wad of toilet paper or maternity pad, support the area just in front of your back passage to support it while you gently bear down with a series of short pushes (rather than straining).
You must tell your midwife if:
You can’t pass any wee or
If there is no sensation to need to wee or
You are leaking wee when you stand or move around
Post-caesarean bladder care
Pass urine within 6 hours after your catheter is removed, and continue to empty your bladder regularly to stop retention and infection.
Drink plenty of water, but don’t force it down.
Your midwife will keep a record of when you empty your bladder, including the time and volume. This will inform them if your bladder is emptying well.
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