Has childbirth left you with no control over your bladder? 40% of women experience some form of urinary incontinence after a vaginal birth. Incontinence is also a possibility following a C-Section, with as many as 25% of moms experiencing such issues following delivery.
Urinary incontinence should not be an acceptable side effect of childbirth. With specific exercise and use of appropriate devices, re-educating your pelvic floor and regaining control over your body is possible. Dreaming of Baby speaks with Brent Reider, President of Relevium Labs, on how pregnancy affects the pelvic floor and on regaining pelvic strength after childbirth.
Daniela: We have with us today Brent Reider, President of Relevium Labs, Inc., with whom we shall be discussing issues related to pelvic floor muscle control and the treatment of incontinence. Good morning, Brent, and a warm welcome to Dreaming of Baby. We’re looking forward to our discussion today as we feel that this is an issue which many mothers have to deal with, sometimes also without sharing their worries or concerns about their pelvic floor after childbirth. To start off, we’d be very grateful if you could introduce yourself to our readers.
Brent Reider, President Relevium Labs, Inc: Good morning, Daniela. Thank you for having me. My name is Brent Reider. I design FDA Cleared Class II medical equipment (7 devices personally, including the Yarlap) and I’m a colleague of the team that designs equipment used by the National Healthcare systems of France, Germany, Scandinavia and Great Britain. In addition, I am an author and referee for medical and scientific peer review journals. My article, “Role of Pelvic Floor Muscles in Female Orgasmic Response,” is a recent British peer review article.
What is the pelvic floor?
Daniela: Great, thank you for that impressive overview, Brent. To start with our discussion today, can you explain to our readers: What is the pelvic floor?
Brent Reider, President Relevium Labs, Inc: The muscles of the pelvic floor are like a hammock. They help hold organs in position and help direct the weight of your body to your heels. If the muscles of the pelvic floor weaken; the organs move, which places pressure on the bladder. This results in stress incontinence – leaking when you cough/sneeze/laugh. Atrophied muscles can contract spasmodically causing urge incontinence or “overactive bladder.” In addition, we believe a weak pelvic floor strains the back muscles and puts an uneven load on the thighs and knees.
Brent Reider: “If the muscles of the pelvic floor weaken; the organs move, which places pressure on the bladder. This results in stress incontinence.”
Daniela: You refer to atrophied muscles contracting spasmodically, can you elaborate a little more on this?
Brent Reider, President Relevium Labs, Inc: That is a great question. Atrophied muscles are muscles that are weakened due to lack of use. When they spasmodically contract, they basically cramp up. Think of your bladder like getting unwanted bear hugs in the middle of an inappropriate time and then having a bladder leak.
How does pregnancy affect the pelvic floor?
Daniela: Thanks for clarifying. Is there any reason in particular why these muscles are not used much? Would this be something related to age, or pregnancy also has an effect?
Brent Reider, President Relevium Labs, Inc: 40% of women who have had vaginal births and 25% of C-Section births will experience some form of urinary incontinence. Women with urinary incontinence have a higher incident of depression (15%) than women without urinary incontinence (9%). The comorbidity appears higher in women with urge (also known as Overactive Bladder). The incidence of female urinary incontinence does increase with age, but female urinary incontinence is common among women of all ages, including collegiate varsity athletes. The repetitive impact of some exercise strains the pelvic floor muscles leading to female urinary incontinence. Studies suggest that 20% of incontinent athletes will discontinue the activity because of incontinence and 18% will modify their performance to limit leaks. In the case of postpartum recovery, the muscles have been strained by childbirth. The muscles need rehabilitation. Good postpartum care has short and long-term benefits. The French, who know a bit about love, call it la rééducation périnéale (perineal re-education). Exercise therapy to tone and re-educate the pelvic floor muscles is an essential aspect of postpartum care in Europe. In the French, British, Scandinavian, and German Healthcare Systems they prescribe pelvic floor muscle recovery as soon as the woman is healed from birthing. Part of the program includes muscle stimulation.
Brent Reider: “Women with urinary incontinence have a higher incident of depression (15%) than women without urinary incontinence (9%).”
Daniela: Focusing on pregnancy per se: in what way and how does pregnancy affect the pelvic floor?
Brent Reider, President Relevium Labs, Inc: Normally, for most young mothers, the pelvic floor muscles are toned and flexible. During pregnancy, the baby rests on the pelvic floor, the added weight causing muscle strain. For most young mothers, this is normal and it isn’t a big deal. The big deal is childbirth. Childbirth is like fitting your head through a turtleneck sweater hoping that the head doesn’t cause too much stretching. But it does, and the pushing out during delivery causes strain on the pelvic floor muscles. So, you have to get them back into shape.
How to prepare your pelvic floor for childbirth
Daniela: You’ve spoken about perineal re-education; before this, is there anything a woman can do during pregnancy to prepare her pelvic floor for childbirth and prevent incontinence issues later on?
Brent Reider, President Relevium Labs, Inc: Yes, this is brilliant! Make sure that you do Kegels. But there is a catch with them: most women who try to tone their pelvic floor muscles with Kegel exercises find it difficult to perform them correctly. In fact, over 50% of women are unable to do a Kegel correctly, even with instruction. This is why the European healthcare systems help the mother by providing her with muscle training through muscle electro-stimulation sometimes before, and always after giving birth. It’s all about muscle tone and re-education.
Brent Reider: “Most women who try to tone their pelvic floor muscles with Kegel exercises find it difficult to perform them correctly. In fact, over 50% of women are unable to do a Kegel correctly, even with instruction.”
Bladder Control Products
Daniela: And how can a new mom re-educate her perineum? Are there any products available to help her out if Kegels prove difficult? How would such bladder control products work?
Brent Reider, President Relevium Labs, Inc: New moms can easily re-educate the pelvic floor muscles at home. Naturally, during exercise, your brain sends an electrical signal to your muscles telling them when to contract and when to relax. Neuro-muscular stimulation (NMES) devices, which are used popularly in Europe, send the signal directly to the muscle. There are also biofeedback devices, but muscle re-education is clinically proven to be most efficiently achieved with NMES. With NMES devices, the programs are clinically proven to be effective and safe. They can tone the pelvic floor muscles effortlessly with programs to build strength and programs to massage and relax – in as little as 20 minutes a day.
Daniela: Can you elaborate a little on the difference between biofeedback devices and NMES?
Brent Reider, President Relevium Labs, Inc: Neuromuscular Electrical Stimulation (NMES) and Biofeedback are complementary – not competitive – technologies for a woman’s well-being. Biofeedback monitors muscle activity only. If you are using the wrong muscles during a workout (i.e. your abs or rear end), biofeedback still registers that activity as your workout. NMES puts the signal directly into the muscles. This efficiency has a number of important benefits for muscle tone and re-education; maximum workout efficiency, improved muscle control, accelerated muscle recovery and improves range of motion of the muscle.
Daniela: Thank you for that overview. How would an NMES device work in practice? Would this be normally recommended for use by an Ob/Gyn or physiotherapist, or any woman can go ahead and use it?
Brent Reider, President Relevium Labs, Inc: Above all, only use FDA cleared devices and make sure it is of the highest quality. The FDA has cleared devices for prescription and over-the-counter use. There is one device for both and that device is also cleared to maintain continence in women. We encourage our customers to include their Ob/Gyns and PTs in their pelvic floor therapy program. Quality care for new mothers is one of the best investments we as individuals and a society can make.
Brent Reider: “Quality care for new mothers is one of the best investments we as individuals and a society can make.”
Daniela: A question that’s important for our readers: How do these devices work in practice and can they be used immediately after birth?
Brent Reider, President Relevium Labs, Inc: NMES devices can be used as soon as she is healed from childbirth – her physician will let her know. Again, we really encourage the licensed healthcare professional to be fully informed and involved.
Can I regain control of my pelvic floor?
Daniela: Thank you for the insight you are sharing with us: a penultimate question: With the use of such devices, is there hope for the pelvic floor, that is, can it be completely healed and its muscle tone reclaimed, or it’s something which needs permanent work – as in women have to use such devices long-term?
Brent Reider, President Relevium Labs, Inc: Recovery time is unique to every woman. Some women will regain muscle tone faster than others. In our experience, some women will regain continence anywhere between 2-10 weeks using a good quality NMES device. After a woman achieves bladder control, the leaks stop, many women continue to use the device once or twice a week to maintain continence and because it feels good! Customers often call to tell us they have bladder control but what is truly exciting is when a woman in her 80’s calls to report she has regained the ability to control her pelvic floor muscles; hold and release. Then she says, “Ah, to be orgasmic again.”
Brent Reider: “Some women will regain continence anywhere between 2-10 weeks using a good quality NMES device.”
Daniela: That is amazing! It’s great to see that there are opportunities for finding solutions to such issues. On a final note, what would be your one piece of advice to moms experiencing incontinence or those who are experiencing a weakened pelvic floor?
Brent Reider, President Relevium Labs, Inc: Treat the cause, not the symptom. Make sure that your pelvic floor muscles are toned and educated because this affects your overall wellbeing. Nature gave you the power to have control, make sure you maintain it and take it to the next level. Historically, whole societies define themselves through the power of women. Every woman is remarkable.
Brent Reider: “Historically, whole societies define themselves through the power of women. Every woman is remarkable.”
Daniela: Thank you, Brent! And thank you for the insight you have shared with us today on this very important subject. It’s been a truly enlightening discussion!
Brent Reider, President Relevium Labs, Inc: Thank you for having me as a guest! It was a great discussion and I hope we can bring awareness to a very common mom problem.
Would you like to regain control of your pelvic floor? Yarlap is an FDA-cleared device to tone and re-educate the muscles of a woman’s pelvic floor, by sending the signal directly to the muscle. Read more about Yarlap, here.
Brent Reider is President of Relevium Labs, Inc. manufacturers of Yarlap.