How To Manage Leaks During And After Pregnancy

How To Manage Leaks During And After Pregnancy

You're expecting and you couldn't be happier! There's literally a mini-you baking in the oven and you feel proud, excited, and even nervous about it. However, now the phrase, "you're expecting", has taken on a new meaning. Sure, you're expecting a baby, but you also may begin to throw up at random times, crave things you've never desired before, and even leak a little after a sneeze. Nobody told you that you should be expecting all of that!

You're able to get past the sleepless nights and aches and pains, but these leaks, they're not your thing. However, this too shall pass. In the meantime, you can implement a few techniques and products to make it a little more bearable.

What's Up With These Leaks?

A woman's body goes through A LOT while carrying a baby! The uncomfortable experiences are the body's way of adapting for the baby and preparing for childbirth. I mean, we've got to expect a little discomfort with a baby growing and organs shifting to make room for it, right?

Stressed Out Sphincter

You can thank your expanding uterus for putting pressure on the bladder and making you spritz when you walk, talk, laugh and sneeze. This extra pressure on your bladder is known as stress incontinence and this happens when the bladder sphincter doesn't function well enough to hold in urine.

Hormones Going Haywire

Hormones play a big part too. Relaxin is a hormone that relaxes your muscles in preparation for labor. Progesterone is also released to soften your ligaments. The result? A pelvic floor that's looser and softer, which leads to less control of your bladder.

Bladder Spazzes and Spritz

Are you frequenting the ladies room more often than usual? Then you might have an overactive bladder. This happens when the bladder starts uncontrollably spazzing out and it's a common condition for pregnant women.

Can I Do Anything About It?

The short answer is yes, you can do something about it. However, what you do about it might not actually stop the leaks. It's one of those things that you can't 100 percent control. However, there are things you can do to help manage it during your pregnancy.

Kegel exercises are helpful before, during and after pregnancy. Doing just a few sets of 20-30 Kegel exercises a day can help whip your pelvic floor muscles into shape. Keep in mind, a stronger pelvic floor can better support your uterus and bladder, which could mean fewer leaks.  Plus, they'll come in handy when it's time to give birth! However, before you decide to implement anything new, like Kegel exercises, be sure to consult with your doctor first.

You're probably tempted to cut back on your water intake but that's not a good idea. Ensure you're getting the recommended amount of water each day. Otherwise, you could wind up with dehydration or an unpleasant UTI.

Could your diet be irritating your bladder? It's certainly possible. Ditch the soda pops, coffee (sorry!), tomatoes, and citrus stuff.

Products Can Help You, Too

One way to keep your leaks to yourself is by using pads, but not just any kind of pads. If you're tempted to grab one of your menstrual pads that have been stashed away for a while, please don't. They might look like they can get the job done but they won't. Menstrual pads are great for absorbing menstrual flow but not the rapid output of urine. Instead, look into bladder control pads. They're much more comfortable and offer better protection. Bladder control pads are designed to control odor, keep you dry, and let you remain discreet about your leaks.

Using a Product is Okay

A lot of women are embarrassed about bladder leakage and don't discuss options with friends or their doctor. Others feel like a few leaks aren't that big of a deal. No matter how you feel about it, you don't have to just deal with it. Doing a few Kegels and wearing a bladder control pad as a backup is a great strategy for managing leaks.

Growing a human being inside of you is going to cause a lot of physical and hormonal changes that you may or may not expect. However, one thing you can expect is to have options to make those pesky leaks a little more bearable!

What are you currently doing about leaks? Tell us about it in the comments!


This Post was brought to you by Lily Bird

Lily Bird is for all women with leaky laughs and dribble dilemmas. We squeeze when we sneeze and drip when we jump. And we think it's high time we stop saying sorry for the spritz. We provide a hassle-free monthly subscription service for bladder leak products as well as free tips and tricks for women to take control of leaks via The Chirp.

The Mama Body: Physical Therapy During And After Pregnancy

Physical Therapy During And After Pregnancy

A Guest Blog by Lizanne Pastore PT, MA, COMT

Eighty percent of the bodily changes occurring during pregnancy happen in the first trimester!  Isn’t that astounding?  A woman’s body must adjust quickly to a 40% increase in fluid volume, increased heart and respiratory rates and myriad other changes that may affect us in different ways.  The fluid volume increase, for example, can make our connective tissues weaker—our tendons can get a little mushy and our nerves and blood vessels a bit softer.  This extra fluid and tissue weakening makes us more prone to things like leg swelling, varicosities, tendonitis, carpal tunnel syndrome, or sciatica.  

The hormonal changes in pregnancy play a big role in our metabolism, mood, memory and, of course, ligamentous laxity.  Some pregnant women experience instability not only in the pelvis and hips, but also in the joints of the spine, elbows, and wrists.  Our musculoskeletal system is taxed by these changes even before the baby gets very big.  Then, as baby grows, we might begin seeing rectus abdominis separation (“diastasis recti,”) spinal problems from posture and center of gravity changes, even rib dysfunction as the ribs are forced out and up to make room for belly.  Foot pain from falling arches from the sudden weight gain can occur, and on and on. 

In the pelvic girdle, there is a list of other maladies that can be downright scary to a pregnant or postpartum mama.  And most women are not warned about these potential problems.   Pelvic girdle pain manifesting as coccyx, pubic or sacroiliac joint pain; groin or hip pain; pelvic muscle or nerve pain; plus urinary or fecal incontinence or pelvic organ prolapse are some of the more common things occurring during or after pregnancy. 

After birth, as Mom is busy caring for her newborn and any other children at home—schlepping heavy car seats, strollers, laundry baskets, breastfeeding through the day and night, lifting ever-heavier babies into and out of cribs—she wonders why everything hurts, or why she feels a clicking in her pelvic bones when she lifts her leg!  Well, she is busy performing exceedingly challenging tasks with a sub-optimal musculo-skeletal-neural system (not to mention sleep deprivation!) 

It is well documented that both pregnancy and vaginal birth increases a woman’s risk of developing pelvic organ prolapse or becoming incontinent later in life.  And many women think that leaking during or after birth is “normal” because their friends, moms, aunts, and sisters leaked, plus there are 20 different brands of incontinence pads to choose from in the drugstore, so it “must” be normal.   

But this is wrong; leaking and pelvic organ prolapse is common, but not normal or OK.   The same holds true for back or pelvic pain.  Sure pregnancy puts demands on our bodies, but there is no reason to “put up” with pain, leaking, prolapse, numb hands or legs!  There is a health professional who knows all about this—a physical therapist specially trained in women’s health issues and the pelvic floor.  These PT’s are special – they understand the pregnant and postpartum body and are experts in negotiating a path to health and strength for women with special concerns.

After an initial assessment, which often includes a thorough pelvic muscle exam and possibly even a biofeedback analysis, the woman is prescribed a home program.  This program may include a combination of postural or corrective exercises, motor training or strengthening exercises, bladder and bowel re-training, special instruction to change movement strategies to limit stressors on the body, and even self-care techniques for pain or prolapse, such as self massage for constipation, or gentle inversions for prolapse. 

Wouldn’t it be amazing if every pregnant woman and new mama could have a visit with a PT like this?  Guess what – they can!  If you are reading this article and are pregnant talk about this option with your doctor.  And if you have friends, sisters, aunts and co-workers who might be pregnant or new moms, talk to them about it.  Tell them to ask their doctors for a referral to woman’s health physical therapist!  

Need help finding a qualified PT? Visit the NAFC Specialist Locator to find one in your area.

About the author:  A physical therapist for 29 years, Lizanne has specialized in treating women and men with complex pelvic floor and pelvic girdle issues since 2005.  She has worked primarily in San Francisco and the Bay Area, running a successful private practice for the past 18 years. She writes, lectures, and teaches about pelvic health at the professional and community levels and is currently a board member of the NAFC.  

4 Moves To Help You Strengthen Your Pelvic Floor Before You Get Pregnant.

How to firm up your pelvic floor before you become pregnant.

Thinking of trying for a baby soon? Now is the perfect time to start strengthening your body in preparation for pregnancy and childbirth. And even if you’re not quite at that stage yet, the moves listed here are great for anyone to improve pelvic floor and core strength.

The pelvic floor acts as a basket of muscles that help support the pelvic organs (your uterus, bladder and bowels).  Keeping them toned can not only help ease pregnancy discomforts (like urine leakage and hemorrhoids), but it can also help you later on in life as your body naturally changes due to hormones, and age. The moves below work not only the pelvic floor, but also other important muscles connected to it to ensure overall core strength.

Four Moves To Firm Up Your Pelvic Floor Before Pregnancy

Kegels 

There’s a reason that you’ve heard again and again that kegels are important.  This exercise has long been touted by professionals as one of the most vital exercises in increasing your pelvic floor strength.   Follow the instructions below to be sure you’re performing them correctly.

  1. Identify your pelvic floor muscles by attempting to stop your urine flow mid-stream. If you can do this, you’ve found the muscles! (Note – don’t practice your kegels in this way on a regular basis – it should only be done to identify the correct muscles.)

  2. Performing with an empty bladder, your first goal should be to tighten your pelvic floor muscles for 5 seconds. Then relax them for 5 seconds. Try to do 5 reps on your first day. As you gain confidence from your new routine, aim for 10 seconds at a time, relaxing for 10 seconds between contractions.

  3. Be careful not to flex the muscles in your abdomen, thighs, or buttocks. Also, avoid holding your breath. Breathe freely during the exercises to keep from stressing the rest of your body.

  4. Aim for at least 3 sets of 10 repetitions per day. The beauty of kegels is that they can be done anywhere, anytime. Try performing them during your downtime, such as waiting in line, or sitting at a stoplight.

  5. Give yourself encouragement. These exercises will feel foreign in the beginning. But the longer you stay with this, the better your bladder health will become. As a bonus, Kegels have been reported to increase sexual pleasure as well.

To learn more about kegels and the variations of kegel exercises that you can perform, review the information on our website found here, or check out one of our most visited blogs here.

Squats

Strong glutes and hamstrings are very important to the overall health of your pelvic floor.  And one of the best exercises to develop these muscles is the deep squat.  Squatting is actually one of the most natural forms of movement there is, however our modern-day lifestyle, characterized by long hours of sitting at a desk or on a couch, has made the squat virtually extinct.  By strengthening your glutes and hamstrings, you’ll be adding additional support to your pelvic floor.  Follow the instructions below to make sure you are performing squats safely and correctly.

  1. Stand with feet slightly wider than your hips, toes pointed slightly outward.

  2. Keep your spine in a neutral position – don’t round your back, and don’t over accentuate the natural arch of your back.

  3. Extend your arms out straight so they are parallel with the ground, palms facing down.

  4. Balance your weight on the heels and the balls of your feet.

  5. Taking a deep breath, begin sending your hips backwards as your knees begin to bend.

  6. Keep your back straight, and your chest and shoulders up.

  7. Be sure to keep your knees directly in line with your feet as you squat.

  8. Continue lowering your hips until they are slightly lower than your knees to perform a deep squat.

  9. Use your core to push yourself back up, keeping your bodyweight in your heels.

  10. Congratulations! You have just completed 1 rep!

It may help to watch yourself in a mirror as you first perform this exercise, as it is easy to perform squats incorrectly.  Some things to watch for are not dropping low enough, leaning your body too far forward, allowing your knees to drift inward, and performing the exercise too quickly.   Aim to complete about 2-3 sets of 10 reps daily.

Finding Your TA

Your transverse abdominus, also known as the TA muscle, is the muscle that is located deep within your core, below the six-pack muscles.  This muscle is often overlooked, but it serves a vital role.  The TA muscle helps to stabilize the core, pelvis and lower back, and is recruited almost anytime a movement is made.  Strengthening your TA muscle will ensure that you are protecting your back and spine from extra force or pressure when you move, and will help aid in pelvic floor stabilization.

The following steps provide a very basic way to locate your TA muscle and give it a workout:

  1. Lie on your back, with your knees bent.

  2. Place your hand on your stomach, just over your belly button.

  3. Inhale.

  4. While you exhale, tighten your stomach muscles and pull your belly button inward. You should imagine that you are tightening a corset and flattening your stomach.

  5. Repeat 3 sets of 10 reps each.

Once you have a good feeling for where your TA muscle is and how to activate it, you can begin incorporating the action into your everyday life - while sitting at work, standing in line, etc.  Also try to practice tightening your TA muscle, like a brace, every time you perform a movement such as lifting, sneezing, squatting, etc.  With practice, this action can become automatic and will aid in your core stability.

Multifidus

The multifidus is one of the most important muscles in aiding spinal support.  The muscles are attached to the spinal column and are called upon when bending backwards, turning, and bending side to side.  These muscles work with the rest of your pelvic floor muscles and TA muscle to help you hold good posture, and to stabilize your lower back and pelvis during movement. Try the exercise below to strengthen the multifidus muscle:

  1. Lie on your stomach, with your forehead on your hands, or a towel, looking straight down. (Not to the side)

  2. Very slowly, rotate your pelvis back slightly so that your tailbone lifts toward the ceiling. This should be a very subtle movement.

  3. Hold for one second, then rotate your pelvis back to the floor.

  4. Complete 3 sets of 10 reps each.

Practice activating your multifidus muscle throughout your day by keeping good posture. 

Note: Even before you’ve had children, there may be times when certain pelvic floor exercises are not appropriate. And, it’s important to know that there is no “one” exercise alone that will strengthen your pelvic floor as it is supported by many muscles.  Always check with your doctor before beginning any exercise program.  And, if you have concerns about your pelvic floor, no matter what life-stage you are in, consult a trained physical therapist specialized in women’s health. Your Physical Therapist will also be able to ensure that you are performing the moves correctly so that you are getting the most out of your workout.  Use the NAFC Doctor Finder to find a doctor in your area. 

 

Pre-pregnancy And The Pelvic Floor - It's All About Prevention

Preparing Your Pelvic Floor For Pregnancy

If you’ve never been pregnant, it’s likely you’ve spent little time thinking about your pelvic floor. And yet, now is exactly the time that you should be focused on it.  A healthy pelvic floor can prepare you for a great pregnancy and a safe delivery, and it can prevent a host of problems that may occur after childbirth. The pelvic floor works as a basket of muscles, holding your uterus, bladder, and rectum in place.  When you’re young, and your pelvic floor has not suffered the effects of age or childbirth, you usually see few complications. But sometimes, strain on the pelvic floor (like carrying a growing baby for nine month, giving birth, and the natural effects of gravity over time) can cause problems like bladder leakage. The good news? These effects can be lessened, or even eliminated, if proper care is given to the pelvic floor now.  Here are the steps you need to take to ensure that you’re taking proper care of your pelvic floor, and yourself, prior to becoming pregnant.

How To Prepare Your Pelvic Floor For Pregnancy

Assemble your squad.

Finding the right team of professionals is key to keeping your health in check.  If you haven’t already, do your due diligence and start seeing these health care professionals on a regular basis.

  • Gyno
  • Primary Care physician
  • Dentist
  • Dermatologist

Need help finding a health care professional? Use our Doctor Finder!

Keep a healthy weight and develop a workout routine.

If you’re planning to get pregnant, don’t fall into the trap of thinking that weight doesn’t matter pre-pregnancy – the healthier you are now, the healthier you will be during your pregnancy, and the easier it may be to shed those extra pounds after baby arrives. Not only that, but keeping your core and pelvic floor strong now will help better prepare you for pregnancy and childbirth.

Maintain a healthy diet.  

Eating right is always a good idea, and it can really help you maintain your weight. In addition, keeping your diet in check can help you prevent diabetes (a condition that is on the rise in the US, and that, in some cases lead to neurogenic bladder.)

Routine Exams

Get a well-woman exam every year – be sure to talk with your physician about general health metrics like blood pressure levels, diet, weight, and any stress that you may be experiencing. Have a regular Pap smear every 3 years if you’re between 21 and 30. While you’re at it, be sure to have a yearly breast exam to check for any unusual changes. Do your own monthly exams as well and become familiar with how your breasts normally look and feel.

Quit those bad habits

If you haven’t heard, smoking is really not cool anymore and even if you don’t believe that, consider this – aside from a host of other health problems, smoking can contribute to a leaky bladder

Uncover any risk factors that you may have by learning your health history

Talk with your family to learn about any risks that you may have health-wise. Knowing these now can help you prevent possible health threats down the road.

Even if you only choose to follow a couple of these steps prior to pregnancy, know this: this time is all about prevention – the steps you take now to take care of your body will pay off in folds down the road.  Don’t wait to start taking control of your health. 

Check in with us all month to learn how to stay healthy at every stage of life.

Women's Health Month

Women's Health Month

May is Women's Health Month, and we're celebrating at NAFC by walking you through all the ways to keep yourself strong and healthy at every stage. Here's a breakdown of what you can expect from us this month:

Week 1:  We're talking about the early years and prevention! Learn about how to strengthen your pelvic floor before pregnancy.

Week 2: Pregnancy and childbirth can really do a number on your pelvic floor. Learn what you can do during pregnancy to prepare for childbirth, and what you can do after baby's here to regain your body.

Week 3: Peri-Menopause and Menopause are an inevitable part of every woman's life. And while hormones can cause major changes to your body, there are things you can do to make this transition as easy as possible.

Week 4: Life after menopause can be a great time for you if you make an effort to remain healthy and strong. Learn about the steps you can take to enjoy these years.

Plus, all month long we'll be shining the spotlight on OAB and sharing tips, tricks and articles to show you how to manage symptoms of overactive bladder.

Follow along with us on the BHealth Blog, and on Facebook and Twitter!

Preparing Your Pelvic Floor For Pregnancy And Beyond

Preparing Your Pelvic Floor For Pregnancy

Preparing Your Pelvic Floor For Pregnancy

A guest blog written by Michelle Herbst, PT

Congratulations! As you prepare for your baby there is a lot to think about. Doctor’s appointments. Baby showers. Child care. Nervous talks with the Dad-to-be. And, don’t forget - YOU. When you start sharing your news - everyone will give you advice. Some stories will be embellished for the good and others will be overstated for how difficult their pregnancy was. But, keep in mind - this is your experience.

Realistic Expectations:

Some Moms-to-be have problems with leakage. Others do not. A positive pregnancy test does not mean you will develop incontinence or a prolapse - which is a descent of the pelvic organs into the vaginal canal. But, normal changes during pregnancy and the process of labor and delivery can set up the conditions for incontinence and prolapse to occur.  

So, here is my advice as a Mom and a physical therapist for preparing your mind and body for your big day.

Kegel:

You will read about these. Your OB Nurse will ask, ‘Are you doing Kegels?’ But, why are Kegels so important during pregnancy?

Performing Kegels during pregnancy can help you prevent or manage bouts of leakage, and will also help you tune in and tone the muscles that will help push and slide your baby out of the birth canal. Here are a more few reasons why Kegels are so important:

-        To establish a mind-body connection of how the kegel muscles feel when activated.

-        To help create stability of spine and pelvis as your baby grows.

-        To prepare for the arrival of your baby and protection of your pelvic organs during delivery.

Labor can be quick or long. Labor can be easy or difficult. You do not get to choose. But, with preparation of your mind and muscles, along with the skills of your birthing team, the end result will be you holding your precious new baby.

Thoughts on Kegels during Pregnancy:

Think of the pelvic floor as a muscular sling that is tethered between your pelvic bone and tailbone. During pregnancy and labor the pelvic floor muscles lengthen but also need to be able push. The goal of performing Kegels during pregnancy is to improve the strength and function of the pelvic floor as well as encourage lengthening of the pelvic floor muscles.

When performing a Kegel it will feel like a gentle tightening and lifting up and in of the muscles between the pubic bone and tail bone. You may also feel a slight tightening between the belly button and pubic bone. That is your abdominals helping out too. That is OK. Now, hold the Kegel as you inhale and exhale. Relax, and let your pelvic floor muscles return to a normal resting tone or sensation.

The Kegel is a cyclic contraction. It is a shortening of the muscle fibers followed by a relaxation and lengthening of the muscles. If you contract the pelvic floor, and follow that with another pelvic floor contraction without focusing on letting the muscles relax and lengthen, you are training the pelvic floor to become shortened strong muscles not the lengthened strong muscles needed to help push and slide your baby out.

Squat:

Yes – squat. Deep squatting is a normal position to void and give birth. Performing a deep squat as an exercise will help you prepare for the positioning and muscle work needed during delivery.  Deep squatting will open your hips, aide in lengthening the pelvic floor and strengthen your glutes. 

How do I do this?

Slowly work into a squat. You may want to or need to keep your squat shallow by holding onto the back of a sturdy chair or counter top as you start bending at your hips and knees. Keep your gaze forward. Work on keeping your knees behind your toes or stacked above your ankle. Think about keeping your shins perpendicular to the floor. If you are able to get into a deep squat, you may want to place your hands at your chest and gently push your elbows to the inside of your knees.

How long and how many?

This will depend on you. You may want to focus on working into and holding the deep squat. Once you have achieved a deep squat you can work on relaxing into this position. Or, you may want to perform slow repetitions of a shallow squat to standing position and put your emphasis on tightening the glutes when returning to standing.

There really isn’t a right or wrong way – just your way and your focus or intent of the exercise. Pay attention to how you feel and listen to your body.

Your Story:

There will be aspects of your pregnancy and the arrival of your baby that you will not be able to control. But, remember, this is your story. You can prepare your mind and body to set up the best possible set of circumstances to deliver a healthy YOU to motherhood. 

 
 

Ask The Expert: Physical Therapy After Childbirth

ASK THE EXPERT

ASK THE EXPERT

Each month, we ask an expert to answer one of our reader's questions.  This month we're happy to welcome Victoria Yeisly, DPT as our expert contributor.

Question: I’ve heard that in Europe it is standard for most women to begin physical therapy to strengthen their pelvic floor as soon as they have given birth.

Do you think women in the United States should be seeing a PT after having a baby, regardless of whether they are having symptoms or not?

Expert Answer:Absolutely!  I support this practice for any woman after having a baby, including both vaginal and C-section deliveries.  Think about it, during the pregnancy, the body changes so drastically, so quickly!  Ligaments loosen; alignment changes, hormones fluctuate, and anywhere from 20-50 lbs may be gained.  Then, you either push a baby out of your vagina or have a major abdominal surgery.  To think that the body just heals and is “back to normal” 6 weeks postpartum is just ridiculous.  In the OB practice where I work, there are 4 of us pelvic floor PTs integrated with the doctors and midwives to help serve this population so women can return to pre-baby function with greater ease and comfort.  In my opinion, this should be the standard of practice for all women.  At minimum, doctors and midwives should at least be making each woman aware of this treatment and let them decide if pelvic floor PT should be a part of their postpartum rehabilitation.  

Have a question you'd like answered? Ask us! Your question may be featured in an upcoming Ask An Expert post!

About Our Expert:  Victoria Yeisley, DPT, has been exclusively practicing pelvic floor physical therapy for the past eight years, with an emphasis on prenatal and post-partum care.  She currently lives in Chicago, IL, and practices at Northwestern Medical Group OBGYN, where she is integrated into the OBGYN healthcare team, as well as working at Chicago Physical Therapists, a private practice.  Victoria is passionate about the care and support of women during the childbearing years and her goal is to increase the awareness of the importance of women's health and treating pelvic floor dysfunction throughout the lifespan.  She is currently pregnant with her first child and expecting in June of 2016!

Here’s What Your Doctor Won’t Tell You About Your Post-Pregnancy Recovery

Post Pregnancy Recovery

As a pregnant woman, you are bombarded with information – books, blogs, websites, and even strangers on the street love to regale you with stories about what you can expect during this glorious time.  Overly emotional? Check.  Crazy heartburn? Yep.  Strange cravings?  You got it.  Everyone has heard these stories and for most women, it’s not all that surprising when they experience them.  

However, it’s what happens after pregnancy that no one talks about.  But they should. 

Urinary incontinence affects many women during pregnancy. The added stress and weight of your baby pushes down on your bladder, causing leakage that occurs when you cough, sneeze, or exert pressure on your abdominal muscles.  This is known as stress urinary incontinence, or SUI.   But did you know that you might also experience urinary incontinence after you have your baby?   

Most women will experience some leakage after they give birth.  This is natural.  After all, your body has been stretched and pushed to its limits during childbirth, especially if you have given birth vaginally.  However, while most women will see this symptom fade within the weeks after delivery, some will still experience leakage for months or even years after birth.  And even if you saw this symptom disappear after childbirth, there is still a chance you may find it reoccur later on in life.  

The good news is that there are things you can do to treat this problem.  Pelvic floor muscle exercises can help strengthen your muscles during pregnancy, and also restore your muscle function after you’ve given birth. Need some guidance on how to perform them?  Find a physical therapist that specializes in women’s health.  He or she will conduct a full examination, and show you how to perform the proper exercises for your condition.  A PT can be seen as soon as 6 weeks post partum to ensure that things are healing properly and to help you start getting your muscle control back.

The truth is, a good pelvic floor workout should be a part of your daily routine no matter where you are in life.  Pre-pregnancy, you’ll build up your muscle strength, which will help you if and when you become pregnant.  Postpartum exercises will help you get your muscle tone back to where it was before you had birth, which can help ease or even eliminate incontinence symptoms you might experience. And continuing these simple exercises into your later years will help keep you strong as your body and hormones change and make you more susceptible to incontinence symptoms.  So start today – it’s never too late, or too soon to get these muscles in check.