Stress incontinence - what to expect with next pregnancy and birth

[PinkParrot]

Has anyone started out a pregnancy with stress incontinence from a previous birth? If so, how was it after the second birth?

Is it the case that the damage has been done and a second birth won't make much difference or will it only deteriorate?

also, tmi, but has the urge to poo (!) been greater for anyone after childbirth? and did this get worse with subsequent pregnancies?

Any enlightenment on these delicate issues much appreciated!

(I know about kegels)

Answer to your first question: Oh yes!
In my experience your pelvic floor gets worse with every birth just because of the sheer physical trauma. Even if it is not bad enough to cause incontinence initially the problem is definitely progressive and then when you reach menopause your lack of hormones means that the muscles get even weaker and start to atrophy. So an underlying problem then comes to the surface.
A third of new mums go on to develop incontinence because there is no effective guidance from the NHS - that's why there are millions of women with the condition and a multi-billion £ industry selling incontinence pads!
Your GP can prescribe something call the pelvic toner which really helps. If you don't want to waste his/her/your time then you can buy it through the partner offers page of mumsnet.
Good luck

Hi PinkParrot,
I think it in part depends on the reason for the stress incontinence and the exact nature of the damage that has been caused by giving birth first time round.
I sustained serious multiple birth injuries when I gave birth to DD and my symptoms includes stress urinary incontinence. I elected to have the repairs done before considering any subsequent DCs, but I was told that a repeat pregnancy and repeat VB (like I was ever going to do THAT again!!) should not make things worse. That said, intuitively, it feels that repeat pregnancy could make things worse just because of the repeated physical toll.
Have you ever had a formal diagnosis? Have you seen any specialists? Whilst GP prescribed stuff can be of benefit, if you are already up to speed on your kegels and these weren't helping you, I would press for a referral to a specialist gynae physio who can assess you properly. The pelvic toner that brendaf mentions may be appropriate, but it may not. You may need something else. Or a referral to a uro-gynaecologist specialising in pelvic floor damage may be in order.
Can't comment on the urge to poo. I had the reverse and often didn't know that I needed to go. But if your 'poo messages' are different, that might suggest some nerve involvement. So that might be even more of a reason to get a referral to a gynae physio for a proper assessment. BTW nerves to heal and the wiring does right itself over time, so don't panic!
Even with all my problems, I don't see the situation as quite as grim as the picture brendaf paints. Yes, sometimes women do fall through the net postnatally, but I think that with careful individualised assessment, treatment and follow-up, women can see a lot of progress. Thinking about my own case, I went from pelvic floor strength of 0/5 to 3/5. It can be done.

Thanks

I did get a referral to a physic but she was pretty hopeless. No bio feedback or assessment, just some electrode treatment. I will have to go back and see someone else. I do kegels but wonder about my technique/strength. I find squeezing really hard but can 'lift' quite well I think. Doc diagnosed stress incontinence. I'm quite surprised about the whole thing as birth was fine - quick, baby average size, minor tear.

Cardamom - encouraged by your experience : )

How bad is it? Mine was very mild, and is no worse.

It is mild - I'm ok to squeeze and cough but if I start running or jumping then I need to go and would leak if I carried on, but recently I have stopped trying those things.
So it's not a big blight on my life right now but I am terrified of proper incontinence and prolapse after my next pregnancy and birth. In fact I'm obsessing about it at the moment as want to get preg soon (age considerations)

Youlllaugh Did you see a physic and do advanced kegel stuff?

No. Prob should have. But no. It is if i sneeze without clenching or run with a full-ish bladder.

If anything, i think it is a bit better now. May be hormonal though. I find it was worse roand ovulation but am back on the pill. Dd2 is 16 months.

Maybe all the reading I've been doing has overly freaked me out. If I could make it through the next pregnancy and birth without a deterioration I would be so happy.

I don't know if I have fecal urge incontinence but I feel I'm at risk of getting it. I would say that when I need to poo there is more urgency than there was before birth. It's not like I can't feel it, just that I need to get to a loo quicker. Is that fecal urge incontinence? I guess a mild form of it? : (

Schmaltzing no haven't thought about type of birth yet. Last time it was all natural no pain relief which was great, but if the same again would make me a contender for bowel incontinence and a C-section would avoid it then I guess the latter would be preferable, much as I hate the thought of surgery