Have you seen the recent TV ads featuring happy mums enjoying life? The ad tells you that you can still be active even if you need additional protection against leakage due to childbirth and/or pelvic surgery. What they don't tell you is that with help, you can avoid the need for this extra protection.

The pelvic floor consists of muscles and fibrous tissue (ligaments). The purpose of the pelvic floor is to support the pelvic organs, bladder, uterus, vagina, bowel and to control their outlets. If the pelvic floor sags downwards (particularly common after child birth) the support and control it should provide will be reduced, with a possibility of loss of bladder control, poor sexual function and problems with bowel control. Eventually it can dominate your life and restrict what you can do.

Like all muscles in your body, the pelvic floor needs to be firm with good muscle tone to work. Exercise during pregnancy can reduce the possibility of problems after childbirth. These exercises should become a daily routine throughout your life time to reduce the risk of prolapse or loss of bladder or bowel control.

How to do pelvic floor exercises

1. Sit comfortably with muscles of thighs, buttocks and abdomen relaxed.
2. Pretend you need to pass urine, but want to hold it back for a few seconds. Relax and repeat.
3. Pretend you need to pass wind, but you need to wait a while. Hold on a few seconds, then relax and repeat.

Now tighten all muscle groups while you exhale for a few seconds, then relax.

DO your exercises at least 5 times a day
DO NOT hold your breath
DO NOT push down instead of tightening and lifting up.
DO NOT tighten your tummy, bottom or thighs
REMEMBER TO DO YOUR EXERCISES DAILY!!

Some physiotherapists have special training, skills and experience in continence management. They can help if you have incontinence, constipation or prolapse, or simply want to learn how to use your pelvic floor muscles correctly and safely. A doctor's referral is not required to see a physiotherapist in private practice. Physiotherapists also work in public hospitals and community health centres. Contact the Australian Physiotherapy Association in your state or territory for the names of physiotherapists in your area who have a special interest in the pelvic floor and continence management. Your doctor or clinic sister may also be able to suggest the name of a physiotherapist who specialises in this area.

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