French women do not have bladder incontinence after childbirth (nor should American mothers)

For many American women, urinary incontinence, or involuntary loss of bladder control, is what we expect in months or even years after giving birth.

French Postpartum Experience: "La R re Education P Rin ale"

France began to provide [pelvic floor physiotherapy] (https://parenting.blogs.nytimes.com/2013/08/12/the-re-education-of-my-perineum/? _ r = 0 http://www.slate.com/articles/life/family/2012/02/postal care-in-u-france-u-vagina-exercises-u and-video-u-games.html) - & quot; La r ducation P R in ale" - For all new mothers in 1985, after doctors and numerous studies pointed out that they were at increased risk of incontinence, C CI explained that Le Kabilu Midwives in Paris. Now, in a hospital maternity ward or six-week check-up, all women get a prescription to see a midwife who specializes in pelvic floor training. The government-funded medical insurance covers 100 per cent of the cost of 20 courses (10 courses of perineal re-education and 10 courses of abdominal re-education).

&Kabilo said: "Recruitment immediately after delivery can prevent future urinary incontinence." & The perineal floor, like other muscles of the body, requires physical exercise. The aim is to help women feel this again. & quot;

After internal evaluation, the intensity of the perineal floor was determined, and midwives taught women to exercise in the perineal floor. Some midwives use their fingers to check manually whether the muscles of the female vaginal wall are contracting. Others use vaginal probes, which are connected to wires on machines and screens that jump when the pelvic floor muscles contract. There are nearly 12 different muscles in the area, and midwives help women understand how to get them to exercise.

-We allow women to feel and contract different areas of the perineal floor. To make it easier to understand, we will talk about waves, and we will guide her to contract these different muscles. Visits lasted 30 minutes and women came twice a week as long as they needed help. Every date assesses progress and allows women to exercise at home every day.

Paris correspondent Mary had two caesarean sections and used postpartum pelvic floor physiotherapy twice. & I thought I would be okay after the first time because I didn't push my baby out of the vagina. But I got 0 out of 5 points (from 0 to 5, 0 is the weakest and 5 is the strongest). I was surprised, she said. & It's painful. You really don't want to go. There's a child at home. But on the tenth time, I got five points. It really works. & quot;

However, although it is free and effective, only a quarter of French women actually use pelvic floor physiotherapy, Cabello said. & Many women don't do this because they are tired, have a baby and start working. She says some women are reluctant to do so because they don't want to be touched after birth.

-There are not enough practitioners. I often refuse new patients because I already have too many. So some people give up because they can't find a doctor.

Nevertheless, a quarter of American women's postpartum experience is impressive.

American Postpartum Experience: "Non-standard Procedures"

In the United States, rehabilitation is not part of the postpartum program. Assessing and reconstructing pelvic floor muscle tissue is not a standard training or procedure for American obstetricians and gynecologists.

says Elzabeth etkin kramer, an obstetrician and gynecologist in Miami, that a normal pelvic examination does not include a pelvic floor examination, but it depends on your gynecologist. Etkin Kramer said that in her office, she always asks about urinary incontinence during a six-week check-up. If it's a problem, she'll do a check-up. If the pelvic floor is weak, she refers the patient to a pelvic floor physiotherapist in her office.

but this is not the case. Few women who work in physiotherapy say their doctors have asked about leakage. Instead, during six weeks of postpartum visits, doctors focused on medical issues - they had 15 minutes to look at a long list of contraceptives, breastfeeding and standard pelvic examinations for infections, placental remnants and scars. Even in the case of urinary incontinence, only one in six patients said that gynecologists and obstetricians recommended pelvic floor treatment, and most of them found her online rather than through referral, Barras said. & It's almost always patient-centered, she said. In other words, it depends on American women seeking help. The problem is that unless women are experiencing a serious leak - which will get worse over time - many people don't know they have a problem with their pelvic floor during a six-week examination. & Women don't know if it's painful to have sex, because they haven't had sex yet. They probably don't know about their pelvic floor cramps because they haven't tried using tampons yet, Barras said.

Moreover, many incontinence women are embarrassed to mention it to their doctors. & Etkin Kramer says women usually don't mention it themselves.

Others believe that it is normal for leaks to occur after the birth of a child. & "Customers tell me that when they ask this question, most [doctors] will say it's normal, it will go on over time, or you'll get it for the rest of your life," Bell said. & A comedian is a new mother. She jokes about how funny it is to pee when she laughs because she has two children. They are joking. It is standardizing it. I think it's common, but it's not normal.

Bales said she often saw women seeking help four or five years after delivery because another physiotherapist who saw knee or back pain again asked about incontinence and referred them to a doctor.

-A patient had a second child four years ago. She's an athlete. She has urinary incontinence and hip pain when running. She told her obstetrician that she was told to wear pads when running, or not to run at all. & These women are not foolish. They are asking the right questions again, but those who intend to lead them to another field are disconnected from the issue of intervention. & quot;

Is France more progressive than most countries? Even in European countries, France is an exception. In Germany and Britain, women only receive physiotherapy to restore their abdominal muscles, not the pelvic floor, Kabilo said. & No pelvic floor treatment is automatic in other countries, and no pelvic floor treatment is so frequent in other countries, she said.

Kabilu believes that many of the reasons for France's leadership are culture. & "As long as we talk about the perineum floor, we talk about sex, which is a taboo in Judaism-Christianity culture," she said. However, the French Women's Liberation Movement in 1968 changed the discussion of women. & We should take good care of ourselves to avoid urinary incontinence. This is consistent with feminism, Kabilo said. & Even before giving birth, it should be part of the education of young women. From a very young age, we should explain that contraction is a kind of muscle, which is a good idea. & quot;

& Etkin Kramer says that in the U.S. health care system, it is impossible not to seek help voluntarily, while in other countries it is automatic.

Balles agreed. & "We must treat postpartum care as a major medical problem and send women to rehabilitation centers immediately," she explained. & It can be traced back to patriarchy in health care. Women's health is not a priority. & quot;

What can American women do? If there is no doctor's support to restore the pelvic floor, what should American women do? Kegel - and often. Kabilo suggests contracting 40 times a day, whether on a bus or cooking. & Working on the perineal floor is healthy and hygienic, just like brushing your teeth. Kabilo said that every woman should not go without these exercises one day.

Not sure if you're right? Sit on a ball or chair. The abdomen pulls inward and the pelvic floor pulls inward. If you think your bottom is raised, you're doing the right thing. You can even try to stop the flow of urine to test yourself once. If you can