“It was my eldest child’s school sports day when I finally reached a tipping point,” says Elaine Miller. “I’d recently had a baby – my third child in four years – and I joined in the parents’ sack race.”
But after a few leaps in the sack, Elaine stopped dead as she realised she’d wet herself.
“I just thought: ‘Oh my God’, because this wasn’t like a little leak you could hide – and the whole of my daughter’s school was watching,” she recalls.
Other mothers watching the race immediately realised what had happened and helped Elaine off the field and into the toilets to clean herself up.
“That’s when I knew I had to finally get help for my incontinence,” she says. It was an issue she had been avoiding dealing with since the birth of her daughter in 2004, more than five years previously.
“Mine was a classic case where it didn’t start off too badly and I buried my head in the sand, but gradually it got worse and worse and started affecting my daily life,” she explains.
In the years leading up to that incident, Elaine had stopped exercising out of fear of leaking in public. She’d quit her gym membership and boxercise classes. She’d stopped taking public transport in case she couldn’t easily access a toilet and avoided long car journeys. She also deliberately dehydrated herself so she wouldn’t need the toilet as frequently.
The consequences for her overall health were dramatic.
“I put on loads of weight and became really sad. The impact on your mental health is huge because you see yourself as dirty and a bit broken,” she explains in an interview on the Mother Bodies postnatal health podcast.
She is not at all surprised by a recent survey by Nuffield Health which found 47 per cent of women in the UK had done no vigorous exercise in the past year. She believes many could be worried about wetting themselves, as she had been.
As a society we may be finally speaking more openly about other aspects of women’s health – from periods to the menopause – but incontinence is rarely discussed, despite affecting an estimated 14 million people in the UK. It can occur in both men and women, although it is more common in women because pregnancy and childbirth – particularly vaginal birth – can strain or damage the muscles and connective tissues in the pelvic floor and bladder which control the release of urine.
Other factors which can contribute to incontinence include obesity (because carrying excess weight puts pressure on the pelvic floor); age-related muscle weakness (which can affect the pelvic floor and bladder); medications – such as some antidepressants; and anything that puts repeated pressure on the pelvic floor, such as straining with constipation or a chronic smoker’s cough.
There are several types of urinary incontinence but the most common are stress incontinence, where urine leaks when your bladder is under pressure, such as when you cough, laugh, sneeze or jump – the issue that affected Elaine – and urge incontinence, where leaks happen as soon as you feel you need the toilet. Studies show around a fifth of women have a combination of both, known as “mixed incontinence”.
According to the NHS, one in three women will experience urinary incontinence in the first 12 months after giving birth and one in four will have symptoms for up to 12 years.
With close to three quarters of a million babies born in the UK annually, this means up to 250,000 women will develop childbirth-related incontinence each year.
But the Chartered Society of Physiotherapy says as many as 71 per cent of women could be affected. Data is hard to verify because many women are too embarrassed to come forward – especially those from some minority ethnic groups.
Elaine, now 50, who lives in Edinburgh with her husband Stephen, a lawyer, their daughter and two sons, now aged 18, 16 and 14, is far from the only mother to put up with the condition for years.
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