I’ve been a freelance writer for about a dozen years and have written for pretty much every women’s magazine out there. Before kids, I used to write a lot for Marie Claire. I pitched every one of my stories — that is, I came up with the idea, wrote it up, and it was approved and assigned by the editors. One of the ideas came about after a friend had her first baby. Afterward, she confided, she was having problems. Any time she laughed, coughed, or ran, she leaked urine. I did research for her and realized that her pelvic floor muscles were probably stretched out or damaged from pushing for more than three hours. It was a story, I decided, and I pitched it to my Marie Claire editor. Here’s an excerpt from the letter (yes, an actual snail mail letter since my editor wanted to see clips, too) I wrote:

Thank you for taking a look at my pitch on vaginal strength and gynecological physical therapy, which I sent to you today via e-mail. As I mentioned in my e-mailed pitch, the researchers I’ve spoken to such as Dr. Lauri Romanzi, a uro-gynecologist at Cornell University-New York Presbyterian Hospital say American women are missing out because few know that their vaginal problems can be solved using directed Kegels, biofeedback, and other physical therapy methodologies. This leads to needless suffering just because doctors and most media outlets are squeamish about the topic. I’d love to be the one that breaks down these barriers and helps let Marie Claire readers in on the secret.

Completely crappy letter, but hey, I was just a wet-behind-the-ears kid. But I digress as usual. The story was assigned, but not exactly in the way I envisioned. The title of my story morphed from “Get a Stronger Pelvic Floor,” to “Best Orgasm Ever!” You can read it here. There’s still advice and info that stands the test of time. The testers were two of my karate pals and me, of course. And I got to go into Dr. Glazer’s New York City office, get uro-dynamic testing, and take home a vaginal biofeedback machine. It was fairly awesome. (I remember being very offended that I was “strong” but lacked “endurance.” In layman terms, my pelvic floor muscles were strong, but got tired quickly.)

Anyway, fast forward a half a dozen years and I was pregnant with my second child — you know, after my first child that weighed in at 8 pounds, 5 ounces at birth and who has a giant head. I got the flu. Twice. I had HUGE issues. Every time I coughed, I leaked. (Sorry for that TMI.) I blogged about it. Anyone who is having similar issues should definitely read that post, Whiz Bang, You’re Wet (Or How Not to Pee Your Pants).

As my story and the book, The Bathroom Key, show, there are millions of women suffering with urinary incontinence but they don’t have to be. There are treatments and exercises and help available. You just have to be willing to talk about a problem that could seem a little embarrassing. In this case I think we as women need to take a page from men. They are more than willing to go into their doctors’ offices and tell them about weak urine streams and erectile dysfunction. Why should we be afraid of talking about a little leaky urine?

Have you ever had a problem with bladder incontinence or any other pelvic floor issues? Did you seek help? How did that go for you? I’d like to know.

And I really, really LOVED the fact that you suggested talking to my doctor if he or she brings up an early childbirth. LOVED the questions you included in the letter to ask him or her before agreeing to be induced or sectioned. I’ve taken the liberty to copy the questions below:

• Is there a problem with my health or my baby’s health?
• Can I wait to have my baby until I am closer to 39 weeks?
• Why do I need to induce my labor or have a C-section?
• Will inducing labor increase my chances of a C-section?

Fan-freaking-tastic! Doctors should have to own up to the fact that they have a wedding or vacation or just don’t like getting out of bed in the middle of the night. They should have to admit that, for the most part, induction and C-sections are just easier for them. They don’t have to deal with missed time in the office or having to leave home early or late or miss their kids’ soccer games. Induction, to be sure, is a process of convenience. Bravo for you, Empire Blue Cross, for actually letting women in on the secret that they are in charge of their own bodies and their own care. (WE ARE, and if we don’t realize this, we SHOULD!)

Oh, and the detailed drawing that shows the difference between a baby’s brain at 35 weeks versus what it looks like at 39 to 40 weeks? Well, that’s just genius. I also liked that you tell women straight out that it’s important to wait until at least 39 weeks because organs are still growing and the ability to suck and swallow is still developing. All in all, it was really smart of you Empire Blue Cross, my insurance provider, to team up with the March of Dimes except for one small problem: I miscarried on August 29th. I have to be honest: My heart actually hurt a little when I opened your envelope.

People, people! Email marketing is really not that difficult. I write about it several times a month for one of my oldest and favorite clients, Crain’s BtoB. You are both large organizations with plenty of marketing cash. You should have some kind of database updating methodology that takes people like me off your lists. I know you didn’t do it on purpose, but wow, that was sucky. Invest in some marketing automation software or a better list management program.

In the meantime, keep up the good work. I can say that even though I am still very, very sad about my lost baby, I am so proud and happy to see that we’re finally on our way to a place where pregnancy and birth aren’t medical conditions, and women are let in on the fact that they — not their doctors — should be driving the way their babies are born.

Best, –KB

It may not be beautiful, but I wear it with pride.

While I was pregnant with Big Girl one of the things I was most afraid of was stretch marks. I knew my skin was a candidate. When I was in my early 20s, I gained 40 pounds and soon after the insides of my thighs sported purple yet translucent marks. What would pregnancy do to me, I wondered.

As soon as I got a positive pregnancy test, I did lots and lots of research on the topic. (A side effect of being a journalist.) I found out that there’s not much you can do to prevent stretch marks. Even those women who don’t gain a lot can end up with a tummy filled with white lines. I did, however, find one promising study about a product only approved for use in Europe. The product, according to the research, prevented stretch marks — big time. I had to have it. My husband, who was working at a large, worldwide company, contacted one of his colleagues in Spain asking him if he would pick up a tube for me. That man, bless his heart, went out and bought me two tubes of the stuff, which I religiously smeared all over my belly twice a day for ten months. (It fit right in with my Natural As Possible theme since it’s mostly herbal extracts and vitamin E.) It worked — to a point. After I gave birth I noticed a tiny stretch mark on my right hip. I dubbed it my Big Girl Tattoo, and proudly showed it off to anyone who would look.

When I got pregnant with Little Girl, my husband had recently quit his job, so I went out on the Internet for my European anti-stretch mark cream fix, buying it from a website written totally in Spanish. (Thank goodness for Google Translate!) Again, I slathered the stuff everywhere. Again, I escaped the fate of many of my friends. The bulk of my belly was fine, but that tiny Big Girl tattoo? Well, it got a little bigger. And wider. And you know what? I am surprisingly okay with it.

It’s a daily reminder of the absolutely amazing work that I did mentally, physically, and emotionally having my babies. Mentally, I was able to get past some pretty difficult eating issues. In fact, I’d even venture to say that my pregnancy cured me of my eating disorder. Even before I felt a single kick I realized that I could never forgive myself if I died because I was trying to be thin. I would never want to leave my kids because I was too vain. (It probably helped that I was smart enough to see a therapist for my entire pregnancy both times around.)

Physically, well, I have documented my birth stories pretty well, but I have never done anything so amazing than those days when I pushed those kids out of me. And emotionally, well, those kids change me every single day. They just do. I am forever grateful for them and for that.

Before I had kids I was big into karate. (That’s me. I don’t do anything without going big.) I took my black belt test three times, failing twice because I was pregnant and once because I just wasn’t good enough. I always said I was going to get a tattoo on my ankle to celebrate achieving my black belt goal. Now, when I look at my hip I realize I have nothing left to prove. Getting that black belt would feel nice, but it’s not going to change me as a person. I am a mother. I am a warrior with a non-quitting spirit every day of my life, and my baby tattoo reminds me of that every single day.

How did your pregnancy (or your partner’s pregnancy) change her body? How did you deal with that? I’d like to know.

Little Girl inside my tummy. May, 2008. Sigh.

Last night I went to spin class and the woman spinning next to me was pregnant. It took me back three years ago when I was that person making sure I was drinking enough and feeling my baby kick to the beat. (Big Girl used to sleep in my belly during the classes. Little Girl was awake and dancing, I think!)

Little things like that remind me how much I love being a mom, and how much I would love to be a mom of three. In fact, it’s times like those that I sometimes feel a visceral pull on my heart. Normally, I love my family, and wouldn’t change a thing, but every once in a while my heart reminds me about how much I’d like to have one more child. As crazy as my life is, as busy as we are, I know I could handle a third.

Sure, I am aware of the fact that I am not an easy pregnant person, and that I have medical issues that might make a third pregnancy dangerous. I don’t even know if I could conceive and carry a third, but the desire is there.

My husband is set, though. He loves having two kids. He’s not interested at all in having a third. As much as I try and tell him how much fun it was/is being one of three, and how maybe this time he’d get a boy, he doesn’t care. He loves having daughters, he says, and as an only child he’s often overwhelmed by the noise and confusion that two children bring. Not even the prospect of going to Islanders games or having a little second mate on our boat are enough to sway him. His girls will go to hockey games with him, he says. His girls will learn to drive the boat.

Sometimes I lie in bed and think about the baby that I lost through a late miscarriage. I think about how he or she would be in the last year of preschool. I wonder if I would be having the same regrets or desire for another if that child had been born. Maybe this is all hormonal — not real. But right now at this time in this place it feels very, very real.

Are you happy with your family size? I’d love to hear about it.

I’ll give you the quick and dirty summary. Researchers think that triclosan interferes with estrogen sulfotransferase, an enzyme that is linked to the metabolism of estrogen. Estrogen that’s supposed to move through the placenta and help the baby grow. Estrogen that plays a “crucial” role in brain development and the regulation of genes, and helps regulate the amount of oxygen that gets through to the developing fetus.

From the report: “We suspect that makes this substance dangerous in pregnancy if enough of the triclosan gets through to the placenta to affect the enzyme,” said James, a professor and chairwoman of medicinal chemistry in the UF College of Pharmacy. “We know for sure it is a very potent inhibitor. What we don’t know is the kinds of levels you would have to be exposed to to see a negative effect. We know it is a problem, but we don’t know how much of a problem. We need to move forward and do additional studies.”

And the Food and Drug Administration’s response? You know, the FDA that in April said it would be taking another look at triclosan. (Even as other countries and entire continents ban the chemical. The European Union, for example, put a complete ban on Triclosan — anything that might come in contact with food — that goes into effect as of 2011.) Crickets, baby. Crickets. Not a word. Even after earlier this year the Natural Resources Defense Council (NRDC) said it was suing the FDA.

For more than a year I have reported on almost every single triclosan-related event. Every new study. Every annoying fact and figure. And we’re still in a holding pattern. Yeah, I know there are far more important things going on now, but it’s TIME that we step up and contact our FDA and tell them how we feel. How do I feel? It’s time to join the rest of the world and make it impossible for triclosan to cross a placenta. We need our government to protect us. Now! Not sure why? Read one of my first blog posts to learn more.

Want to get involved? You can contact the FDA directly. Check out this link for phone and email info. You should also contact your local congressperson. Here’s a link where you input your state and Zip code. We are the only ones who can affect change. Remember, the chemical lobby spends MILLIONS every year to keep things the way they are. But WE are the ones who vote people in or out of office. We do have power. We do.

The nutritionist spend about an hour or so with me during our first meeting. We discussed the food I liked, the food I didn’t, and what the growing baby inside of me needed. Not just calories, but also calcium, vitamins, protein, and essential nutrients. Then, based on my height and weight, she gave me a target calorie goal. I would be journaling my food intake every day, writing down exactly how much iron, for example, I was taking in, how much protein, how much fiber (to help ward off constipation), how much folic acid, how much good fat. I was charged with a huge responsibility: Take in enough good stuff to help that little baby grow. I took it very seriously.

I ate real, whole food. Lots of lean meat, cheeses, vegetables. I ate a protein bar every day. (They were super-yummy chocolate raspberry bars.) I ate yogurt. Almost everything was organic. If I ate something sweet it was made with real sugar — no artificial anything. At the end of my pregnancy I had only gained 19 pounds. It seemed to be the right prescription, though. Big Girl was born a week late at 8 pounds, 5 ounces. I went home with only ten pounds to lose. It came off that first month. So what’s the point of this story? Who cares?

Well, according to a recent study by Janet Currie, a health economist at Columbia University, and Dr. David S. Ludwig of Children’s Hospital Boston, women who gain too much weight during pregnancy may be setting their kids up for obesity in adulthood. A scary thought — that overeating during pregnancy can make your kid fat. The New York Times has a great story about this study and others. It talks about the recommended guidelines for weight gain — typically much less than most people gain. It’s not happening, though. Very few people stay within the recommended range. Pregnancy is now a free-for-all, with many women eating hot fudge sundaes every night and chocolate chip muffins for breakfast with snacks of candy in between. (And many end up with too-large babies and gestational diabetes and all sorts of health complications.)

It could be so easy to say women are just selfish gluttons. But that would be too easy, and not the real reason, I think, that women are getting so fat during pregnancy. I think the problem stems from our society’s ideals that say people — women in particular — should be super-skinny. Most aren’t, of course, but most of us try to get or stay slim. When you’re pregnant and this no longer applies, your mindset shifts. I have several friends who were size 2 before they got pregnant and who gained 40, 50, or even 60 pounds over the course of 10 months. They have been subsiding on next to nothing pre-baby and so when they were told, “Make sure you’re eating enough for the baby,” they went nuts. Who wouldn’t want to eat everything you’ve been denied for months and years? Heck, if I didn’t go into pregnancy with a nutritionist in my corner who knows how much I would have gained?

For me, though, I couldn’t eat all those “bad” foods because I was so focused on the nutrition. In fact, I think my healthy gain can be linked back to the protein and iron goals I had. Sure, I could meet my caloric needs eating five bowls of ice cream, but in order to hit 40 grams of protein, I had to be eating enough meat, hummus, beans, and soynut butter to make that number. Same went for iron. I have always been slightly anemic because I am not a red meat eater. So every morning I started my day with a big bowl of Cream of Wheat. I also ate broccoli, beans, and spinach. I am not exaggerating when I say after hitting all my nutrient goals some nights I felt quite literally stuffed. I couldn’t have chowed down on brownies if I wanted to. I didn’t have the room in my stomach.

I’m not sure why pregnancy isn’t seen as more of a collaborative health condition. I don’t know why, for example, every woman doesn’t get to meet with a nutritionist and a therapist after seeing their doctor or midwife. I can tell you that, as someone who went through it not once but twice, it was really nice having lots of different supporters in my corner. And that cream of wheat really is a great way to start the day.

How much weight did you or your spouse gain during pregnancy? Were you happy with your gain? Would you do anything differently? BTW: This post is how I am participating this week in Real Food Wednesdays and Fight Back Fridays — two awesome campaigns to get people eating real food again.

Billy Joel was playing Shea Stadium — concerts that were being billed as the “last play at Shea” since he would be, what else, the last artist to play the stadium before it was knocked down. The concerts were scheduled for mid-July. I was due mid-June. I bought the tickets in March because I figured what would be the big deal about leaving a month-old baby with her grandma? I delivered a week late, though, which meant that Little Girl was only 25 days old on July 16th, the date of our concert. Still, no big deal, I thought. Boy, was I wrong.

It took me forever to leave the house. I kept asking if my mom was going to be okay. Little girl was so little. My mother shooed us out of the house. We got on the Long Island Rail Road, planning on transferring to a special line that only runs during Mets games and other events. We got there, meeting our close friends who are Billy fanatics like us. And everything went downhill from there.

I had a physical ache in my body wondering if the baby was okay. Elsewhere, on the stage, Billy was doing his best to thrill the crowd. And he did. Angry Young Man, My Life, Everybody Loves You Now, The Entertainer. The hits kept rolling. So did the stars. Tony Bennett came out for an amazing New York State of Mind. The crowd went wild. John Mayer was next to sing along to This is the Time. Don Henley came out for Boys of Summer, a tip of the hat to the Amazing Mets, Shea and its baseball heritage. Normally, I would have been singing and swooning and swaying along. Not this time, though. For example, I can’t remember if I stuck around for Pink Houses with John Mellencamp or if my husband told me about him.

Yes, I left. I left that amazing concert on that beautiful, historic summer night. I couldn’t concentrate on the music. I kept calling home. I wanted to see my little girl more than one of my favorite musical stars. I told my husband to stay (why should he waste what was a pretty expensive ticket) and jumped on the train by myself. I transferred at Jamaica — or was it Woodside, I can’t remember — and drove myself home. I then walked the two or so miles from the train station to my house. I beat my husband by maybe 30 minutes since he didn’t wait for the train and he had the car to drive home.

At the time, I thought I was insane. Why couldn’t I be away from my little girl for a few hours? She was in very capable hands. But when I calmed down a bit and did a little research I realized that my desire to see a great show was up against biology, and of course biology was going to win!

When babies are born we have chemicals like oxytocin, which is called “the hormone of love and bonding” that flow through our veins. Chemicals that trigger feelings. Chemicals that make us want to take care of and nurture our babies. Biology wants us to bond in a big way and keep those babies right next to our bodies so they can eat, grow and be happy. (In fact, one study links the first trimester levels of oxytocin in a woman to the level of bonding they have with their newborns. And another April 2010 study suggests we might be able to help autistic children recognize emotions by introducing oxytocin via nasal spray into the equation.)

And so, looking back at that crazy night I can finally forgive myself for being so erratic and missing out on such a historic night. Am I sorry I missed Piano Man where the entire crowd sang so loudly the stadium shook? Sure, but some things are bigger and stronger than Billy Joel. (Sorry, Billy!)

As inductions went up, so did C-sections.

I am a reality show watcher. I love E!, especially. The shows are so bad that they are good. My husband and I (okay, I) love yelling at the screen when people do really stupid things. But over the holidays, I was doing more than yelling. I actually started to cry. The show: Kendra, the spin-off of The Girls Next Door. The problem: they induced her a little early, resulting in a C-section. The entire time I was watching, I was telling at the screen: “Don’t do it! Inductions rarely work! You’re going to end up with a C-section.” Which is exactly what happened.

I’ve written about this before. According to the National Vital Statistics Report by the U.S. Department of Health & Human Services, the rate of inductions more than doubled over the past 20 years. It was 9.5 percent in 1990. It was 22.3 percent in 2006. I’ve also recounted the stats that The March of Dimes is trying to get out there: that babies shouldn’t come out until they are ready. Late preterm infants (babies born between 34 and 37 weeks) are:

• 6 times more likely than full-term infants to die in the first week of life (2.8 per 1,000 vs. 0.5 per 1,000)
• 3 times more likely to die in the first year of life (7.9 per 1,000 vs. 2.4 per 1,000)
• Often weigh between 4½ and 6 pounds, and they may appear thinner than full-term babies.
• Remain at higher risk than full-term babies for newborn health problems, including breathing and feeding problems, difficulties regulating body temperature, and jaundice
• More than three times as likely to develop cerebral palsy and are slightly more likely to have developmental delays than babies born full term.

But doctors continue to do scheduled inductions and, when those inductions fail, C-sections at 37 weeks. Some just skip the induction entirely and do the C-section from the start at 37, 38, 39 weeks. (And The March of Dimes and researchers says 38 and 39 weekers aren’t a good idea, either. Check out this great March of Dimes feature: Why The Last Weeks Count.)

Right now I’ve got a friend who is pregnant. She was due on January 7. She had a C-section with her first baby. Now she’s trying for a vaginal birth after cesarean (VBAC). Amazingly, her doctor is letting her go one week post-date. He knows that most first-time moms are a little late. (And since she never delivered vaginally, as far as her cervix is concerned she’s a first time mom.) I am so impressed with that doctor and with my friend. She’s been done for a while. She’s got a 19-month-old, and running around after him tires her out. But she wants to have a third baby, and she doesn’t want to take on all the risks that a second and third C-section entails. So she’s waiting. And the doctor isn’t pressuring her or pushing her.

I wish Kendra Wilkinson’s doctor was as kind. I wish he let her body do what it needed to do. Yes, her baby was large, but that doesn’t mean she wouldn’t have been able to deliver him. Or maybe he would have been one of the 15 percent of people who the World Health Organization expects will have C-sections. (Yes, that’s right. The WHO recommends that countries set a goal of a 15 percent C-section rate. Sort of stinks that, right now, the U.S. rate is 31 percent.) But she’ll never know, will she? In the meantime, if you’re reading this please think good thoughts for my friend. She’s only got 24 hours before her scheduled C-section.

Are you a mom? How did you deliver your baby? Did you have a choice? Did you ever feel pressure to do one thing over the other? Talk about it below.

Being born is hard enough. We need to give our babies the best chance possible.

I’ve written about it before: Both my kids were a week late. And both times my midwives and the doctors they worked with were pressuring me to induce. (Well, the second midwife not-so-much, but she did say she had to induce if I went past that weekend.) One high risk doctor told me he would have induced Keira, my youngest, at 37 weeks. If he had, she would have been classified a late preterm birth, one of a growing category of preterm babies here in the U.S.

You might not think a baby born at 37 weeks would be considered preterm, but it is. And unfortunately, even late preterm babies are at risk for a host of problems, according to the March of Dimes. Late preterm babies are:

• 6 times more likely than full-term infants to die in the first week of life (2.8 per 1,000 vs. 0.5 per 1,000)
• 3 times more likely to die in the first year of life (7.9 per 1,000 vs. 2.4 per 1,000)
• Often weigh between 4½ and 6 pounds, and they may appear thinner than full-term babies.
• Remain at higher risk than full-term babies for newborn health problems, including breathing and feeding problems, difficulties regulating body temperature, and jaundice
• More than three times as likely to develop cerebral palsy and are slightly more likely to have developmental delays than babies born full term.

That’s why, while it’s easy to be tempted into letting a doctor or midwife induce, it may not be in the best interest of moms or babies.

November is Premature Awareness Month. Want to learn more about why you should hold off whenever possible with artificial inductions? Here’s a quick Q&A with Janie Wilson, MS, RN, Women & Newborns Director of Nursing Operations at Intermountain Healthcare in Salt Lake City, Utah, a not-for-profit hospital system that is responsible for delivering 53 percent of all babies in that state. Recently, the organization implemented a program to reduce unnecessarily early labor inductions with amazing success.

KB: Why are so many women delivering via induction today?

JW: It’s a combination of doctors and women. Women don’t want to be pregnant anymore after 36 or 37 weeks. Meanwhile, if a doctor selectively induces you on Thursday morning, he or she won’t be at the hospital at 2 a.m. on a Saturday night.

KB: What’s the risk of inducing before 39 weeks?

JW: We, as a country, are electively inducing women at 39 weeks when their cervix isn’t ripened. But if you do this, those same women may have a long, protracted labor, along with an increased risk of C-section and morbidity.

KB: What has your hospital done about this?

JW: We’ve got a guideline that says we do not electively induce a first-time mom until they pass the 39-week mark and have a Bishop’s score of 10 out of 13. This score takes into account five components of a vaginal exam: cervical dilation, effacement, consistency, and position along with fetal station — how far down the baby’s head is. We require both because due dates are just an estimate.

KB: What would you tell an expectant mom who is consider induction — whether it’s coming from her or her doctor?

JW: Some women will go wherever the provider will lead them. But this is not like scheduling your nail appointment. You have to make your own decisions. There are associated risks and costs that go along with inducing early. If you wait until your body is actually ready to deliver you will generally have a much better outcome.

Just look at what we’ve accomplished. Since 1999, our percentage of all inductions before 39 weeks has dropped significantly, from approximately 28 percent to only 3.4 percent. We’ve also seen a 90-minute drop in the average length of labor in electively induced patients, with fewer emergency cesarean sections and other medical complications associated with deliveries. Our average length of stay has dropped three hours. Today, our primary C-section rate (the rate of first time moms) is almost zero. We have really changed our culture for the better. Women should demand the same outcomes for their own births.

The March of Dimes this week released its Premature Birth Report cards. Alarmingly, the majority of states received an F; not a single state got an A. One state — Vermont — got a B. To learn more about prematurity, or to get involved with changing this dangerous paradigm, join the March of Dime’s National Advocacy Network by clicking here.

I got the flu not once but twice when I was pregnant with Little Girl. I coughed almost non-stop from January through March. It was horrendous. All that coughing lead to leaking. It was so bad that I tried using panty shields, pads, wash cloths, but nothing worked until I sent my husband out to get Depends. I was crushed. Wearing Depends in my 30s. How could this be? I spoke to my midwife who told me I would get better once I stopped coughing. It was stress incontinence, she said. She also said that — once the rather large baby wasn’t in there pressing down on my bladder — I’d stop even the little leaks, too. Little Girl was a big baby, but her older sister, who clocked in at 8 pounds, 5 ounces, had stretched the muscles of my pelvic floor. It was almost a given that I would leak when I coughed.

The pelvic floor muscles, which hang like a hammock from the public bone to your coccyx bone, support your internal organs, holding up your bladder, uterus, and bowel. They also control the muscles that open and close the anus, vagina, and urethra. Mine were obviously a little loose. Think about taking a rubber band and holding it in one place for ten months. Once you let go, it’s going to sag. And I had issues with my bladder before pregnancy, too. As someone who is very, very flexible, my muscles weren’t as tight as they could have been. I am definitely not alone, since one-quarter of all women — and one third of older women – report having issues with their pelvic floor. So what’s the cure? Here are a few ways to tone your nether regions.

• Kegel exercises. Simple Kegel exercises — tightening and releasing the pelvic floor muscles — can help strengthen everything down there, and get it working again. But you have to be consistent. I often forget to do my Kegels, because, as I have found, they can be really difficult to do. That’s why the easiest place to start is on the toilet. Stop and start your urine stream when you go to the bathroom. Once you identify the movement, which is sometimes described as pulling your vaginal muscles up and in, you can do it out of the bathroom, too. You don’t want to squeeze your butt or abs. You’ll know if you’ve got it because you’ll see a difference in your “response” time when you try and stop the flow. Plus, you may even feel a little sore in your lower abdomen. I will honestly say I barely got one or two in when I first started after having Little Girl because I couldn’t get my muscles down there to work. But if you keep it up, it does work. An October 2009 study found that 83 percent of women who did Kegel exercises reported a decrease in urinary incontinence. (Note to pregnant women: Kegels while pregnant can reduce the length of labor, and help prevent urinary incontinence, according to two separate studies.)
• Physical therapy. If you hurt you arm, you’d see a physical therapist to help rehabilitate it. PTs can also help women rehabilitate their pelvic floor muscles when they don’t want to do it alone. A recent study found that women can get wonderful results with this method. The physical therapist, who should have special training for this type of work, can help you find different exercises to strengthen your pelvic floor. You can find a practitioner by checking out FindaPT.us, and selecting Women’s Health in the pull-down menu.
• Biofeedback. I actually tried biofeedback when I was writing a story for Marie Claire. You get a device that looks like a small radio attached to a t-shaped probe. The probe goes where you think it would; you hold the radio-looking thing in your hand. You have to try and get a set of lights to light up by squeezing on the t-shaped thingy. The lights move up based on the amount of pressure you apply, and stay lit up based on duration. The stronger your muscle, the higher the lights will go, and the longer they will stay on. I can tell you when I did this experiment, I found that my muscles were sore after the first week! Doing Kegels correctly, which is essentially what I was doing, is really hard! But worth it. And now that I’ve met my deducible with my health insurance, I think I’m going to get a biofeedback machine of my own.
• Having an orgasm. One of the least-invasive ways to start strengthening your pelvic floor again is by having sex, and having an orgasm, according to Dr. Lauri J. Romanzi, a uro-gynecologist I have interviewed in the past.  “Orgasm and arousal brings blood into the region and promotes healing. The contractions of an orgasm help strengthen the muscles and help bring muscle tone back into the area,” she explained. While you’re probably going to need to do one of the other three options, it’s good to know you can get started improving things by taking matters into your own hands. (Or your partners, as my husband wanted me to point out.)
• Meditation. This one surprised me. According to a study from Loyola University, you can visualize and meditate to improve bladder control. “[Patients] then listen to an audio recording with a series of relaxation and visualization exercises at home twice a day for two weeks. Patients track the number of incontinence episodes that they experience in a pre- and post-therapy diary. The majority of patients, including Raisor, experienced a substantial improvement in symptoms.”  Wow. And cool! I’m looking forward to trying it out soon!

Have you had issues with incontinence or pelvic pain? How did you treat it? How long did it take? I’d love to hear about it.

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