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Protect Your Pelvis

Pregnancy and childbirth can really take a toll on a woman's private parts, but you don't need to settle for a future with a leaky bladder or sagging sex life. There are ways women can prevent these problems, says Roger Goldberg, M.D., a urogynecologist and pelvic surgeon at the Evanston Continence Center of Northwestern University Medical School, in Illinois, and author of the new book Ever Since I Had My Baby. These tips can help keep your pelvic area in top shape during and after pregnancy.

Kegels and more Kegels: You've heard it before -- these exercises tone and strengthen the muscles surrounding the vagina, perineum, and bladder and are key for maintaining continence during and after pregnancy; they're also good for your sex life. Try doing 30 squeezes (lasting 5 to 10 seconds each) twice a day, says Dr. Goldberg. (To locate the muscles, try stopping and starting the flow of urine.)

Have a massage: Gently stretching the perineum, the area between the vagina and rectum, may reduce your risk of vaginal tearing or an episiotomy during delivery. Starting at week 34 of pregnancy, gently rub and squeeze the area (or ask your partner to) for 10 to 15 minutes a day, using a lubricant like K-Y jelly.

Stay fit: Exercising regularly during pregnancy and avoiding excess weight gain can help you avoid pelvic injury. Prenatal yoga, with its focus on opening the pelvis, is a good choice, says Dr. Goldberg.

Keep regular: The straining that accompanies constipation -- a common pregnancy problem -- puts pressure on pelvic muscles. To stay regular, eat plenty of fiber (good sources include black beans, prunes, and bran) and drink enough water.

Avoid an episiotomy: While a cut to the perineum may be warranted in certain cases -- to speed delivery of a baby in distress, for example -- studies show that episiotomies increase the risk of pelvic injury. Talk with your doctor about his or her views on the topic. Have a pushing plan: Many women want a vaginal birth, but pushing for too long can increase the risk for pelvic injury. It's unclear how long is too long for a particular woman, but you can talk to your doctor to learn more about other techniques, such as delayed pushing, that may help.