Normally, your nerves, ligaments, and pelvic floor muscles work together to support your bladder and keep the urethra closed so urine doesn’t leak out. Overstretching or injury to these areas during pregnancy or childbirth can cause them to stop working properly. Stress incontinence is a common complaint among pregnant women, and some find that it continues to plague them after they have their baby.
This common postpartum symptom is caused by the pregnancy and delivery weakening muscles around the bladder and pelvis, which make it harder for you to control when urine starts or when it stops (they’ve taken a licking and, consequently, keep on dripping). Plus, as your uterus shrinks in the weeks immediately following delivery, it sits directly on the bladder, compressing it and making it more difficult to stem the tide. Hormonal changes during and after pregnancy can batter your bladder; you may have also struggled with bladder control during pregnancy.
Those who give birth vaginally are more likely to have the problem than women who deliver by cesarean section. That said, even some moms who avoid labor altogether and have a scheduled c-section continue to have stress incontinence after delivery.
Some studies show that having an assisted vaginal delivery, particularly with the use of forceps, contributes to urinary problems after childbirth. And some studies, but not all, have found that having a prolonged pushing stage or a large baby makes stress incontinence more likely.
Women who are obese are about four times as likely to have stress incontinence, and smokers are at greater risk too. Recent research suggests that genetic predisposition may play a role as well.
The chance of having urinary incontinence is also higher for mothers who have had many children, especially if they delivered vaginally. However, women who have reached menopause experience incontinence in similar numbers regardless of the number of pregnancies they had or the type of delivery.
Most women who develop stress incontinence during pregnancy find that it goes away soon after delivery. For some moms, the leaking stops completely or becomes much less frequent within a few weeks of giving birth, while for others it can persist in varying degrees for several months or even longer. Some have urinary incontinence again (or develop it for the first time) years later, since the problem becomes more common as women age.
Talk to your caregiver, who may want to examine you and rule out a urinary tract infection (especially if you also have pain or burning when you urinate).
To ease your symptoms, he or she will likely recommend that you do regular Kegel exercises and make them a lifelong habit. When done correctly and often enough, they can strengthen your pelvic floor muscles, giving you better control. If you’re not sure you’re doing them correctly, ask your practitioner to show you how.
Urinary incontinence is very common in the postpartum period (more than a third of moms spring that particular leak). It can take between three to six months, or even longer for some women, to regain complete bladder control though there are steps you can take to get it back faster.
- Do your Kegels, do your Kegels, and do your Kegels! Try to work up to three sets of 30 Kegel exercises a day.
- Start shedding those pregnancy pounds sensibly, since all those extra pounds are still putting pressure on your bladder.
- Train your bladder to behave. Urinate every 30 minutes before you have the urge, and then try to extend the time between pees each day.
- Try to avoid constipation after pregnancy, so full bowels do not put added pressure on your bladder.
- Keep drinking at least eight glasses of fluids every day (cutting back on water to control the peeing only makes you vulnerable to dehydration and urinary tract infections).
- Avoid coffee, citrus, tomatoes, soft drinks, and alcohol — all of which can irritate your bladder and make urine harder to control.
- Pads can help absorb leaking urine. Do not use tampons. They do not block the flow of urine and they are off-limits during the postpartum period anyway.
- As a last line of defense, do Kegels or cross your legs when you feel the need to cough or sneeze, or when you’re about to laugh or lift something heavy.
In the meantime, here are a few other tips:
- Use a sanitary pad to protect your clothes from urine leaks, and try crossing your legs and tightening your pelvic muscles when you feel a sneeze or a cough coming on.
- Try cutting down on caffeine. There is some evidence that consuming less caffeine might help, and it certainly can’t hurt to try.
If the incontinence continues for more than a month despite doing regular Kegel exercises, seek out a pelvic rehab physical therapist. Many women with urinary incontinence find relief from pelvic floor therapy. In rare cases, surgery is necessary to correct the problem. Pelvic rehab can help treat other urinary concerns as well. Some women feel a frequent or sudden, compelling urge to pee, even when their bladder isn’t full. This urge may send them to the bathroom more often than necessary or it may cause them to leak before they can get there. Others are unable to start the flow of urine at will or empty their bladder completely when urinating. Postpartum incontinence is a normal thing after giving birth and will not last forever. Make sure you ask your health care provider questions or for advice if it is bothering you.