The long-awaited plus sign shows itself on your pregnancy test, you share the exciting news with your family and friends, and begin analyzing every little change your body makes in the weeks to follow.
Pregnancy is an incredible time of transformation for a woman’s body with more than 90 percent of women reporting they experience symptoms by the first eight weeks. While some symptoms may be welcome (like missed periods and food cravings), others are more challenging to manage like nausea, fatigue, and bladder leakage.
Women should not hesitate to ask questions or share concerns with their provider about pregnancy symptoms. Seeking guidance and professional support is especially important when a topic is confusing or varies greatly from woman to woman like urinary incontinence, incontinence after pregnancy, and incontinence treatment and prevention recommendations.
It is not uncommon to have questions about the risks of incontinence during or after pregnancy. However, it is important to first understand the types of urinary incontinence, which include:
- Stress: Loss of urine due to physical pressure on the bladder
- Urgency: Loss of urine due to an urgent need to urinate (commonly caused by bladder contractions)
- Mixed: A combination of stress and urgency incontinence
- Transient: Loss of urine due to medication or a temporary condition such as a urinary tract infection or constipation
What is Pregnancy Incontinence?
During the early stages of pregnancy, blood flow to the kidneys can increase 35 to 60 percent. This extra blood flow can make the kidneys produce up to 25 percent more urine soon after conception. Increased urine production is at its height at 9 to 16 weeks of pregnancy, and tapers down from there.
Do you leak a bit of urine every time you cough, sneeze, exercise, or laugh? You aren’t alone. A growing uterus places pressure on the bladder and may result in the need to pass urine frequently, and at times, incontinence. As your baby grows during pregnancy, he or she pushes down on your bladder, urethra, and pelvic floor muscles. This pressure can weaken the pelvic floor muscles and lead to incontinence or problems passing urine. Changing hormones can also have an effect on the lining of your bladder and urethra. The good news is… most bladder leakage or control problems go away after childbirth when the muscles have had time to heal.
It is important to note that it is not recommended to restrict fluids during this time. It is essential that you and your growing baby stay hydrated by drinking at least six to eight glasses of fluids each day to maintain a healthy pregnancy. Drinking less than the recommended amount may result in dehydration. If the need to go to the bathroom keeps you up at night, try drinking more fluids during the day and cutting back a few hours before you go to bed.
What are the Risk Factors for Pregnancy Incontinence?
When you’re pregnant, pelvic floor muscles are working overtime. That said, most women who are carrying a child are at risk for some form of pregnancy incontinence. Women who have had an overactive bladder or urgency incontinence prior to pregnancy will most likely have symptoms that continue or worsen during pregnancy.
Other risk factors include:
- Advanced maternal age
- Being overweight
- Previous vaginal delivery
- Previous pelvic surgery
- Smoking, which leads to chronic coughing
- Neurological diseases
What Causes Urinary Incontinence After Pregnancy?
It may surprise you to learn that it doesn’t matter what type of delivery you have (vaginal or cesarean section) - women who have given birth have much higher rates of post-pregnancy stress incontinence than those who have never had a baby.
Simply explained, giving birth can contribute to incontinence after pregnancy. The American Congress of Obstetricians and Gynecologists has found that cesarean delivery reduces incontinence during the first year, but benefits are diminished two to five years after delivery.
A normal labor and vaginal delivery can weaken the pelvic floor muscles and damage the nerves that control the bladder. A long labor and prolonged pushing can increase the likelihood of immediate pelvic floor muscle weakness following delivery. Additionally, a uterus shrinks in the weeks following delivery and as it sits directly on the bladder, compression can make it more difficult to control the flow of urine.
Loss of bladder control is also caused by pelvic organ prolapse (slipping down) that can occur after childbirth. In this case, the pelvic muscles stretch and become weaker during pregnancy and vaginal delivery. If the muscles do not provide enough support, the bladder may move down or sag, causing mobility of the urethra, leading to incontinence with increased abdominal pressure.
How Long Does Incontinence Last After Giving Birth?
Ready for some good news?
Most women’s incontinence symptoms go away in the days or weeks after their baby is born. Bladder leakage that happens as a result of labor and delivery tends to diminish after the muscles have had time to heal. For some women, leaking may continue to get worse. If this is the case, incontinence can be managed with certain exercises such as Kegels, and other methods including bladder retraining, weight loss, and more.
If you have concerns following the delivery of your baby, and lifestyle changes haven’t worked to improve incontinence issues six or more weeks after delivery, speak with your doctor about treatments and medications that are available to help.
It’s important to understand that it can take three to six months, or longer for some women, to regain complete bladder control. Be patient and learn the steps you can take to make the process go faster.
How do I Prevent Incontinence After Pregnancy?
Pregnancy incontinence is a normal occurrence following the delivery of a baby; however, there are some ways you can help prevent it or improve bladder control.
- Take your time while using the toilet. When urine is allowed to flow at its own speed, you aren’t using your pelvic floor to push it out.
- Treat urinary tract infections (UTIs) promptly. UTIs irritate the bladder lining and it’s important to seek treatment immediately if you have symptoms.
- Document when you have bladder leakage issues. This will help with planning trips to the bathroom and provide information to your doctor.
- Maintain a healthy weight. Excess weight can put added strain on the muscles of the pelvic floor.
- Don’t smoke. A chronic cough because of smoking weakens the pelvic floor and contributes to incontinence.
- Do pelvic floor muscle or Kegel exercises. They are safe and effective before, during, and after pregnancy.
- Avoid carbonated and caffeinated drinks such as soda, coffee, or tea. These types of beverages can make you feel like you have to use the bathroom more often.
- Talk to a trusted obstetrician about your concerns and to seek diagnosis or treatment advice.
What are Some Pregnancy Incontinence Treatments?
When considering treatment options for pregnancy incontinence, the first course of action should incorporate lifestyle changes and bladder management. If these steps don’t improve your symptoms, your doctor may recommend other treatment options depending on what type of incontinence you are experiencing. These options may include:
- Control of pelvic floor muscles- Kegel exercises.
- Elimination of bladder irritant food and beverages.
- A Pessary inserted into the vagina to support the urethra, preventing urine leakage.
- Urethral surgical sling that involves placing a sling around the urethra to lift it back into a normal position.
- Bladder support “tampons” that support the urethra from leaks.
- Medications to help overactive bladder.
- Bladder retraining tactics for urgency incontinence.
The most important factor is to remember to be patient - it can take a month or longer for certain treatments to begin working.
How Do I Find the Right Doctor?
There are many important aspects to finding the right medical provider. The most critical element is to ask about the doctor’s viewpoint on concerns that are most important to you. You can never fully predict what pregnancy, labor, delivery, and life will bring. However, you can learn about your doctor’s approach to care and how their team will respond in situations pertaining to your health.
At Moreland OB-GYN, we specialize in women’s health care and always prioritize the needs of our patients. Do you have a question you’d like answered? Our team is a trusted source for information - connect with us here.