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Bladder Leakage During and After Pregnancy, Oh My!

Jan 14, 2022 | 4 Minutes Read

Ask any woman if her bladder seemed to have a life of its own during pregnancy and you’ll her some amazing stories! But the fun doesn’t end there. Bladder control during and after pregnancy also evolves and changes just as you’re recovering from birth and beginning breastfeeding and parenting.

It’s normal for women/birthing persons to have at least some degree of urinary incontinence (bladder leakage) during pregnancy, which is the involuntary loss of urine. It’s normal and something nearly allmany expecting mothers experience. Incontinence can range from mild to severe in pregnant women. Some risk factors for incontinence during pregnancy include age and body mass index. Other risk factors for incontinence during pregnancy include:

  • Age
  • Body Mass Index
  • Previous vaginal delivery that weakened the pelvic floor or damaged the nerves around the bladder
  • Bladder infections (e.g., urinary tract infections (UTI)
  • Smoking
  • Gestational diabetes

Causes of Bladder Leakage in Pregnancy

There are many physical changes to your body during the months your pregnancy. As your child grows, so does the amount of pressure on your bladder. This may cause your pelvic floor muscles to weaken from the strain of carrying your growing baby.

The pressure on your bladder may send you in a hurry to the bathroom more often. Sometimes you may not make it in time and experience accidental leaks. Additionally, the changes in hormone levels during pregnancy can weaken to your pelvic floor muscles, increasing the urgency to get to the bathroom fast.

Early Pregnancy Urine Frequency

Newly pregnant women may urinate more frequently in the early weeks of pregnancy because your growing uterus is located within the pelvis and competes for space with your bladder. As the pregnancy proceeds, your uterus rises into the abdomen after the 12th week. It’s at this time you’ll begin to feel some relief from more frequent urination. However, you’re not entirely off of the hook just yet, mama—during the last weeks of pregnancy, as your child gets in position for birth, their child's head may push directly on your bladder, increasing the need to urinate often.

If you experience unexpected leaks while pregnant, it’s typically temporary so try not to worry. Your bladder should return to its pre-pregnancy condition not too long after giving birth. You can regain your pelvic floor, ligament, and tissue strength again.

Some women experience urinary incontinence post-pregnancy, but this typically resolves within six months to one year. Post pregnancy bladder leaks might stick around due to a weakened pelvic floor, but Iif theyit continues beyond six months to one year, please reach out to your healthcare provider for options in strengthening your pelvic floor and treating incontinence.

Types of Pregnancy Incontinence

Stress incontinence is considered the most common form of pregnancy incontinence. It results from weakened pelvic floor muscles, ligaments, and tissues, which cause involuntary urine leakage. You may notice urine leakage when pressure is exerted during coughing, sneezing, or laughing.

Urge incontinence (also known as overactive bladder) results from tissue or nerve damage to the bladder that causes frequent, sudden, and intense urges to urinate. During your pregnancy, weight from your uterus can press on the nerves leading to the bladder, causing it to have spasms that send you to the bathroom in a hurry.

Prevention and Treatment for Incontinence During Pregnancy

Although incontinence is normal for pregnant women/birthing people, ensuring you are comfortable is essential. Below are some management tools and techniques to help you reduce the severity of your symptoms and support post-pregnancy healing.

Tools and Techniques

  • Pelvic Floor Exercises
    • Will help strengthen pelvic floor muscles to hold urine better and prevent bladder leakage during pregnancy.
  • Develop a Schedule
    • Createing a urine emptying schedule with set times you go to the bathroom to take some urgency out of your urination. You may consider going to the bathroom every 2 hours regardless of feeling the urge to urinate.; sSimply adjust your schedule as needed until you find a timeframe that works for you.
  • Weight Management
    • It's normal and healthy to gain weight during pregnancy. However, being mindful of not putting on too much weight can alleviate urinary incontinence symptoms.
  • Wearing Protection
    • Wearing a urinary incontinence liner or pad may protect your underwear and keep you feeling clean and comfortable. These pads are made to capture and hold liquids, which makes them different from the liners designed to collect blood products during your period or postpartum recovery.

Causes of Post-Pregnancy and Childbirth Incontinence

Typically, bladder control problems after childbirth will improve in the first six months as your body recovers. Below are some factors that may add to your risk of experiencing bladder leaks post-pregnancy and childbirth:
  • Delivering a large baby
  • Cesarean surgery
  • Birthing your first baby
  • Experiencing long labor
  • Challenging vaginal birth

Signs of Stress and Urge Incontinence Post-Pregnancy

Stress Incontinence – Leaking when:
  • Coughing
  • Sneezing
  • Lifting/exercising
Urge Incontinence – Urinating:
  • More than 8 times per day
  • Waking up two times or more to pee
  • Sudden, intense and frequent urges to urinate

Treatment for Urinary Incontinence Post-Pregnancy

If you’re experiencing stress incontinence, regular pelvic floor muscle exercises or pelvic floor training will help speed up regaining your strength and control quickly after childbirth. It’s important to note that any "pushing down" action during the first weeks after birth may stress and further stretch your pelvic floor muscles. You can protect those muscles by following these helpful tips:
  • Avoid exercises that strain your pelvic area.
  • Avoid lifting heavy loads.
  • When sneezing or coughing, cross your legs and squeeze tightly together.
  • Lose some weight to decrease extra pressure on your bladder.
  • Squeeze, lift and hold your pelvic floor muscles before you sneeze, laugh, cough, or lift an object.
Remember, if your bladder control does not improve after six months, talk to your healthcare provider. This will provide the opportunity to discuss new treatment options and explore other possible causes of the stress incontinence you are experiencing.

If you’re struggling to get to the bathroom on time, you may be dealing with stress incontinence. Developing and adhering to a bathroom schedule can alleviate some of the urgency associated with having an overactive bladder. Also, some lifestyle changes can assist you with controlling your bladder after pregnancy, including the following:
  • Having a bladder-friendly diet (e.g., pears, bananas, lean proteins, whole grains, nuts, bread, green beans, squash, and eggs).
  • Keeping hydrated with water.
  • Double voiding by waiting 30 seconds after you urinate and void again to ensure your bladder is empty.
  • Speaking to your healthcare provider about potential medications.
Using products specific for urinary incontinence helps ensure maximum comfort. Avoid menstrual products for bladder leakage as they are not as great at absorbing urine. Instead, look for bladder control pads when shopping for sanitary products. Tap the link to learn more about light bladder leakage.

Shawana S. Moore, DNP, CRNP, WHNP-BC, is a Philadelphia-based, board-certified women’s health nurse practitioner and the director of the Women’s Health-Gender Related Nurse Practitioner Program at Thomas Jefferson University.

The information contained on this article should not be used as a substitute for the medical care and advice of your health care professional.