The body changes significantly in pregnancy, from organs shifting around to accommodate a growing fetus to changes to the actual pelvis shape. Many of these are discussed and embraced — except for negative symptoms, such as postpartum incontinence.
Although over 30% of women are affected by involuntary urination more than 6 months after giving birth, this common issue is often treated as a shameful secret. However, it's important to understand that postpartum incompetence is common and normal, and it doesn't have to last forever. This is what you need to know about postpartum incompetence, including what it is, why it happens, and what you can do about it.
Understanding Postpartum Incontinence
The primary cause of postpartum incontinence relates to how pregnancy affects the pelvic floor muscles, or the muscles that are located between the tailbone and the pubic bone. These muscles are responsible for supporting the bowels and bladder, playing a role in urethral and sphincter control. When these muscles aren't fully functional, it can be harder to hold urine or defecate properly.
For most people, pelvic floor muscles are naturally able to handle these responsibilities, but pregnancy can stretch and weaken these muscles, particularly during childbirth. The stress of pushing can result in weakening, which makes it much harder to hold in urine when necessary. This is particularly true for those who require an episiotomy or the use of a vacuum or forceps.
In addition to these physical changes, the hormones in pregnancy can also affect bladder control. The changes in progesterone levels can cause a natural weakening of the pelvic floor as the body's muscles and tendons loosen to prepare for birth, creating an extra barrier. While incontinence after childbirth is much more common in women who deliver vaginally, those who require cesarean sections may still experience a period of incontinence due to these hormonal shifts.
Types of Urinary Incontinence After Childbirth
Postpartum incontinence can vary from woman to woman and may appear in several ways. These are the primary types of postpartum incontinence.
Stress Incontinence
Stress incontinence refers to a loss of bladder control when the bladder is under pressure. This can include jumping, laughing, exercising, or even something as simple as sneezing — in short, any action that presses, even mildly, on the bladder. Despite the name, psychological stress, such as problems at home or struggles at work, doesn't play a role in stress incontinence.
Stress incontinence is directly tied to weakened pelvic muscles. Under normal circumstances, the pelvic floor muscles can hold firm against normal pressure, but when they're weakened or damaged, standard daily activities can result in unintended urine leakage.
Urge Incontinence
Unlike stress incontinence, in which small releases of urine can release without warning, urge incontinence involves feeling frequent urges to pee, even with an empty or near-empty bladder. When urges get too strong, the bladder can squeeze or involuntarily spasm, causing urine leakage. Urge incontinence can be related to an overactive bladder, with similar signs and symptoms, such as the urge to urinate frequently, but isn't exactly the same thing.
Urge incontinence is less common after childbirth than stress incontinence, but still affects many postpartum women. This form of incontinence is generally driven by hormonal changes, rather than pelvic floor damage from pushing or tearing during delivery.
Treatment Options for Postpartum Incontinence
Postpartum incontinence can be both stressful and embarrassing, particularly while adjusting to a new life as a mother. However, it doesn't have to be a permanent struggle. There are ways to minimize or alleviate bladder control problems, ranging from exercise to employing the perfect products.
Pelvic Floor Exercises (Kegels)
Pelvic floor exercises, also called Kegels, can be one of the best options for those working to overcome postpartum incontinence. These exercises are designed to strengthen pelvic floor muscles. They're often associated with sexual performance for women without incontinence, but they can be a great way to help rebuild any strength lost in pregnancy and childbirth. For those with stress incontinence, Kegels can minimize or fully prevent the involuntary loss of urine when pressure is put on the bladder.
Kegels are very simple exercises that can be done discreetly. In essence, all you need to do is loosen and tense your pelvic floor muscles, or the muscles you normally use to hold urine. Let your muscles relax as if you're going to relieve yourself, and then tense up as hard as you can as if you're holding in urine. Hold this position for several seconds before releasing. For best results, you may find it helpful to do these exercises three times a day in sets of 10. However, it's best to check with your doctor before incorporating Kegels into your routine.
Biofeedback Therapy
Biofeedback therapy is another treatment option that involves a small device to prompt muscle response. Rather than simply loosening and tensing muscles independently, this therapy involves the use of a physical device with sensors that connect to a computer monitor to inform on muscle performance.
This process is painless and can be performed in a doctor's office. One sensor is placed on the abdomen near the bladder, and the other is placed in the anal canal. Patients will then perform Kegel-like exercises, and the sensors should capture accurate measurements of muscle strength. Sessions generally last around an hour.
Biofeedback therapy is similar to performing Kegels at home on your own, but it also involves the benefit of measurement and professional guidance. Sessions can be scheduled based on personal goals and managed by pelvic floor muscle tone improvement from session to session.
Incontinence Products
While working to strengthen your pelvic floor muscles, incontinence products can play a big role in helping you feel your best in the interim. Safeguarding against leaks no longer means bulky fits; today's incontinence products are made to look and feel like regular underwear or period pads, providing discrete coverage in a comfortable way. These thin, odor-neutralizing, flexible, and breathable products make it easier than ever to protect yourself.
While these products won't improve bladder control, they can play a huge role in self-confidence and personal comfort as your muscles are healing post-childbirth. Incontinence pads and underwear can help you feel like yourself again, even while you're still healing.
Prevention and Self-Care Strategies
If you're newly pregnant and worried about living with incontinence after childbirth, you aren't alone. Many soon-to-be moms are concerned about lasting problems. However, there are things you can do while pregnant and in the immediate aftermath of delivery to minimize your chances of ongoing bladder control challenges.
Pelvic Floor Exercises During Pregnancy
Pelvic floor exercises, such as Kegels, aren't limited to the post-delivery period; with your OB-GYN's consent, you can do these exercises throughout your pregnancy to keep your pelvic floor muscles as strong as possible before giving birth. Not only can this reduce the risk of long-term damage after childbirth, but it may also make the process of pushing a little easier.
Doing the same Kegel exercises as described above — three sets of 10 per day — can help you prepare yourself for delivery and strengthen your pelvic floor after you welcome your little one into the world.
Postpartum Recovery Practices
Being kind to yourself after delivery is one of the best things you can do for both your mental and physical health. It's very important to rest after giving birth or at least as much as possible with a newborn. Don't push too hard, too soon; your body needs time to recover with as little pressure as possible.
It can be tempting to hit the gym as soon as you're in less pain or your incision is done healing, but holding off can be a benefit. Return to physical activity gradually, and refrain from doing too much, too quickly. A rapid return to your pre-baby workout routine can hinder healing and cause negative side effects, such as urinary incontinence after childbirth, more likely.
Maintaining a Healthy Lifestyle
A healthy lifestyle is important for many reasons, including pelvic floor health. Women with postpartum incontinence should focus on drinking plenty of water, eating a diet high in fiber, and getting proper exposure to vitamins and minerals. Carbonated soft drinks, caffeine, and alcohol should also be cut out; these substances can put extra strain on the body and compromise healing.
Regular exercise can also benefit pelvic floor strength. As soon as you're healed and finished easing back in, a workout routine can keep your whole body stronger and more capable.
Other Preventive Measures
Using your body properly can help you avoid all kinds of physical issues, including muscle strains throughout the body. For example, when lifting heavy objects, always lift from your knees, not your back. Hold heavy loads, such as your growing child, as close to your body as possible, and maintain a stable base when carrying. Don't attempt to lift or carry items that compromise proper form.
Constipation can be common following childbirth, as well as during periods of stress or when eating poorly, but it's important to prevent straining and pushing on the toilet. Instead, drink lots of water and use a laxative or stool softener when constipated to avoid unnecessary pressure.
Seeking Professional Help
If doing exercises at home isn't enough for you physically or psychologically, professional help is always an option, and it's never too early to get help if you feel you need it. Healthcare professionals can oversee treatment, including biofeedback therapy, medication to control urges, and guidance with exercises.
Many women recover from the worst of postpartum incontinence in the weeks following delivery, but if you're seeing extended symptoms or no improvement after sufficient time and plenty of exercise, seeing a professional should be the next step. There are plenty of options to consider, from speaking with your OB-GYN to connecting with a specialized pelvic floor therapist.
The Bottom Line
Postpartum incontinence is incredibly common in women who have just given birth. But that doesn't mean you need to suffer in silence. There are plenty of ways to address incontinence after childbirth, work to prevent it before delivery, and protect from leaks in the meantime.
The more postpartum incontinence is discussed, the more normalized it becomes. Speaking openly and honestly can help you know you're not alone and make therapies and incontinence products empowering, not a hidden secret.
If you're living with incontinence and ready to do something about it, we're here for you. Shop Nexwear Today!