Pregnant woman sitting with her doctor

Pregnancy Incontinence

What Is Pregnancy Incontinence?

Urinary incontinence is a common condition where someone loses the ability to control urine passage. It may present as increased urgency to urinate, more frequent trips to the bathroom, or leaking urine between bathroom visits. There are several factors that contribute to urinary incontinence; however, women who are pregnant or who have given birth have a higher risk of developing incontinence.

The bladder is an organ that sits above your pelvic bone and is surrounded by muscles. It releases urine through a tube called the urethra. A combination of nerves and muscles controls your bladder. As the bladder fills with urine, its muscles relax and the sphincter muscles help you keep your bladder closed until you urinate. When the bladder is full, nerves signal the brain that it requires emptying.

As you experience changes in your body during and after your pregnancy, you may start to lose control over your bladder. This is typically normal, and many pregnant women experience at least some degree of urinary incontinence. However, you should always discuss any changes with your doctor to rule out more serious concerns and prevent complications. Incontinence is different from the condition of frequent urination, which causes a need to visit the bathroom more often but is not related to a loss of control. This may or may not have an underlying medical cause. Discuss your experience with your doctor. Together, you can identify the cause of your concerns and work on ways to improve incontinence.


Causes of Incontinence During Pregnancy

Control of the bladder is often lessened during pregnancy and following childbirth. Urinary incontinence can result from physical stress on the bladder or an urgent need to urinate due to bladder contractions. Sometimes, a combination of these two is the culprit. The growth of the baby puts pressure on the bladder, which causes leakage. Your body also naturally produces more urine between weeks 9 to 16 of your pregnancy due to the increased flow of blood to the kidneys. Other causes are weakened muscles in the pelvic floor, damage to the pelvic nerves, or pelvic organ prolapse.

Physical Changes During Pregnancy

Your body undergoes many changes to accommodate your growing baby. Because the bladder sits under the uterus, it starts to become compressed as your baby grows. The pressure and reduced space for urine are the reasons you feel the need to urinate more frequently than usual.

Weakened Pelvic Floor Muscles

Childbirth puts a lot of strain on the body, which can lead to weakened muscles in your pelvic floor. Sometimes, they stretch to the point where your uterus, bladder, or rectum is no longer sufficiently supported and droops.  

Hormonal Changes

The increase in the hormone called progesterone is often one of the causes of incontinence. This hormone is responsible for loosening your joints and ligaments to make room for your body to expand to accommodate your baby and allow for delivery. A side effect of this is a decrease in bladder control.


How Do Pregnancy and Childbirth Affect Bladder Control?

Stress incontinence is a common type of incontinence that causes urine leakage during physical activity, such as laughing or coughing. Carrying and delivering a baby has an effect on your bladder control regardless of the type of delivery you have. Once your baby is born, the uterus takes weeks to shrink back to its pre-pregnancy state. During this time, it remains sitting on the bladder which can cause problems with your urine flow.


What Causes Bladder Control Loss in Women After Pregnancy and Childbirth?

The main causes of ongoing urinary incontinence after delivering your baby are:

  • Pelvic organ prolapse. This is a condition called cystocele where the muscles surrounding your bladder are too weak to hold it in the proper position and it slips.
  • Nerve damage. A particularly difficult vaginal delivery may cause pelvic nerve damage. If the bladder’s nerves sustain damage, they can’t perform their function, and the result is incontinence.
  • Delivery injury. Incontinence may be the result of prolonged pushing or injury to the muscles from an intervention such as forceps.


Is Incontinence Normal During Pregnancy?

More than one-third of all pregnant women experience incontinence during or after pregnancy. It’s considered a normal response to the pressure put on the bladder by your growing baby (but always check with your doctor to rule out other conditions that can cause incontinence).


Does Pregnancy Incontinence Go Away?

Normally, urinary incontinence stops within several weeks of giving birth, but every woman’s experience depends upon her pregnancy, delivery, and overall health. It’s possible for incontinence to continue if you experience complications like pelvic organ prolapse.


When Does Urinary Incontinence Start in Pregnancy?

Every woman’s body is unique, so when you start to experience incontinence can vary. The majority of women with incontinence notice it the most during their second and third trimesters. Some also have incontinence issues during the 3 months following childbirth.


Symptoms of Pregnancy Incontinence

There are a number of symptoms that point toward incontinence. These include:

  • An urgent need to urinate
  • Urinary leakage
  • Increased frequency of urination

You may be at greater risk of experiencing these symptoms depending on your age, weight, and history of previous pregnancies and deliveries. Smoking, diabetes, and some neurological diseases are other risk factors. If you notice any changes in your urinary habits during or after your pregnancy, reach out to your doctor for advice.


Coping With Pregnancy Incontinence

The stress of dealing with incontinence on top of being pregnant can be difficult to deal with. Implement some helpful strategies to help you cope.

Lifestyle Changes

Simple changes to your diet and adding Kegel exercises to your routine can make a big difference. A high-fiber diet helps you avoid constipation, which can strain your pelvic floor. Try to avoid drinking carbonated drinks or drinking late at night. 

Products for Incontinence Management

There are products available to deal with incontinence. Nexwear has a variety of pads and disposable underwear that offer comfortable, effective protection. They are discreet and give you peace of mind to go about your day as usual with no worries about embarrassing accidents.

Seek Support From Loved Ones and Health Care Professionals

Dealing with incontinence on your own is often frustrating. Don’t be afraid to open up to your loved ones to get support and advice. Someone you know could be going through the same thing and have valuable input to help your own situation. It’s also crucial that you talk to your doctor to get medical advice and treatment.


Diagnosis and Treatment

Many incontinence issues can go away on their own with time. However, you should always contact your doctor if the problem is severe or if it persists beyond 6 weeks post-delivery. Early diagnosis from a medical evaluation helps to uncover any hidden reasons that are contributing to the problem so you can address them. 

Incontinence during pregnancy puts you at a higher risk of experiencing continued problems after your baby is born. Consulting with your physician gives you the insight needed to track and monitor your condition for changes that require further evaluation or treatment. Taking action as soon as possible helps improve the condition and may even reverse it entirely.

Diagnosis requires you to schedule an appointment with your doctor that involves a physical examination and possible testing such as:

  • Ultrasound. The ultrasound waves produce images that let your physician determine whether your bladder completely empties.
  • Urinalysis. A sample of your urine undergoes testing for infections that could be contributing to the problem.
  • Bladder stress test. Your doctor will have you perform physical actions like bearing down or forceful coughing to check for evidence that these stressors cause leakage of urine.
  • Cystoscopy. This test uses a tube to insert a tiny camera into the urethra to check it and your bladder.
  • Urodynamics. This is a pressure test. Again, a small tube is inserted into your urethra to your bladder. This time, the tube allows water to fill the bladder completely, allowing your doctor to measure the interior pressure.


Non-Surgical Treatments

Depending upon the cause and severity of your incontinence, you might be able to effectively treat it with some simple exercises and lifestyle changes:


Kegels are simple exercises you can do to improve your muscle tone and treat your problems with bladder control and urine leakage. They target the muscles that surround and support the bladder, bowels, and uterus. Doing Kegels gives you greater strength and control over your muscles, allowing you to tighten and relax them at will. Incorporating Kegel exercises into your routine after delivering your baby helps the perineal tissue to heal faster, strengthens your pelvic floor muscles so they return to their pre-pregnancy state, and results in better bladder control.

These exercises are most effective when done every day. To perform the exercise, contract the muscles you would use to stop your urine flow. Focus on your interior muscles and refrain from tensing the muscles in your buttocks, legs, or abdomen. Hold the contraction for 5 to 10 seconds and relax. Repeat 10 times, three times each day. It may take time to build up to the full 10 seconds. 

Bladder Training

Adopting a bathroom schedule might help you avoid incontinence episodes. You can try to slowly increase the time between bathroom trips to build muscle strength and regain bladder control. This trains your bladder to hold more fluid and diminish the likelihood of leakage.

If you are going to try bladder training, you must visit the bathroom on schedule, even if you don’t have the urge to go. When you feel the need to urinate between scheduled trips, try to use a technique like Kegels to suppress the urge. You can set up your schedule to accommodate your immediate needs and level of incontinence. Visits every 15 to 30 minutes might be necessary at first. Gradually work up to several hours between bathroom visits.

Weight Management

Dropping excess weight is another great strategy to address incontinence. Carrying extra weight puts more pressure on your bladder. The good news is that a reduction in weight as small as 10% can yield positive results. Always consult your doctor before beginning a weight loss or maintenance program, especially during and after pregnancy. It’s essential that you prioritize your health and your baby's health by consuming the right nutrients.

It’s a good idea to keep a journal to track your experiences and note down the frequency of your incontinence struggles, the times of day they occur, and any potential triggers. Review this information to notice if there are any patterns that help you get ahead of incontinence by adjusting your lifestyle habits and planning bathroom breaks in advance.

Surgical Options

Your doctor might recommend surgery to address your incontinence if other methods don’t produce the desired outcome. The most commonly used surgery places a sling made of synthetic mesh between the urethra and vagina for added support. It has been shown to be highly effective in most cases.

An alternative to the mesh sling is a pubovaginal sling made from grafted tissue of the patient. Another possibility is urethral bulking injections. These are given in the office and provide an option for patients who cannot have surgery.


Preventing Pregnancy Incontinence

Understanding when incontinence starts in pregnancy gives you the knowledge to take preventative action to potentially avoid issues with incontinence. It’s a given that your body will experience a great many changes during and after pregnancy. Vaginal deliveries, especially with large babies, can impact your pelvic floor muscles and nerves, so it’s important to talk to your doctor about your options. One of the best methods for preventing incontinence is doing Kegel exercises. These are safe to do and can help you keep your pelvic floor muscles in good condition.

Maintaining a Healthy Weight

Just as losing weight following your pregnancy can improve incontinence, maintaining a healthy body weight before you become pregnant is an excellent strategy to prevent incontinence.

Pelvic Floor Muscle Exercises

You already know the importance of exercising your body to stay healthy and prevent disease. The same general concept applies to the health of your pelvic floor. Don’t wait until you are pregnant or recovering from childbirth to start your Kegel exercises. They should be part of your regular exercise routine to keep yourself in good shape and prevent incontinence and other issues.

Proper Hydration

Drink plenty of water. Concentrated urine can irritate the bladder, and dehydration can increase the risk for or aggravate incontinence.

Avoiding Bladder Irritants

Spicy foods, caffeine, acidic foods, and some teas can also irritate the bladder and make incontinence worse. Ask your doctor to recommend a healthy diet that reduces common irritants.


The Bottom Line

Incontinence can become a hurdle for any pregnant person or anyone who's recently given birth. There are methods you can implement to reduce the symptom, but be sure to see a healthcare professional if it persists.

If you are experiencing incontinence, know that you are not alone and you have no reason to feel anxious or embarrassed about your loss of bladder control. Browse the Nexwear collection of products to get your favorites shipped directly to your door for ultimate convenience.