Pregnancy and Incontinence

Pregnancy Incontinence

Incontinence—that is, lack of control over urination—is common in women, especially those who are pregnant or who have been pregnant before. [1] Urinary incontinence may manifest as leaking urine throughout the day, urine escaping your urethra as baby kicks your bladder or as baby’s physical presence puts pressure on your bladder, leaking that accompanies urgency to go or an inability to “hold it” as well as you once were able to, or a combination of some or all of the above. [2] Read on to learn more about the causes of incontinence and what you can do to help with this issue during and after pregnancy.

Causes of Incontinence

Urination starts when the muscles around your urethra—the tube through which urine travels from the bladder to leave the body—relax and stops when those muscles contract again to stop the flow of urine. Because a lot is happening in your body during pregnancy, the normal function of the muscles around your urethra can become disrupted even very early on. [1]

And the location of your bladder and urethra in relationship to big changes that are happening in your abdomen already does not help either. Your pelvic floor— the muscles and connective tissue at the base of your hip girdle—support your bladder, as well as your bowels, your uterus, your vagina, and eventually the bulk of your growing baby. As your baby grows and hormones change the stretchiness of all your muscles and connective tissue, your body asks more of your pelvic floor, which means that things that are connected to it, namely the bladder and urethra, also have to change a bit in response, which can lead to incontinence. Changes in hormones also change how relaxed the bladder and urethra are, which may make a difference in the frequency and urgency of urination. [2]

Another huge reason for incontinence during pregnancy is pressure. Pressure could be your baby kicking your bladder, a cough or sneeze, exercise, or laughter. Anything that exerts a force on your bladder can lead to stress incontinence and may mean leaking urine. The last reason that you might develop incontinence—during pregnancy or otherwise—is a medical condition. Diabetes, overactive bladder, and urinary tract infections can all contribute to urinary incontinence, and for this reason, it is never a bad idea to talk to your care provider about your experiences. [2]

Preventing and Treating Incontinence

In a 2013 review [3], Norwegian urologists discussed the following factors that could minimize the risk of developing pregnancy-related urinary incontinence:

  • Avoid smoking before becoming pregnant and during pregnancy
  • Get pregnant at a healthy weight
  • Avoid constipation, which can put added pressure on your urethra and bladder
  • Learn about and do exercises to train your pelvic floor; kegels are one example, but there are lots of other good options.

Once you have already developed incontinence (remember: this is very normal during pregnancy!), there are a few things that you can do to attempt to treat it at home. Bladder training is one option that you can try, where you might plan to go to the bathroom at a certain interval of time—every 45 minutes, for instance—and then eventually lengthen the time between bathroom trips. You can also attempt to wait a bit past your initial urge to urinate, in order to strengthen the muscles that control the release of urine. Another option is kegels, which are exercises used to strengthen the pelvic floor. Briefly, you do this exercise by tightening just the pelvic floor muscles—not the muscles of your abdomen, buttocks, or thighs—and then consciously relaxing those same pelvic floor muscles. If you are having trouble figuring out which muscles are which, talk to your care provider. [4]

If you’ve tried the home options for treating incontinence and are still unhappy with how things are going and have spoken to your care provider about ruling out medical causes of your incontinence, speak to your care provider about your other options. They may refer you to pelvic floor physical therapy, which can help with all manner of challenges—including urinary and fecal incontinence and all manner of aches and pains—that arise both during and after pregnancy. Though incontinence is common, it is treatable, and you don’t have to suffer.

References:

  1. Everyday Health, Managing Incontinence During Pregnancy
  2. Healthline, Pregnancy Incontinence: why it happens and what to do
  3. S.L. Wesnes and G. Lose, “Preventing urinary incontinence during pregnancy and postpartum: a review,” Int Urogynecol J, 2013.
  4. WebMD, Urinary Incontinence and Pregnancy
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and daughter in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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