Urinary Incontinence After Pregnancy

Maybe it happens like this: You bring your child to a friend’s house for a playdate, get too close to the family cat, and — achoo! — a little bit of urine comes out. First, don’t worry. Urinary incontinence after pregnancy is common. In fact, nearly 50% of women report having issues of urinary control after pregnancy. Second, this doesn’t mean urinary incontinence has to be your new normal. Below are some facts and advice for keeping you confident and dry.

Why you leak:

Urinary incontinence is usually caused by damage to the muscles and nerves that surround your bladder. The stress of pregnancy and delivery can overstretch these nerves, ligaments, and pelvic muscles, resulting in a loss of urinary control that’s known as stress incontinence. It’s common to experience stress incontinence when you sneeze, cough, laugh, or exercise after pregnancy.

Pelvic floor exercises:

Injuries from pregnancy and delivery can make it harder to squeeze the muscles at the bottom of your bladder. Kegels are a type of exercise that help keep these muscles strong during pregnancy, and help restore them after delivery. The vaginal muscles you use to stop the flow of urine are your Kegel muscles. To perform a Kegel:

• Start with your abdominal, thigh, and buttocks muscles relaxed.
• Tighten your pelvic-floor muscles.
• Hold for 10 seconds.
• Slowly release your pelvic muscles.
• Repeat this pattern of holding and releasing 20 times, 5 times a day.

Bladder training:

Bladder training exercises can be helpful in controlling incontinence. One exercise involves keeping a chart of the times you urinate and the times you experience incontinence. Using this chart, you can make timely trips to the bathroom to avoid leaks, then gradually begin lengthening the time between bathroom trips to reestablish a more regular schedule.

Pessary:

A pessary is a small silicone ring that you place inside your vagina in the morning and remove at night. These devices help block the urethra, support the bladder neck, and strengthen pelvic muscles. For some women, the use of a pessary can be helpful for controlling leaks while exercising or playing sports.

Surgery:

Although many cases of urinary incontinence resolve themselves within the first year, five years after delivery, more than 1 out of 10 women still report having leakage they describe as socially bothersome. That’s why BIDMC has experienced OB/GYN surgeons who specialize in urinary incontinence and can help come up with a personalized plan that’s right for you. So if urinary incontinence is intruding with your daily life, know that we’re here to help.