Postpartum urinary incontinence
Reviewed by Dr. Jennifer Lincoln
Even after healing from delivery, one symptom that tends to linger for many people who give birth vaginally is urinary incontinence. In fact, an estimated 33 percent of women experience urinary incontinence during the first three months after birth.1
33%
33 percent of women experience urinary incontinence during the first three months after birth.2
What it is
Urinary incontinence is an inability to effectively control the release of urine from the bladder. After giving birth, urinary incontinence can lead to involuntary leaking when exercising (such as walking, running, or jumping) or exerting your abdomen to perform a bodily function (such as laughing, sneezing, or coughing). You may also experience leaking immediately after emptying your bladder.
Why it happens
As your baby grows inside you, the enlarging uterus puts pressure on the bladder below it. This extra pressure makes it easy for any additional stress on the bladder to push out urine. Then, during delivery, the muscles and ligaments supporting the bladder are stretched and weakened. This can leave you feeling as though you have less control over them when you have to “go”—and even when you don’t. Pregnancy hormones, which don’t simply disappear when you enter the postpartum phase, may also contribute to a weaker bladder.
When it happens
Some people experience urinary incontinence during pregnancy, especially in the second and third trimesters, when the growing fetus and expanding uterus start to place more weight on the bladder and pelvic muscles. For others, it can take several weeks, or even months, after delivery for the symptoms associated with urinary incontinence to appear. And it does not always go away as fast as it appears. Some experience the effects of urinary incontinence years after giving birth.3
“Don't be surprised if incontinence symptoms show up weeks or months later,” says Dr. Jennifer Lincoln, an obstetrician-gynecologist. “We have treatments to help.”
Who’s most likely to experience it
While women who give birth vaginally are about twice as likely to experience urinary incontinence as women who give birth via C-section4, pregnancy itself is a risk factor, so it can happen regardless of what type of delivery you have. In a study of more than 12,000 women, 31 percent reported urinary incontinence six months after delivery5. At one year, however, the symptoms tend to resolve, with 22 percent of women having persistent but not majorly disruptive symptoms.6
11-23%
Between 11 and 23 percent of women have persistent incontinence symptoms one year after delivery.
What to do about it
If you’re experiencing urinary incontinence, there are plenty of at-home remedies that may help. Here are a couple to consider:
- Kegel exercises: Named after gynecologist Arnold Kegel in the late 1940s, these pelvic floor exercises have become one of the most tried-and-true methods of treating (and preventing) urinary incontinence. They involve squeezing your pelvic floor muscles the way you would to stop peeing midflow. You can practice by squeezing, holding the squeeze for 10 seconds, and then releasing, and repeating 10 times a day. Many people do Kegels incorrectly, which can delay treatment, so ideally you’ll have an evaluation with your OB-GYN or a pelvic-floor physical therapist.
- Incontinence pads: For times you know that you are going to be more active, consider wearing incontinence pads, which are often thinner and more comfortable than menstrual pads.
- Intravaginal inserts: Poise Impressa is a disposable intravaginal insert that works to cut down on incontinence episodes by supporting the bladder.7 It, as well as regular tampons, may be used after six weeks postpartum.
When to get help
Ask for a referral from your health care provider for a pelvic-floor physical therapist so that you can incorporate specialized strengthening exercises before symptoms of urinary incontinence even appear—and if or when they do appear. If you’re still experiencing symptoms several months after giving birth, consider making an appointment with your OB-GYN or primary care provider to discuss other options. Surgery for incontinence is generally reserved for after you have finished childbearing.
References
1 https://pubmed.ncbi.nlm.nih.gov/21050146/
2 https://pubmed.ncbi.nlm.nih.gov/21050146/
3 https://www.sciencedaily.com/releases/2012/03/120325102613.htm
4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009182/
5 https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.2008.02107.x
6 https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.0001-6349.2004.00431.x#:~:text=One%20year%20after%20the%20birth,95%25%202.9%E2%80%9348.1).
7 https://www.poise.com/en-us/products/impressa/introduction
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