Leaking Urine Postpartum? What to Do About it...

TEAM KNIX / FERTILITY PREGNANCY

It is well-known that pregnant women need to pee more often. Indeed, it’s not unusual to experience light bladder leaks during pregnancy. But what about after you’ve given birth? Postpartum urinary incontinence (incontinence after childbirth) is a reality for many women and some statistics point to 1 in 3 women experiencing light bladder leaks after childbirth.

But why does it happen and what can you do about it? Read on...

Postpartum Incontinence: What Is it?

Any involuntary bladder leaks after childbirth are known as “postpartum urinary incontinence”. But this is a broad term that covers a few different kinds of incontinence that a new mother may experience. 

Many women find they experience stress urinary incontinence, which is loss of bladder control when you:

  • Laugh
  • Sneeze
  • Cough
  • Exercise
  • Lift something heavy or bend over

Learn more about stress incontinence (SUI) here. This is the most common form of incontinence for women to experience after giving birth. In the case of pregnancy and postpartum incontinence, loss of bladder control is usually a common - and temporary - experience.

If you have an overactive bladder, you might experience urge incontinence. Urge incontinence manifests when there is a sudden and urgent need, or ‘urge’, to pee that seemingly comes out of nowhere. 

If this urgent need cannot be immediately acted upon, this feeling can lead to involuntary urine leakage of small amounts of urine. Urge incontinence may be a temporary or persistent experience depending on the cause.

Finally, it’s possible to experience mixed incontinence after childbirth. Mixed incontinence is a combination of stress and urge incontinence.

What Causes Postpartum Incontinence?

The cause of postpartum urinary incontinence may seem obvious… After all, a lot has happened ‘down there’ during childbirth. But experts are not completely clear on what part of childbirth causes postpartum incontinence. It may depend on multiple factors, including:

  • Genetics
  • Duration of labor
  • Vaginal delivery (versus C-section)
  • Delivery with forceps or vacuum delivery
  • A history of UTIs
  • Whether you’ve been pregnant before

Additional Risk Factors

  • Are overweight
  • Smoker

How Long Will Postpartum Incontinence Last?

Urinary issues related to pregnancy in women usually resolve about 6 weeks after you give birth. You should track your experience of incontinence after childbirth and chat with your doctor if the condition worsens or shows no signs of abating in that time period.

How to Prevent Postpartum Incontinence…

Prevention is often easier than the cure and while there are no hard-and-fast guarantees that you can completely avoid urine leaks after birth, here are some steps you can take to reduce your odds.

Do Kegel Exercises / Pelvic Floor Exercises

These exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum and will help you manage bladder control problems.

Good news: Kegel exercises or pelvic floor muscle exercises can be done any time, either sitting or lying down. You can even do Kegel exercises when you are eating, sitting at your desk, or when you are resting.

If you’re unsure how to do pelvic floor or Kegel exercises, your doctor or physiotherapist can help you. But basically it’s like pretending you have to urinate and then holding it. You relax and tighten the muscles that control urine flow.

One way to learn the pelvic floor muscles you should activate is to pay attention when you pee: Start to pee and then stop. You should feel the muscles in your vagina, bladder, and anus get tight and move up. These are the pelvic floor muscles. 

Gain a Healthy Amount of Weight

Because being overweight puts you at greater risk of experiencing incontinence during and after pregnancy, it is advisable to not gain excess weight during pregnancy. 

Obviously, some weight gain during pregnancy is perfectly normal, natural and healthy for you and baby. So work with your doctor to determine the right amount of weight and try to maintain a healthy diet and exercise regime (adhering of course to medical advice).

Stop Smoking

Nicotine causes the muscles of the bladder to spasm, which is why it is a risk factor for incontinence (more generally, not just pertaining to pregnancy). Obviously, there’s a whole host of medical reasons to quit smoking as well. If it’s something you’re trying to do, chat with your doctor to get the support and resources you need to do it safely and sustainably.

How to Treat Postpartum Urine Leaks

Invest in Leakproof Underwear

Leakproof underwear will offer you protection from any involuntary urine leakage and help minimize the embarrassment and inconvenience of urinary incontinence. Depending on the style, leakproof underwear can absorb up to 8tsp of liquid.

Manage Your Weight (Healthily)

If you gained a lot of weight during pregnancy, that additional weight can be a factor in experiencing urinary incontinence postpartum. That said, we’re certainly not advocating a crash diet or anything extreme (there’s no expectation from us that your body should “bounce back” immediately after pregnancy.)

Work with your healthcare provider to plan how to manage your weight. Make sure your goals are realistic and sustainable. 

Continue with Those Kegels 

So you did your Kegels during pregnancy and you’re still experiencing postpartum incontinence? Don’t give up! Maintaining a strong pelvic floor is still important and will help your body recover from childbirth. 

See a Physical Therapist / Pelvic Health Specialist

If your body went through a lot during childbirth, don’t feel you have to figure it all out alone. A physical therapist or pelvic health specialist can offer pelvic floor physical therapy to help build strength. 

They will help identify the muscles that have weakened and help you build a strong core, as well as pelvic floor. Plus, if you’ve struggled with Kegels, they’ll set you on the right path. Physical therapy can help more broadly with your recovery from childbirth, as well as address issues like incontinence (fecal or urinary).

Try Bladder Training

Bladder training involves taking bathroom breaks at regularly timed intervals. Keep a log of when you use the bathroom and make sure you’re going at regular intervals. By ensuring your bladder is emptied frequently, you minimize the chances of leakages. Over time and as your pelvic floor muscles strengthen, you can add more time between your bathroom breaks.

Avoid Food & Drink That Irritates the Bladder

You can also adjust your diet to minimize foods and beverages that may irritate the bladder. 

Foods to avoid include:

  • Sweeteners, including corn syrup, honey and artificial sweeteners
  • Spicy foods
  • Acidic foods, like citrus fruits and tomatoes

Beverages to avoid include:

  • Alcohol (alcohol is a diuretic, meaning it makes you urinate more often)
  • Caffeine
  • Carbonated beverages

Note: You should not reduce the amount of water you drink (either during or after pregnancy) thinking that this will help with incontinence. It may result in you becoming dehydrated, or increase risk of a UTI (urinary tract infection). Indeed, when you are pregnant, you should drink between 2 and 3 litres of water per day. 

When You Should Talk to Your Doctor

As you have medical check-ups before and after pregnancy, keep your doctor apprised of any experience of incontinence. They will likely reassure you that it’s highly common for women to experience some light bladder leaks during and after pregnancy.

However, if the condition persists 6 weeks after childbirth or increases rather than diminishes, do bring it up again. If Kegel exercises, leakproof underwear and timed bladder training don’t help, your doctor may want to explore more medical treatments. These may include:

  • Vaginal pessary or urinary insert
  • Botox
  • Medications
  • Hormone replacement therapy (HRT)

Surgical options for urinary incontinence may include:

  • Sling procedure
  • Injectable bulking agents
  • Retropubic colposuspension

The sling procedure is the most  common surgical procedure performed in women with stress urinary incontinence. This procedure entails the surgeon using the person's own tissue, synthetic material, or donor tissue to create a ‘sling’ or hammock that supports the urethra. Learn more about it from the Mayo Clinic.

Outlook

But for most women, some loss of bladder control during and after pregnancy is just one of the many temporary changes your body will go through during pregnancy. It may not be what you want to hear, but it can take many months for the body to fully recuperate, so be patient with yourself and your body.

Leakproof underwear will make the realities of postpartum incontinence a little easier to bear. After all, this is a special time of your life and you don’t want to be held back from bonding and enjoying your new addition.