Pregnancy Incontinence: Everything Pregnant Women Need to Know

It’s one of the more commonly known facts for pregnant women - that you need to pee more often. The reason appears obvious: Your growing baby and uterus put pressure on your bladder, causing you to feel the urge to pee more often.

But this isn’t the entire story. Let’s get into it!

What *Normally* Happens When You Pee 

Your brain and bladder work together to control urinary function. 

The bladder stores urine until you are ready to release it, and the muscles of your pelvis hold the bladder in place. The muscles of the bladder are usually relaxed and hold urine in the bladder, and the neck of the bladder is closed. 

The urethra is the tube that carries urine from the bladder to outside the body. The sphincter muscles are closed around the urethra. When those muscles do their job, you have bladder control, and urine does not leak outside the body by accident.

When you are ready to pee, your brain lets the bladder know. This causes the bladder muscles to contract, which forces urine out through the urethra. The sphincter also opens up when the bladder contracts, allowing the urine to pass through the urethra and leave the body.

Urinary incontinence happens when urine leaks outside your control and your intention to pee.

What Causes Urinary Incontinence During Pregnancy

Involuntary loss of urine in women during pregnancy and childbirth is completely normal. So, too, is taking more trips to the bathroom when you’re pregnant, especially between 18 and 30 months. But why?

• Increased pressure on the bladder: Your growing baby puts pressure on the bladder and surrounding organs, which can lead to loss of urine or an increased need to urinate in women.
• Extra fluids in your body: When you are pregnant, you should drink between 2 and 3 liters of water per day. More fluids make it easier to leak urine.
• Hormonal changes: Hormonal changes during pregnancy cause your pelvic floor muscles to relax, which can lead to incontinence.

These changes can also lead to light bladder leaks. 

Stress Incontinence During Pregnancy

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 here. In the case of pregnancy, loss of bladder control due to stress incontinence is a common (and usually temporary) experience. A difficult vaginal delivery from a past pregnancy increases the chances of weakened pelvic floor muscles.

Stress urinary incontinence has nothing to do with emotional stress but is about physical exertion. This can be the obvious physical exertion of doing exercise. But stress incontinence can also occur during normal bodily functions and involuntary reactions like coughing, sneezing, and even laughing.

When any of those exertions cause an involuntary loss of bladder control, we’re talking about stress urinary incontinence. And the cause is generally weakened muscles that become weaker when the body is experiencing the ‘stress’ of those exertions, so it fails to hold in your pee.

UTIs and Bladder Control Problems During Pregnancy

Finally, if you have a history of urinary tract infections (UTIs) or have previously had a vaginal delivery, your risk of urinary incontinence during pregnancy is greater. 

Moreover, if you suffered from urinary incontinence before your pregnancy, it will likely continue and perhaps worsen during pregnancy.

What to Do About Urinary Incontinence During Pregnancy

Rest assured, pregnancy incontinence or light bladder leaks are common experiences during pregnancy. The good news is that experiencing incontinence is usually temporary. This doesn’t make it less inconvenient or embarrassing at the moment, but at least you know they’ll probably subside after you give birth and your pelvic muscles recover.

To help you cope here and now with pregnancy incontinence, do the following:

Try Kegel Exercises to Strengthen Your Pelvic Floor Muscles

These exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine, and rectum. They 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. Long term, these exercises can help mitigate the risk of pelvic organ prolapse.

How to Do Kegel Exercises / Strengthen Pelvic Muscles

If you’re unsure how to do pelvic floor muscle exercises (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. 

Troubleshooting Pelvic Floor Exercices: Don’ts

Like many conversations around women’s health, there can be some misconceptions about exercises for pelvic floor muscles. Here are some of the things that people regularly get wrong about Kegels:

• If you experience pain: Stop right away. This is not the kind of exercise where you should “feel the burn” or “push through the pain.” Exercising pelvic floor muscles should be completely painless; they can even be pleasurable. Make an appointment with your doctor to discuss it if you experience pain.
• Flexing butt or abdomen muscles: Your butt and abdomen should stay relaxed when you flex your pelvic floor muscles.
• Straining while doing the exercises: You should not strain in any way when doing Kegels. This can have a counterproductive result, adding pressure to the pelvic floor muscles instead of strengthening them.
• Relying too much on stopping urine mid-stream: This might be a good way to initially locate the pelvic floor muscles, but doing this regularly can disrupt your ability to urinate and have the opposite effect; weakening your pelvic floor muscles. This is because when you urinate, your brain sends a message to your bladder to loosen the muscles to allow urine to pass out of the body. By holding it in, you’re interrupting that natural process.
• Not asking for help: If you’re having trouble locating the right muscles or are unsure you’re doing Kegels right, you should absolutely ask for help from a physical therapist. Especially if you’re recovering from surgery, childbirth, or another trauma, it can be difficult to engage the right muscles. Most of us have to learn to lift weights at the gym. This is no different. So don’t leave it to guesswork; seek help!
• Stopping! If you’re doing Kegels to manage urinary incontinence or just to maintain your pelvic floor muscles, don’t stop. Incontinence may return if you stop. Stick to a daily routine.

Reduce Certain Beverages & When You Drink to Minimize Pregnancy Incontinence

You’ve probably already reduced or eliminated your caffeine and alcohol intake during pregnancy, but think about cutting back further if you’re experiencing light bladder leaks or pregnancy incontinence. Also, minimize carbonate or sugary beverages, which may aggravate the bladder.

If you experience urinary incontinence more at night, ensure you’re not drinking too much close to bedtime. While it is very important to stay hydrated and drink enough water during pregnancy, you can time it to minimize leaks or increased bathroom breaks at night.

Healthy Weight Gain Will Minimize Pressure on the Bladder and Pelvic Floor

Weight gain is a normal and healthy part of pregnancy. Work with your doctor to determine the healthy amount of weight you should gain. Additional weight may increase the pressure you’re feeling and exacerbate bladder control problems.

Try Timed Bladder Training to Control Urinary Incontinence

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 urine leakage. Over time and as your pelvic floor muscles strengthen, you can add more time between your bathroom breaks.

Wear Leakproof Underwear to Manage Pregnancy Incontinence

Leakproof incontinence 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.

Pregnant Women: When to Seek Medical Advice for Urinary Incontinence

Do mention to your doctor at your regular check-ups if you are experiencing urine leakage or urinary incontinence, just to keep them in the loop on all your pregnancy experiences. 

Beyond keeping your doctor apprised of any experience of urinary incontinence, always seek more immediate medical advice if you experience the following:

If Leaks “Gush” From Your Vagina

This could be amniotic fluid and not urine. If the flow is intermittent and small in volume, leaks are probably urine. When amniotic fluid leaks it usually “gushes” for a sustained amount of time. Any presence of white waxy or dark green substance also indicates it’s amniotic fluid. Amniotic fluid is odorless, while urine smells, well, like urine (an ammonia-like odor).

You Experience Stinging or Burning When Urinating

Urinary incontinence is one symptom of urinary tract infection (UTI). Another symptom is a stinging or burning sensation when you pee and a decreased or irregular flow of urine. If you experience this, you should visit your doctor. If you have a history of UTIs, you have greater chances of experiencing a UTI during pregnancy.

Preventing UTIs

Ways to prevent UTIs include:

• Drink plenty of water
• Urinate before and after having sex
• Wipe from front to back after you pee
• Wear breathable, natural underwear and clothing, changing your underwear daily

UTIs are treated with antibiotics for 3 to 7 days. These antibiotics are safe for your baby. However, untreated UTIs can lead to a kidney infection, which can cause early labor.

Any Unusual Vaginal Discharge

You may have more vaginal discharge than usual when you become pregnant. But it’s also important to know what’s normal and when to seek medical advice. 

Normal vaginal discharge is:

• Clear and white
• Normal or mild smell (not strong or unpleasant)
• Is sticky, slippery, or wet

Some women experience a ‘show’ in the final stages of pregnancy, which is a thicker discharge streaked with pink jelly-like material.

Contact your doctor immediately if:

• You are under 37 weeks pregnant, and vaginal discharge is bright red
• There is an unpleasant smell from the discharge
• Discharge is brown or green
• You experience itching around the vagina

Leaking Urine Causes You Distress

Hopefully, the reassurance that an occasional light bladder leak is completely normal during pregnancy helps settle your mind. However, if you’re distressed about urinary incontinence or if you continue to leak urine after making changes, do discuss it with your healthcare provider.

Outlook

If pelvic floor exercises, leakproof underwear, and timed bladder training don’t help, your doctor may explore the use of a vaginal device (a pessary). Moreover, if you have any risk factors for postpartum incontinence, you can discuss treatment options with your healthcare provider. 

In the weeks after delivery, pay heed to whether incontinence begins to subside or increases. Giving birth can contribute to incontinence after pregnancy as muscles can be injured during vaginal delivery. If this happens, do talk to your doctor.

But for most women, some loss of bladder control during pregnancy is just one of the many temporary changes your body will go through during pregnancy, and your body will begin to recover after the baby is born.

Written by Jane Flanagan — Updated on April 5, 2022.

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.