Urinary Incontinence After Childbirth | Causes and Solutions

Updated: Nov 18

Urinary incontinence is the unintentional passing of urine, and it affects at least 7 million women in the U.S. Performing a vaginal birth can increase the chance of developing urinary incontinence after childbirth. This is referred to as postpartum incontinence.


Postpartum incontinence is a common side effect of childbirth and will usually resolve with time and healing. Pelvic floor muscles are used to support the bladder. During and after pregnancy, the body goes through changes, and hormones shift, decreasing the strength of the pelvic floor muscles.

During the birthing process, the pelvic floor muscles can be damaged, which includes the muscles and nerves that help control bladder function. This results in postpartum incontinence.


Types of Postpartum Incontinence


The two primary types of incontinence are stress and urge.


Stress incontinence occurs when stress or pressure is placed on the bladder. If a leak occurs when you laugh, run, sneeze, jump, or other occurrences that put pressure on the bladder, you have stress incontinence.


An overactive bladder causes urge incontinence. Urge incontinence is the inability to hold in your urine before reaching a restroom.


A person can have both types of urinary incontinence, which can lead to stress, anxiety, and embarrassment for many people. Almost two-thirds of women with stress incontinence will also experience urge incontinence. This is referred to as mixed incontinence.


Symptoms of Incontinence


Unintentional leakage is the primary symptom of urinary incontinence. Other symptoms that may occur:

  • Pelvic spasms

  • Enuresis (bed-wetting)

  • Frequent trips to the bathroom (well more than is typical)

The following activities induce stress incontinence:

  • Standing up

  • Bending over

  • Laughing

  • Sneezing

  • Heavy lifting

  • Exercising

  • Coughing

Urge incontinence may cause an uncontrollable urge to urinate.


Risks of Incontinence


Postpartum incontinence is more likely to occur in situations related to:

  • Bladder issues develop during pregnancy

  • Long labor times

  • Large baby expectancy

  • First baby

  • Incontinence present before giving birth

  • Difficulties during pregnancy

Those who have a cesarean delivery are less likely to experience postpartum incontinence. However tempting it may be to schedule a C-section and lower your odds, it’s not advisable to do so. It may be less likely, but a substantial number of women will still end up leaking regardless; and two decades later, women who have received C-section deliveries are still no better off than women who have delivered vaginally.


Not only that, but C-sections pose their own risks, to both mom and baby. It’s not worth the risk. Even though leaking urine may be embarrassing, it’s important to understand that this is a natural part of life, and your body is still amazing for its ability to grow and produce a baby. Take care of your body; with proper care, you can often recover from urinary incontinence over time.


Treatments to Manage Incontinence


There are many things that people can try as treatments to manage urinary incontinence after childbirth.


Pelvic Floor Muscle Exercises (Kegels)


Pelvic floor muscle exercises, also known as Kegels, are performed to help increase the strength and elasticity of your pelvic floor muscles. Before attempting these exercises, it may be best to speak with a midwife or pelvic floor physical therapist about the best time to begin.

To perform pelvic floor muscle exercises:

  • Lie down with your knees bent and legs spread apart.

  • Pretend you're attempting to prevent urine from leaking by tightening the muscles around your vagina and urethra.

  • Ensure you are not contracting your abdomen muscles by placing a hand on your lower abdomen. If you are squeezing your abs or buttocks muscles while performing these exercises, you're doing them incorrectly.

  • In five to ten seconds intervals, breathe in and out while tightening your vagina muscles. Look to complete three to four sets of ten every other day.

If done correctly, Kegels can help to minimize both types of incontinence. However, Kegels may not be enough to stop urine from leaking or spritzing alone.


Absorbent Pads

An absorbent pad will absorb the urine and prevent it from soaking into a person's clothing. Wearing an absorbent pad in your underwear may be required to capture any leaks that occur. Depending on the severity of the leak, anything from a panty liner to an adult diaper can help.


Pessaries


For persistent leakage prevention, a pessary is a treatment that involves inserting a small silicone into the vagina to support the urethra. It is placed inside the vagina after you wake up and removed before sleep at night.


Both over-the-counter and custom-made pessaries are available. Some are single-use disposable devices whereas others can be reusable for a longer time.


Electrical Stimulation Therapy


Electrical stimulation for urinary incontinence is a technique that sends a gentle electric current to contract the pelvic floor muscles.


One very effective tool for using electrical stimulation to relieve urinary incontinence is Dr. Jane's Incontinence Treatment Stimulator (ITS). It produces a mild and comfortable electric current to contract and relax the pelvic floor muscles. This, in turn, strengthens the pelvic floor muscles to help prevent urine leakage.


Vaginal Collagen Injections


Vaginal fillers are not just useful for the rejuvenation of your genitalia. To combat incontinence, collagen injections can help bulk up and strengthen the tissue around the urethra. Keep in mind that this procedure is not recommended for younger women.


Surgery


Certain procedures such as bladder sling surgery and retropubic suspension surgery are available to women who do not respond to pelvic floor physical therapy.


Bladder sling surgery is a procedure where the surgeon uses tissues from your body to construct a sling. An incision is then made where the surgeon will place the sling at the neck of the bladder.


Retropubic suspension is a surgical procedure to stop leakage by supporting the bladder and urethra. There are two major surgeries for treating this issue: Burch colposuspension and Marshall-Marchetti-Krantz (MMK) procedure.

Surgery is always a last resort. If you are thinking about retropubic suspension surgery, ensure that you prepare yourself both physically and mentally.


Can Incontinence Be Prevented?


New moms can take steps to minimize the risk of developing long-term urinary incontinence after childbirth and regain bladder control. Making crucial lifestyle changes will help relieve urinary incontinence and boost overall health.

  • Your bladder is easily irritated by the consumption of caffeine, alcohol, carbonated beverages, and spicy foods. Lessen your overall intake of products that may contain them.

  • Nicotine causes your bladder muscles to spasm. Smoking can result in the development of a chronic cough. The combination of both spasms and cough can bring about more episodes of leakage if incontinent. Save your bladder and lungs some stress and quit smoking altogether.

  • Obesity puts constant pressure on your pelvic floor muscles. Get your body in shape and your bladder under control by shedding a few extra pounds.

When To Contact a Doctor


Urinary incontinence in small amounts is common during pregnancy and after childbirth. Postpartum incontinence shouldn't last longer than a few weeks following delivery. A new mom needs only contact a physical therapist, midwife, nurse, or doctor if postpartum incontinence persists longer than six weeks following childbirth.


If urinary incontinence begins to affect your mental well-being or quality of life, it is essential to seek the help of a healthcare professional. They can help develop a plan of action to reduce the symptoms of urinary incontinence and help get life back on track.


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