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Incontinence During Pregnancy: The What, Why, and How

Incontinence During Pregnancy: The What, Why, and How
Shweta Chaubey

5 Key Takeaways

  • Incontinence is a common problem, affecting more than 50% of pregnant women. Stress urinary incontinence (SUI), which occurs when you cough or sneeze, is the most common type.
  • The growing baby puts pressure on the bladder, causing urine leakage. Hormonal changes can also cause the muscles in the pelvic area to weaken and contribute to leakage.
  • Kegel exercises, weight management, and lifestyle changes can often improve control. Alternative options include electrical stimulation therapy, medication, and surgery in severe cases.
  • If you are experiencing incontinence, it is important to talk to your doctor. Early diagnosis and intervention can help prevent long-term complications and improve your quality of life.
  • While incontinence products can provide temporary relief, it's important to address the underlying cause for long-term improvement.

 

Incontinence and pregnancy are often juxtaposed. That is because pregnancy can sometimes lead to or aggravate urinary incontinence. Here is what incontinence during pregnancy is and how to manage it.

What is incontinence during pregnancy?

Urinary incontinence is a condition in which you face difficulty controlling your bladder. If you suffer from incontinence, you may feel a sudden urge to urinate, or you may experience urine leakage between bathroom visits. Additionally, you may need to visit the toilet more frequently than usual. Bladder control issues can occur due to various reasons, such as pregnancy and delivery.

But the good news is that incontinence during pregnancy is often temporary, and things typically return to normal a few months after your baby is born or the pregnancy is terminated.

What is the most common type of incontinence in pregnancy?

There are two common types, namely, stress urinary incontinence (SUI) and urge urinary incontinence (UUI).

Stress urinary incontinence is the most common type that can develop during pregnancy. With SUI, you may experience dribbling or pee leakage when you:

  • Cough
  • Sneeze
  • Laugh
  • Indulge in basic activities such as walking

Urge incontinence is a condition that occurs when the muscles in your bladder contract involuntarily, resulting in an uncontrollable urge to urinate. It can cause you to rush to the bathroom only to find that you have leaked urine before reaching the toilet.

Is it common to experience leakage during pregnancy?

Approximately 54.3 % of women experience bladder control problems during pregnancy. It can most commonly develop during the third trimester when the fetus is heaviest and places the most pressure on your bladder; however, it suggests incontinence can happen at any stage. Additionally, it is also common to experience bladder control problems after giving birth, especially if it is a vaginal delivery.

What are the signs of pregnancy incontinence?

Many women have experienced urine leakage unintentionally, commonly known as a dribble, at some point in their lives. However, during pregnancy, these accidents can become more frequent. Changes in bladder control may become noticeable as early as the first trimester, and the probability of losing control over the bladder increases as pregnancy progresses.

Signs and symptoms include:

Causes for bladder control loss during pregnancy and after childbirth

During pregnancy, your uterus is positioned behind the bladder. As the fetus grows inside your uterus, it can exert pressure on your bladder, making it difficult to hold urine. However, due to the increased production of progesterone, these muscles become more flexible and allow your body to adjust to the growing fetus and eventually deliver the baby when the time comes. There is a high chance of it leading to bladder control loss. Additionally, weak pelvic floor muscles and vaginal deliveries can also make it difficult to control the urge to urinate.

Other causes include -

  • Pelvic nerve damage: The nerves controlling bladder function can be damaged during vaginal delivery.
  • Injury during delivery: Delivery with forceps can sometimes cause damage to the pelvic floor and anal sphincter muscles.
  • Injury because of prolonged pushing: Pushing for an extended period during vaginal delivery could damage the pelvic nerves.
  • Pelvic organ prolapse (POP): Pregnancy can weaken the pelvic muscles to the point where they cannot support your organs. This can lead to the dropping or sagging of the bladder (cystocele), which in turn can cause incontinence problems.

Risk factors for incontinence during pregnancy

If you had bladder control issues before pregnancy, they are likely to persist or worsen during pregnancy. Conditions that affect the bladder, such as recurring urinary tract infections (UTIs), can also lead to bladder control problems. Other risk factors include:

  • Obesity or being overweight

A BMI (body mass index) greater than 25 increases the risk of urinary incontinence (UI). Moreover, if the BMI is greater than 30, the risk of UI is more than doubled. In some cases, losing weight can reverse incontinence issues. Therefore, it is recommended to work with a healthcare provider to achieve a healthy weight that suits your body.

  • Age

Some studies suggest that women who give birth for the first time after the age of 30 are more likely to experience stress urinary incontinence (SUI) than those who are younger than 30. Vaginal deliveries are also more likely to cause incontinence issues and increase the risk of pelvic organ prolapse (POP) after pregnancy, as compared to delivering a baby via cesarean section.

  • Episiotomies

It is a surgical procedure where a small incision is made by the surgeon in the tissue beneath the vaginal opening during childbirth. The purpose of this procedure is to facilitate the baby's exit. Earlier, doctors believed that this procedure was helpful in reducing risks such as urinary incontinence and making deliveries easier. However, recent studies have shown that the procedure might, in fact, weaken the pelvic floor muscles.

  • Large babies

Babies weighing more than 9 pounds at birth may increase the risk of nerve damage during delivery.

  • Diet and lifestyle

Certain foods and drinks can irritate your bladder and increase the likelihood of urge urinary incontinence (UUI). Drinking beverages containing caffeine, such as coffee, alcohol, and carbonated drinks, can cause your bladder to contract, resulting in a sudden urge to pee. Spicy or acidic foods can also irritate the bladder. Although the evidence is not entirely consistent, some studies suggest a link between smoking and an increased risk of urinary incontinence.

Alternative treatments to manage incontinence during pregnancy

Your doctor may recommend alternative treatment options, such as:

  • Electrical stimulation therapy

It is a non-invasive and effective treatment option that can help strengthen and rehabilitate weak pelvic floor muscles. This therapy involves the use of a small, battery-operated device that delivers low-frequency electrical currents to the pelvic muscles, causing them to contract and relax. Electrical stimulation is often used with Kegel exercises, which can improve the strength and tone of the pelvic floor muscles. This therapy is a safe and painless way to address pelvic floor dysfunction. It can be a beneficial treatment option for individuals experiencing urinary incontinence, fecal incontinence, or other pelvic floor-related issues.

  • Medications

Some medicines can be used to treat a type of bladder problem called urgency urinary incontinence (UUI). This problem causes you to feel like you need to go to the toilet suddenly, and sometimes, you might not be able to hold the urine in and leak. If you've tried things like going to the bathroom at regular times and avoiding drinks that might irritate your bladder, but it hasn't helped, then medication might be an option. These medicines can make your bladder hold more urine before you need to go to the toilet, which can help you to control the problem better.

  • Pessary

It is a small and flexible plastic device designed to support the vagina walls. It can be conveniently removed, replaced, and cleaned at home, making it a popular option for women who are looking for a non-surgical method of managing pelvic organ prolapse or urinary incontinence. The pessary is inserted into the vagina, where it helps to maintain the proper positioning of the organs and prevent them from protruding. It is available in various shapes and sizes, and your doctor can help you choose the right one based on your individual needs.

 
  • Surgical Procedures

There are several surgical procedures available for the treatment of stress urinary incontinence that do not respond to conservative measures. One of the most common and effective surgeries involves the insertion of a synthetic mesh sling between the vagina and the middle portion of the urethra. This sling supports the urethra like a hammock and helps control urine leakage during activities such as coughing, sneezing, laughing, and exercising. Other effective surgeries for SUI that do not involve mesh include the Burch Colpo suspension and the traditional pubovaginal sling with graft material procured from the patient's own body. For patients who cannot undergo surgery, the urethral bulking injection is an office procedure that may help relieve symptoms.

  • Incontinence Products

These products are effective in managing leaks and preventing skin irritation. Some of the most sought-after products are incontinence pads or underwear, booster pads, diapers, and underpads. However, it's important to note that these products are only a temporary solution. To improve urinary control in the long term, it's essential to address the underlying issue, such as weak pelvic floor muscles.

 
  • Kegel Exercises

Engaging in pelvic floor exercises during pregnancy can significantly improve muscle strength, potentially leading to long-term improvements in urinary control. Kegel exercisers can also help with pelvic floor training.

 
  • Weight loss

Excess body weight puts pressure on the bladder, so losing even 10% of your weight can significantly help with urinary incontinence. If you are pregnant or have recently given birth, working with your doctor to manage your weight gain can help relieve the pressure on your bladder and pelvic floor.

  • Quit Smoking

Smoking can lead to bladder irritation and chronic coughing, which increases the risk of urinary incontinence. Therefore, quitting smoking can be beneficial for reducing the risk.

When to talk to your doctor?

If you experience urinary incontinence during or after pregnancy, know that you are not alone. It would be best if you considered talking to your doctor immediately.

Reference:

 

Disclaimer: All content found on our website, including images, videos, infographics, and text were created solely for informational purposes. Our reviewed content should never be used for the purpose of diagnosis or treatment of any medical conditions. Content shared on our websites is not meant to be used as a substitute for advice from a certified medical professional. Reliance on the information provided on our website as a basis for patient treatment is solely at your own risk. We urge all our customers to always consult a physician or a certified medical professional before trying or using a new medical product.

 


HPFY Shweta Chaubey

Shweta Chaubey

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Shweta Chaubey, has been a Health Products For You contributor since 2021. An advocate-turned-writer, her desire to create meaningful and positive content has brought her to HPFY and what better than writing ...

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