Although pregnancy is one of the most wonderful and awe-inspiring times in many womens’ lives, it can lead to unfamiliar and often uncomfortable changes in the body. Urinary incontinence during pregnancy is quite common, affecting millions of women every year. Understanding how and why pregnancy incontinence happens – and what you can do to prevent or manage it – can lead to improved wellbeing and comfort.
What Is Pregnancy Incontinence?
Urinary incontinence can be defined as the bladder’s inability to hold urine, and it can come in many forms. Some people describe it as a constant feeling of needing to empty their bladders; others describe it as waking up multiple times throughout the night with the feeling of a full bladder. Though pregnancy incontinence may include some of these symptoms, the more common experience involves what is known as stress incontinence, or leaking urine when coughing, laughing, or sneezing due to pressure on the pelvic floor.
How Common Is Incontinence During Pregnancy?
In 2021, a study published in the International Urogynecology Journal looked at 407 women throughout their pregnancies and deliveries, and they found that nearly 70% experienced stress incontinence to some degree. Of those women, almost 43% reported having an incontinence episode once a week or less.
What Are the Causes of Pregnancy Incontinence?
Pregnancy incontinence can be caused by one or a combination of several different changes that occur during the gestational period. The two main causes of incontinence during pregnancy are hormonal changes and stress to the pelvic floor.
Hormonal Changes
Urinary incontinence occurs when the bladder’s sphincter – the muscle that opens during urination – is not functioning properly. During pregnancy, two hormones called relaxin and progestin act as natural muscle relaxers, which allows for some flexibility as the baby grows and during the birthing process. These hormones affect all the muscles in the body – including the bladder sphincter. As a result, some women may experience pregnancy incontinence to varying degrees.
Pelvic Floor Stress
Stress incontinence, on the other hand, occurs when the bladder’s sphincter opens during exertion or physical stress. During the third trimester of pregnancy, women’s organs shift and compress to make room for the growing baby. As the baby moves around in the uterus, it can put pressure on different organs at different times. When a pregnant woman coughs, sneezes, or laughs, the pressure from the lungs or diaphragm can cause the baby to shift, putting more pressure on the bladder and forcing the sphincter muscle partially open.
Can You Prevent Pregnancy Incontinence?
Many urologists, gynecologists, and obstetricians recommend Kegel exercises to strengthen the pelvic floor during and after pregnancy. Kegel exercises, informally known as “Kegels,” involve voluntarily contracting and relaxing the pelvic floor muscles for a few seconds multiple times throughout the day.
A group of researchers studied a group of women who either did or did not perform Kegel exercises through and just after pregnancy, and they published their findings in the Journal of Women’s Health in 2021. Six months after childbirth, about 44% of the participants were still experiencing some urinary incontinence. The women who were instructed to perform 16 Kegels twice each day after childbirth experienced far less urinary incontinence than the women who either did not perform Kegels, or who did not perform Kegels regularly.
Managing Incontinence During Pregnancy
An article published by UCLA Health found that the vast majority of women who give birth do not develop long-term incontinence. Decades worth of research has shown that organs and muscles return to their normal positions as the tissues go through their normal healing processes post-childbirth. In fact, 60% of women who experience pregnancy incontinence will see their symptoms resolve completely in the first two months after childbirth. There are five things you can do to manage incontinence during pregnancy.
1. Do Kegels
Most doctors agree that three sets of 10 Kegels daily can significantly decrease the risk and severity of pregnancy incontinence. Women who experience stress incontinence during pregnancy can also perform a Kegel when they are about to sneeze or cough, thereby limiting or even completely preventing leakage. Over time, Kegels help decrease bladder urges, as well.
2. Drink Plenty of Fluids
Though it may seem counterintuitive to continue drinking eight to 10 glasses of water a day, it is vital for pregnant women to keep themselves and their unborn babies hydrated. Cutting back on intake just to avoid bladder leaks can cause more serious health issues, including urinary tract, bladder, or kidney infections, which can make pregnancy incontinence worse.
3. Avoid Caffeine and Alcohol
The majority of pregnant women nix alcohol and significantly cut back on caffeine after their positive pregnancy tests, but these substances do not only affect the baby. Research published in 2023 in the journal Neurourology and Urodynamics showed that caffeine, carbonation, and acidic juices may all serve as bladder stimulants and irritants that can make pregnancy incontinence worse.
4. Minimize Constipation
The bowels and bladder share a confined space during pregnancy, and the bowels can actually press into the bladder during the final trimester. When the bowels are full due to constipation, they can put extra pressure on your bladder, causing additional stress and leakage. Talk to your obstetrician if you continue to experience constipation despite drinking plenty of fluids and consuming the recommended daily amount of dietary fiber – between 20 and 30 grams.
5. Use Pads and Incontinence Products
It is estimated that between 35% and 67% of all women experience some form of urinary incontinence during pregnancy, and another 15% to 45% experience it during the postpartum months, according to the International Journal of Obstetrics and Gynecology. While women who are experiencing significant incontinence despite lifestyle changes and pelvic floor exercises should visit their obstetricians or general practitioners, those who want extra comfort and peace of mind despite their occasional leaks can rely on quality protection products that protect against wetness and odor.
Pads can make urine leaks less bothersome and embarrassing because they absorb the liquid and odor, making it possible for pregnant women to go about their daily lives. Rather than using pads designed for menstruation, be sure to choose a product that is specifically made to absorb urine leaks, and change it frequently to avoid irritation.
Despite their best efforts at prevention and management, many women will continue to experience some form of incontinence during pregnancy. Fortunately, high-quality incontinence products make it possible to go on living a normal life, day and night, without the fear of embarrassment or shame.
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Pregnancy can be a beautiful time in a women's life, however, incontinence can be common throughout this period. Take control of pregnancy incontinence with UnderX today!
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