Female Bladder Leakage: Solutions to Get Control | UCLA Obstetrics & Gynecology
How to Manage Pregnancy Incontinence
Incontinence is common during pregnancy, but it can be managed with the right habits. Find out how to keep incontinence in check when you're expecting.
By Marie Suszynski
Medically Reviewed by Rosalyn Carson-DeWitt, MD
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Urinary incontinence affects some 10-13 million Americans — and the condition is twice as common in women. Women are more likely to have bladder control issues, largely because of the changes the body experiences during pregnancy and childbirth. According to the National Association for Continence, 63 percent of stress-incontinent women say their symptoms began during or after pregnancy. In one study, most of the 500 otherwise healthy participants experienced urinary incontinence at some point from the first through the third trimester.
“I would say virtually all pregnant women experience some type of incontinence,” says Anthony Atala, MD, a spokesman for the American Urological Association and director of the Institute for Regenerative Medicine at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.
But incontinence problems don’t have to rule your life during pregnancy.
Why Pregnancy Incontinence Occurs
First, understand the urination process. You’re able to urinate when the muscles around your urethra relax, which allows urine to flow from your bladder out of your body. When you’re finished urinating, the muscles around your urethra contract, holding off any urine flow until you’re ready to empty your bladder again.
Pregnancy can interfere with the normal way your urethra relaxes and contracts. Hormone changes during pregnancy and added pressure on the bladder from your uterus can cause stress incontinence, Dr. Atala says. When you have stress incontinence, you may urinate when you sneeze, cough, or laugh. Walking, running, or exercising can also cause leakage.
Researchers have also discovered that women who have a family history of incontinence, have a higher body mass index, gain more than the recommended amount of weight during pregnancy, and are over 35 when they get pregnant also have a higher risk of experiencing incontinence.
How to Avoid Pregnancy Incontinence
Urinary incontinence doesn’t have to make your life miserable when you’re pregnant. Here’s what to do to avoid leakage:
Schedule your bathroom breaks.There’s no way around it: When you’re pregnant, you’re going to have to excuse yourself to use the lady’s room more often. Being more cognizant of that will help you avoid leakage. Atala suggests planning to use the bathroom at least every two hours. That may mean scheduling bathroom breaks into your day so you don’t get caught with a bladder that’s too full when you can’t get to a restroom.
Practice Kegels.Kegel exercises help to strengthen the pelvic floor and help you avoid leakage, but you need to practice in order to do them properly, Atala says. If you’ve never done a Kegel before, start by stopping the flow of urine the next time you urinate. The contraction of those muscles is how you do a Kegel, and you can do Kegel exercises any time throughout the day, whether your bladder is full or empty.
Simply contract the same muscles you would to stop the flow of urine, hold the contraction for a count of 10, and then release. The American Congress of Obstetricians and Gynecologists suggests doing Kegel exercises 10 to 20 times in a row two or three times a day.
Kegel exercises really do help with incontinence. In a review of studies, researchers found that women who practiced pelvic floor muscle training when they were pregnant with their first baby prevented leakage later in pregnancy and after giving birth. Kegel exercises also helped women who had persistent incontinence problems after giving birth. Keep in mind that it takes about four to eight weeks of doing them regularly before you’ll see results, Atala says.
Watch the weight gain.Studies show that women who weigh more when they get pregnant or who gain an excessive amount of weight during pregnancy are more likely to experience urinary incontinence.
Incontinence: Will It Continue After Pregnancy?
Pregnancy and having a vaginal delivery can stretch the muscles that support the pelvis, making them weaker. As a result, you may leak urine or have trouble urinating even after you’ve given birth.
In a recent study of pregnant women, researchers found that 62 percent had incontinence during the pregnancy. And 50 percent continued to have problems with leaking urine after childbirth. Women who didn’t have problems with incontinence during pregnancy had a lower risk of postpartum incontinence compared to women who experienced incontinence at any point during their pregnancy.
An Unspoken Epidemic?
Unfortunately, many women with incontinence don’t tell their doctors. Some experts suggest this may be because women don't consider just a few drops of leakage anything to worry about, or they may feel embarrassed to discuss incontinence with their doctor.
But no amount of urinary incontinence needs to be tolerated. If urinary incontinence becomes a problem during your pregnancy or doesn’t go away after pregnancy, be sure to tell your doctor so you can be treated for it. In the meantime, take comfort in knowing that there are strategies to minimize the risk of those embarrassing and uncomfortable leaks from occurring in the first place.
Video: How To Do Kegel Exercises For Bladder Control
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