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Incontinence During Pregnancy

Incontinence During Pregnancy

Pregnancy is an exciting time for many women - it means that before you know it, you will have an adorable baby in your arms. You might look forward to little laughs, teaching your baby first words, and witnessing many other milestones. 


Even though this is a happy time in life, it isn’t always the most glamorous. Growing a tiny human is hard work - you will experience many changes both in your physical appearance and your bodily functions: cue swollen feet, shortness of breath, and even urinary incontinence. 


That’s right - you may lose control of your bladder. Buckle in and get ready, because sometime soon, every laugh, sneeze, or cough might result in a leak down under. Keep reading for answers to many popular questions about pregnancy incontinence, how common it is, how to prevent and manage it, and when to call a doctor.


In this article:

What Is Pregnancy Incontinence?

Pregnancy incontinence is a fancy word for loss of control of your bladder, or leaking urine. When your body makes urine, it starts in your kidneys. Then, it is stored in the bladder. When you feel the urge to pee, your bladder muscles tighten and usher urine through a small tube called the urethra. Simultaneously, the muscles around your urethra relax, allowing the urine to pass through

Pregnancy Incontinence and Your Urinary System

Pregnancy incontinence rears its ugly head when this internal system doesn’t do its job correctly. In short, when the bladder muscles tighten and force urine through the urethra, the muscles are not strong enough to keep the urethra shut. Pregnancy incontinence can also happen as a result of pressure brought on by sneezing, laughing, or coughing. This leakage can occur in small bursts or large amounts at a time. 


What Causes Incontinence During Pregnancy?

A wide range of different factors causes incontinence during pregnancy. These factors include uterine size, your baby’s position, hormonal changes, and even your weight. Get your popcorn ready, because it’s about to get interesting!


Uterine Size 

In early pregnancy, incontinence is often caused by your uterus. As your uterus grows to accommodate your growing baby, more pressure is placed on your bladder and the surrounding muscles. The stress placed on your bladder as a result of these changes irritates the area, bringing on that leaky bladder that you have come to (probably) hate.


Baby’s Position

Later on in your pregnancy, your growing baby is the primary source of urinary incontinence. As you get closer and closer to labor, your baby begins to descend into your birth canal. This means it’s almost time to meet your new little bundle of joy! 


However, over time, the stress this puts on your pelvic floor muscles causes urinary incontinence. The stress caused by your baby weakens the muscles surrounding your bladder and urinary tract. This weakening of muscles causes your urinary system to decline as a result, causing urinary incontinence.


Hormonal Changes

Urinary incontinence can also be brought on by hormonal changes that occur during pregnancy. Changes in the levels of relaxin and progesterone may be responsible for incontinence. 


The relaxin in your system is responsible for controlling urinary continence. During pregnancy, this hormone has been shown to facilitate tissue growth surrounding your urinary tract, which causes added pressure to the area. The tension adds extra stress to your bladder, which results in unexpected leaks throughout the day. 


Progesterone plays a massive part in relaxing muscles contained in the urinary tract system. The relaxation of these smooth muscles results in reduces the bladder and urethral tone. Consequently, it is more difficult or impossible for you to control your urinary urges.


Maternal BMI and Weight Gain

Maternal weight is also a known factor in pregnancy incontinence. This can be due to obesity, or can be brought on by the rapid weight gain pregnancy is known for. 


Obesity (or a high BMI) before pregnancy is a known risk factor for pregnancy incontinence. Luckily, this is one of the most easily modifiable risk factors for this condition. 


Maternal weight gain during pregnancy has definite risks for causing incontinence. This is just another example of how extra pressure on your uterine area causes this type of problem. As you gain weight, blood flow to your urinary tract is significantly reduced, leading to incontinence.


How Common Is Incontinence During Pregnancy?

Urinary incontinence is no stranger to pregnant women. As many as four in ten women have been shown to struggle with this issue at some point in their pregnancy. In short, - you are not alone. You can take comfort in knowing that someone out there feels your pain (and can probably relate to your frustration, too).


Pregnancy incontinence by Number of Babies

Studies show that about 31% of those bearing singletons and 42% of those bearing twins reported dealing with leaky faucets at one time or another. Urinary incontinence is twice as likely to occur in women than men. This is due in part to the permanent changes that your body sustains after pregnancy.


When Does Incontinence Normally Begin During Pregnancy?

Incontinence in pregnancy can begin as early as the very first trimester. Each pregnancy and woman is different, but there is some data showing a correlation between incontinence and gestational age.


Pregnancy Incontinence by Trimester

There is no doubt that pregnancy incontinence seems to get worse with each passing day, but is there scientific evidence to back this up? Here’s the good news: you’re not crazy. The bad news is, every trimester you begin is bound to be worse than the last one concerning incontinence.


One study found a link between urinary incontinence and weeks of gestation. The creators of this study found the highest number of instances of urinary incontinence in the third trimester, followed by the second trimester, then the first. 


Statistically, 13%-19% of women report incontinence in the first trimester. The second trimester was similar at 19.2%. The third trimester, however, showed a significant increase in reports, coming in at 37.5%. 


The increase in prevalence concerning fetal age is likely due to the growing size of the baby and the womb. As things get bigger and push outward and downward, all the extra pressure on your urinary system brings on incontinence.


Can I Prevent Urinary Incontinence During Pregnancy?

You cannot always prevent urinary incontinence since it partially has to do with your hormones and your growing baby. There are, however, some things that you have control over. You don’t have to let a tiny dictator rule your entire life for the next few months. 


Controlling Your Weight

Ensuring that you are at a healthy weight before you start trying to get pregnant is always a good idea. This is especially true if you want to ward off incontinence during pregnancy. Since an elevated BMI at least partially contributes to your likelihood to become incontinent during pregnancy, you need to be paying close attention to that in the months leading up to that positive test. 


Pelvic Floor Exercises

Performing pelvic floor exercises such as Kegels can make a big difference when it comes to urinary incontinence. These exercises work to strengthen the muscles that are responsible for causing incontinence. As a bonus, these types of activities can also aid in having a more comfortable delivery when it does come time to push, and it can help you to recover quickly after the fact, as well.


Eat Foods High in Fiber 

Eating a diet high in fiber reduces your chances of becoming constipated, which can put pressure on your bladder and cause urinary incontinence. Doing everything you can to prevent this extra pressure from irritating your bladder will make a world of difference in combating incontinence issues.


How To Manage Urinary Incontinence While Pregnant

Managing urinary incontinence during pregnancy can be annoying and off-putting at times. Your hormones are raging, your back and feet likely hurt, and you live in constant fear of your next cough or sneeze. (OK, so that’s probably a bit dramatic, but it’s the hormones talking!) Here are a few things you can do to manage your urinary issues while pregnant:


Plan Ahead

Have a change of clothes ready for any unexpected accidents. The last thing you want is to have a little (or big) accident in the middle of your grocery shopping. Having an alternate outfit on hand will save you any potential embarrassment in the checkout line. 


Invest in Super Absorbent Pads

Part of coping with urinary incontinence means keeping products on hand to keep you fresh and dry. Start each day with a fresh absorbent pad and change it out every few hours. This will help control leaks and prevent any risk of infection stemming from wearing the product too long.


Avoid Caffeine

Caffeine has properties that work to irritate your bladder and make incontinence worse. Additionally, excessive caffeine use can cause harm to your baby. Try replacing any caffeine-heavy drinks such as coffees and teas with water or fruit teas for the best results.


Will Incontinence Stop After Giving Birth?

The majority of women will see a complete resolution of incontinence problems following the birth of their babies. In most cases, once the pelvic floor muscles have had a chance to relax and recover from the stressors brought on by pregnancy, the problem disappears. You can expect a full recovery within six weeks of the birth of your baby.


When To Call A Doctor

During pregnancy, pay close attention to any symptoms that accompany your incontinence. If you experience any itching, burning, or foul smell, that could be a sign that other factors are at play. Some issues related to these symptoms can pass problems along to your baby in childbirth. You should always err on the side of caution and have them checked out by a licensed professional.


Once you have your baby, continue to monitor any leaking that might occur. If your problems persist longer than six weeks or get progressively worse, contact your doctor or obstetrician. This could be a sign of a more severe condition that requires physical therapy or surgery to resolve.


Office On Women's Health, Urinary incontinence, January 2019.

National Institutes of Health, National Library of Medicine, Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment, February 2013.

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  • Mary Dean
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