During pregnancy, many women will experience what is known as transient stress incontinence**.** This is a temporary form of incontinence caused by increased liquid in the bladder and added abdominal pressure due to being pregnant.
How does transient stress incontinence occur?
Typically, there are sphincter muscles at the base of bladder that remain closed and prevent any urine from leaking out until the appropriate signal is sent to the brain and spinal cord. These muscles are also supported and held closed by the surrounding pelvic floor muscles. During pregnancy, changes in the body cause these muscles to become overstretched, weakening bladder support. Abdominal pressure on the bladder from laughing, coughing or sneezing, as well as added weight from pregnancy can then force urine out of the bladder, causing a leak.
Fortunately, transient stress incontinence caused by pregnancy generally resolves itself within a month or two following childbirth.
But even if the leaking stops, experts note that women become predisposed to have this issue occur again later in life. So what can you do to help prevent incontinence following childbirth, and what options do you have if your bladder issues persist following childbirth?
Don’t stay silent
Experts recommend that women understand that they do not have to suffer in silence with any form of incontinence, and that talking about these issues is nothing to be embarrassed about. Physiological changes in the body can naturally cause bladder issues to occur. And with increasing recognition and research around incontinence, there are plenty of options to choose from. If you are experiencing incontinence symptoms, begin with a conversation with your physician or OB-GYN.
Understand the risks
The Urology Care Foundation reports that aside from natural changes during pregnancy, delivery and having multiple children can raise a woman’s risk of developing incontinence. It also notes that the method of delivery, whether it be vaginal or C-section surgery, does not help in reducing risk.
Women should also understand that not all leaking episodes will be the same. As your body continues to change during pregnancy, so will incontinence symptoms.
Older women who are pregnant may be more prone to incontinence than younger women during pregnancy. Lastly, any preexisting conditions such as kidney stones or Parkinson’s can contribute to urinary leakage.
Focus on overall healthStaying on top of overall health can also reduce the need for pelvic surgery later on and is key to finding treatment and relief. Dr. David Shusterman, urologist at Advanced New York Urology encourages women to get a** complete urological examination following childbirth** - which can help identify possible triggers. He also advises that patients consider weight loss if needed, and stop smoking. Women who smoke are reported to be twice as likely to experience incontinence issues than others, and losing just 8 percent of body fat can cut episodes of stress incontinence almost in half.
However, during pregnancy, maintaining optimal weight and health to support your baby should be a primary concern. If concerned about weight and weight loss, be sure to consult your doctor before making any changes.
Consider treatment and exercisesIf incontinence episodes persist during and following childbirth, there are many options for treatment that you and your doctor can discuss. For** occasional leaking**, experts recommend wearing pads or using a pelvic strengthening device/kegel exercises.
Those with morrequent episodes may also want to consider a pelvic strengthener device, or medication for muscle relaxation. Neuromodulation, a newer treatment that works in a similar way to acupuncture, may also be beneficial.
If episodes are persistent, women can be fitted for a pessary, which is inserted into the vagina and acts as bridge support for the bladder, relieving pressure. Further, there are a number of different surgeries that can be considered to help support or reposition the bladder to reduce or eliminate leaking.