What Are The Risk Factors For Pregnancy Incontinence
When youre pregnant, pelvic floor muscles are working overtime. That said, most women who are carrying a child are at risk for some form of pregnancy incontinence. Women who have had an overactive bladder or urgency incontinence prior to pregnancy will most likely have symptoms that continue or worsen during pregnancy. Other risk factors include:
Bladder Control During Pregnancy
Aside from a growing belly, you may notice other changes in your body now that you are pregnant. One thing you may notice is the loss of urine when you are not trying to urinate. Loss of bladder control, also called incontinence, is common during pregnancy and after childbirth. Needing to run to the bathroom often or leaking urine can make you feel embarrassed. Do not feel shy about asking for physical therapy for incontinence. They can help you understand and manage bladder control, and make sure there are not other conditions causing your incontinence. Here is some information to help you learn more.
HOW DOES THE BLADDER WORK?Urine is stored in your bladder, which is an organ located in the pelvis. The muscles of the pelvis help keep your bladder in place. When you urinate, urine travels from your bladder and out of your body through a tube called the urethra. Ring-like muscles keep the urethra closed so urine does not pass until you are ready to urinate. Muscles at the end of the urethra and in the pelvic floor also help to hold back urine.
HOW CAN BEING PREGNANT CAUSE BLADDER CONTROL PROBLEMS?The weight of a baby in your belly and the act of giving birth will put pressure on your bladder and may cause your pelvic muscles to stretch and weaken. This causes your bladder to sag, and your urethra to stretch. Nerves can also be damaged. It is this damage to muscles and nerves that can cause bladder control problems to persist.
What Causes Urinary Incontinence During Pregnancy
Hormonal changes, especially fluctuating levels of relaxin and progesterone , are mainly to blame.
Risks for incontinence during pregnancy increase if you have a history of urinary tract infections, you previously delivered vaginally, you’re older or you weigh more .
If you were bothered by leaks before getting pregnant, youll probably experience even these days. Unintended leakage can happen anytime but especially when you laugh, sneeze or cough.
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Incontinence Can Happen To Any Pregnant Woman
Whether you have early pregnancy incontinence or issues with bladder control closer to your delivery date, you might feel ashamed or embarrassed. Know that this is not your fault, and you should not feel bad about yourself.
Incontinence during pregnancy can happen to any woman, regardless of fitness level, weight or body type.
For almost all women, the incontinence will go away after childbirth. This happens once the pregnancy hormones are out of your body and the uterus goes back to its normal size. If you have concerns about incontinence or bladder control problems during pregnancy or after giving birth, contact All About Women today.
How Does Urinary Incontinence Happen
Normally the bladder muscles tighten when you need to urinate if you have to hold it, the sphincter muscles close to prevent leakage. When youre ready to urinate, the bladder forces urine out of the urethra, and the sphincter muscles relax, releasing urine out of the body.
Incontinence happens when the bladder muscles tighten suddenly and the sphincter muscles are unable to shut the urethra.
This situation is often a symptom of another condition. Weight, constipation, nerve damage, infection, and diet can all contribute to urinary incontinence. And, of course, pregnancy.
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What Causes Urinary Incontinence After Pregnancy
It may surprise you to learn that it doesnt matter what type of delivery you have – women who have given birth have much higher rates of post-pregnancy stress incontinence than those who have never had a baby. Simply explained, giving birth can contribute to incontinence after pregnancy. The American Congress of Obstetricians and Gynecologists has found that cesarean delivery reduces incontinence during the first year, but benefits are diminished two to five years after delivery. A normal labor and vaginal delivery can weaken the pelvic floor muscles and damage the nerves that control the bladder. A long labor and prolonged pushing can increase the likelihood of immediate pelvic floor muscle weakness following delivery. Additionally, a uterus shrinks in the weeks following delivery and as it sits directly on the bladder, compression can make it more difficult to control the flow of urine. Loss of bladder control is also caused by pelvic organ prolapse that can occur after childbirth. In this case, the pelvic muscles stretch and become weaker during pregnancy and vaginal delivery. If the muscles do not provide enough support, the bladder may move down or sag, causing mobility of the urethra, leading to incontinence with increased abdominal pressure.
How Can You Improve Postpartum Urinary Incontinence
Follow these tips to help with those leaks after childbirth:
- Do your Kegels. You’ve heard it before, but Kegel exercises are one of the best ways to strengthen your pelvic floor both during pregnancy and postpartum. Try to work up to three sets of 10 Kegel exercises a day, holding each squeeze for 10 seconds while standing.
- Train your bladder.Urinate every 30 minutes before you have the urge, in other words and then try to extend the time between bathroom trips each day. Over time, bladder training may help you work up to what’s considered more normal urination intervals, every three to four hours during the day and four to eight hours at night.
- Increase your fiber intake. This may help you avoid constipation after pregnancy, so full bowels don’t put added pressure on your bladder.
- Drink enough fluids. Although you should continue drinking at least eight glasses of fluids every day , you may find it helpful to limit fluid intake around bedtime if you experience incontinence during the night.
- Avoid coffee, citrus, tomatoes, soft drinks and alcohol. These beverages can irritate your bladder and make urine harder to control.
- Invest in postpartum pads. Pads can help absorb leaking urine .
- Maintain a healthy weight. Extra pounds can put added pressure on your bladder.
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Behind Postpregnancy Problems With Oab
During your pregnancy, you may have developed some minor issues with incontinence, which makes sense given that your growing baby placed more pressure on your urinary tract, namely on your bladder and on your bladder sphincter.
In many cases, these incontinence problems resolve themselves shortly after childbirth, but many women are left with ongoing OAB, which may be caused by:
- A weakened pelvic floor
To put some numbers to the problem, at least 40% of women in the United States have OAB, mainly due to pregnancy and menopause.
Common Causes Of Incontinence During Pregnancy
As the bladder fills with urine, it relaxes. Strong sphincter muscles keep it closed. Nerves send impulses to those muscles when the sphincter needs to relax, which allows the bladder to empty. When you’re pregnant, changes in your hormones further increase the relaxation of your muscles. Pressure from the growing fetus puts stress on the same muscles. For some new moms, the incontinence continues for a few weeks after delivery.
Constipation during pregnancy may also cause incontinence. The fullness of the colon puts more pressure on your bladder.
If your birth required the use of forceps, you’re at a higher risk of incontinence after delivery. Forceps can damage the muscles and nerves of the bladder’s sphincter.
Prolonged pushing at delivery may also cause incontinence after delivering your baby. This is also related to the nerve and muscle damage, which takes a few weeks to heal. If you develop pelvic organ prolapse after delivery, you also have a higher risk of temporary incontinence after birth.
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Take A Virtual Tour Of Our Labor & Delivery Suites
Before your big day arrives, get a preview of the accommodations for new moms at UT Southwestern’s Clements University Hospital. From the chef-prepared meals to the roomy, high-tech labor and delivery suites, we want to make sure that you, your baby, and your family have the opportunity to bond in a safe and soothing environment.
What Causes Incontinence After Pregnancy And Childbirth
Bladder control problems after childbirth will often improve in the first six months as your body heals. Until then, you may feel a bit baffled by this new reality. Weâre here to help you make sense of it all.
Here are some factors that may add to your risk of experiencing bladder leaks after pregnancy:
- Having your first baby
- Experiencing a long labor or a difficult vaginal delivery
- Having a C-section
Did you have a caesarean section? Some might think that a C-section can eliminate the impacts of labor on the pelvic floor. It is actually the weight of your baby through your pregnancy that weakens your pelvic muscles. So even if you had a C-section, you may still experience a sensitive bladder.
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How To Get Incontinence Supplies Through Insurance
Follow these steps to see if you qualify to receive incontinence supplies covered by your insurance.
Pregnancy Incontinence Prevention And Treatment Methods
The long-awaited plus sign shows itself on your pregnancy test, you share the exciting news with your family and friends, and begin analyzing every little change your body makes in the weeks to follow. Pregnancy is an incredible time of transformation for a womans body with more than 90 percent of women reporting they experience symptoms by the first eight weeks. While some symptoms may be welcome , others are more challenging to manage like nausea, fatigue, and bladder leakage. Women should not hesitate to ask questions or share concerns with their provider about pregnancy symptoms. Seeking guidance and professional support is especially important when a topic is confusing or varies greatly from woman to woman like urinary incontinence, incontinence after pregnancy, and incontinence treatment and prevention recommendations.
It is not uncommon to have questions about the risks of incontinence during or after pregnancy. However, it is important to first understand the types of urinary incontinence, which include:
- Stress: Loss of urine due to physical pressure on the bladder
- Urgency: Loss of urine due to an urgent need to urinate
- Mixed: A combination of stress and urgency incontinence
- Transient: Loss of urine due to medication or a temporary condition such as a urinary tract infection or constipation
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What Causes Pregnancy Incontinence
Your bladder sits right above your pelvic bones and is supported by your pelvic floor. It relaxes and fills with urine throughout the day while the sphincter keeps the organ closed until you can use the bathroom. During pregnancy and childbirth, your pelvic floor muscles are put to the test.
Common causes of pregnancy incontinence include:
Pressure: You may leak when you cough, sneeze, exercise, or laugh. These physical movements put extra pressure on your bladder, which causes stress incontinence. Your baby also puts extra pressure on your bladder as they grow bigger.
Hormones: Changing hormones can affect the lining of your bladder and urethra.
Medical conditions: Some medical causes for incontinence include diabetes, multiple sclerosis, anxiety medications, or a stroke in the past.
Urinary tract infections : Between 30 to 40 percent of women who didnt treat their UTI completely will develop symptoms during pregnancy. Incontinence is a symptom of UTI.
Incontinence During Pregnancy & After Childbirth
Are you pregnant or are post-delivery and experiencing frequent urination or bladder leaks? Learn about the causes of incontinence and how to treat it.
Pregnancy is an exciting time full of anticipation. It also involves some drastic changes to your body. Some changes you may not be expecting are frequent urges to urinate or the occasional bladder leak during pregnancy. You may have noticed that everyday activities like laughing, coughing, sneezing or exercising result in some dampness in your underwear. Having incontinence during and after pregnancy is normal and something that nearly all expecting mothers experience.
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The Expansion Of The Uterus And Fetal Weight
Two major factorsexpansion of the uterus and increment increase in fetal weight with gestational age, especially at the third trimesterinfluence the incontinence mechanism. They put direct pressure on the bladder, which may lead to changing the bladder-neck position and reducing bladder capacity, contributing to bladder pressure that exceeds urethral pressure . This results in urine leakage.
In summary, commonly encountered prenatal physiological changes such as increasing pressure of the growing uterus and fetal weight on PFM throughout pregnancy, together with pregnancy-related hormonal changes in progesterone, estrogen, and relaxin, may lead to reduced strength and supportive and sphincteric function of PFM. PFM muscle weakness causes bladder-neck and urethral mobility, leading to urethral sphincter incompetence. Hence, when intra-abdominal pressure is increased with coughing, sneezing, laughing, or moving, the pressure inside the bladder becomes greater than the urethral closure pressure and the urethral sphincter is not strong enough to maintain urethral closure. Urinary leakage will be the result. In particular, SUI is common during pregnancy and puerperium. After delivery, SUI symptoms resolve in the vast majority of cases . The healing process may take some time after the delivery , but in a significant percentage of women, it can persist in subsequent stages of life . In primiparae women, SUI symptoms tend to resolve within 3 month after delivery .
When Should Women See A Doctor About Postpartum Incontinence
Women should talk to their doctor or a female pelvic health specialist six weeks after delivery if they had incontinence before, during or after pregnancy. Regular, unintended urine leakage may mean a woman has another medical condition. The loss of bladder control should be treated sooner rather than later, or it can become a long-term problem.
We have a postpartum pelvic floor program uniquely designed to help women who experienced third- and fourth-degree anal sphincter lacerations during delivery. Women will meet with our pelvic floor physical therapists and begin therapy treatment 6-8 weeks post-delivery.
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How To Manage Incontinence While Pregnant
There are several ways you can manage incontinence during and after your pregnancy. While staying hydrated prevents constipation and helps with swelling, it’s important to avoid caffeine. Drinking caffeinated beverages could add to your urinary leakage.
As soon as you feel the urge to urinate, go to the bathroom. Trying to hold it puts more stress on your bladder. Take note of what times of the day you have urine leakage. If there’s a pattern, you might be able to change your schedule and go to the bathroom before there’s a leak.
Watching your weight gain during pregnancy may also help you manage incontinence. Ask your healthcare provider about the right amount of weight gain for you and the recommended rate of weight gain for each trimester.
Childbirth And Incontinence: Things You Should Know
The connection between incontinence and childbirth has been assumed for a long time. When gynecologists see women for problems of incontinence, we are not surprised to find the most severe problems often in those women who had many children or who delivered large babies. Recently doctors started working out the details of these relationships and are looking for the specific reasons why some women go on to develop incontinence and other women never have this problem.
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Treatments For Pregnancy Incontinence
Few women need any medical treatment for pregnancy incontinence. In almost every case, it can be managed with lifestyle changes such as consuming less fluids later in the day. This could minimize incontinence in the evening and overnight. It will also decrease the number of times you have to wake up overnight in order to urinate .
Also, make sure you’re getting enough fiber. A diet high in fiber will help you avoid constipation. If you’re taking iron for pregnancy-induced anemia, ask your doctor if there’s a supplement that won’t cause constipation.
Does Incontinence Go Away After The Baby Is Born
Some womens incontinence symptoms go away in the days or weeks after their baby is born. For others, the leaking continues or may get worse. However, incontinence can be managed with first line treatments such as Kegels, bladder retraining, weight loss, and exercise.
Speak with your doctor about your concerns, especially if lifestyle changes dont work or youre still experiencing incontinence six or more weeks after delivery. You may want to consider other treatments such as medications and surgery after your pregnancy.
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How Are Bladder Control Problems Treated
There are several techniques for treating bladder control problems. Kegel exercises may help to improve bladder control and reduce urine leakage. In addition, changing your diet, losing weight, and timing your trips to the bathroom may help.
Some suggestions to help with bladder control problems include:
- Switching to decaffeinated beverages or water to help prevent urine leakage. Drinking beverages such as carbonated drinks, coffee and tea might make you feel like you need to urinate more often.
- Limiting the amount of fluids you drink after dinner to reduce the number of trips to the bathroom you need to make during the night.
- Eating foods that are high in fiber to avoid being constipated, since constipation can also cause urine leakage.
- Maintaining a healthy body weight. Extra body weight can put additional pressure on the bladder. Losing weight after your baby is born can help to relieve some of the pressure on your bladder.
- Keeping a record of when you experience urine leakage. Its a good idea to keep track of what times during the day you have urine leakage. If you can see a pattern, you might be able to avoid leakage by planning trips to the bathroom ahead of time.
After youve established a regular pattern, you might be able to stretch out the time between trips to the bathroom. By making yourself hold on longer, youll strengthen your pelvic muscles and increase control over your bladder.