As so many new moms will tell you, diaper changes aren't just for their newborns. Whether you've experienced a trickle of urine after laughing or coughing, or a full-blown pee-your-pants moment, you're not alone, mama.
Here are 10 facts to know about postpartum urinary incontinence.
1. There's a good reason why bladder leakage can happen.
In her third trimester, the average pregnant woman is carrying an extra 25-35 pounds, according to Charisse Balance, DPT, RYT. When you consider the extra weight in pounds, the baby itself weighs four to 10 pounds; the placenta two to three, the uterus two to five, the amniotic fluid, two to three; and up to four pounds extra in blood volume, that's a lot of additional weight your body isn't used to carrying.
According to Charisse, many women compensate for this weight by postural changes—tilting the pelvis forward, so the weight drops into the pelvic floor. Think of your pelvic floor muscles as a bowl, into which you've dropped 30 pounds, nonstop, for three months. Understandably, this can temporarily damage these muscles, which are responsible for closing your urethra.
2. You're not alone.
Seriously. At least one in three new moms experiences postpartum urinary incontinence.
3. There are two types of urinary incontinence.
Identifying which type of urinary incontinence you're experiencing—and it can definitely be both!—is important as you seek help and resources. Stress incontinence has nothing to do with mental or emotional stress and is instead the term for involuntary loss of urine caused by physical movement or activity. Leaking following coughing, laughing, or exercising is likely stress incontinence.
On the other hand, urge incontinence occurs when you have just emptied your bladder and still feel the urge to pee.
It is important to differentiate incontinence and a urinary tract infection, because sometimes the symptoms can feel similar. UTI symptoms may include:
- Frequent or strong urge to pee without much pee coming out
- Foul-smelling, cloudy, or bloody urine
- Burning when you pee
- Lower back pain
Report these symptoms to your provider right away.
4. Treatment exists—just ask the French.
While many American women have never even heard of a pelvic floor therapist, new mamas in France get 10 to 20 appointments with one—paid for by the government. This type of physical therapy helps to retrain the pelvic floor muscles, so bladder leakage doesn't have to be part of the postpartum experience.
5. You may still experience bladder leakage after a C-section.
One misconception about postpartum bladder leakage is that it only affects women who give birth vaginally. Charisse reminds us that a C-section is abdominal surgery, and in any other abdominal surgery, the patient would be sent to physical therapy for scar release and recovery. But alas, that is not the case for mamas who have had a C-section.
Adhesions in the fascia, according to Charisse, can contribute to misalignment and tightness everywhere else in the abdominal region, which can contribute to pelvic floor dysfunction, which we know leads to incontinence.
Consider working with a physical therapist post-C-section to ensure you're getting all the help you can to treat any signs of bladder leaks.
6. Incontinence is common, but not normal.
Postpartum urinary incontinence is super common, but it isn't normal. And, a new survey from Cora found that 45% of new mothers said that after giving birth, having bladder leakage was worse for them than healing from childbirth. With that kind of impact, what we need to normalize is the conversation around how to treat it, so new mamas don't have to suffer in silence.
7. Kegels aren't the only solution.
If you've suffered from bladder leakage before, you've likely been told to do Kegel exercises to help recover your pelvic floor. While they can be effective, it's not the best idea for all cases of urinary incontinence.
First of all, seeing a Kegel isn't exactly as easy as watching someone flex their bicep. Therefore, it's more difficult to know if you're doing it correctly. When done incorrectly, even if it is, in fact, the best course of action for your type of incontinence, it can do more harm than help.
Then, there are cases where Kegels are actually a no-no. According to Claire Mockridge, a fitness and Pilates instructor whose work is based in biomechanics, "Your pelvic floor could be too tight. If you've been squeezing and squeezing, it can get bunched up. Whereas you need to relax your pelvic floor so you can get more length into the muscles—any muscle in the body actually needs length before strength. The longer a muscle is, the more load it can withstand. Think of a hammock that's hanging between two trees and loaded with rocks. If the trees are further apart, the hammock can hold more rocks and more weight."
8. Lifestyle changes can help reduce bladder leakage.
It's unpopular to give advice that involves cutting coffee, but caffeine may be a contributing culprit to your urinary incontinence. "Some behavioral changes can treat incontinence, including lifestyle modifications such as decreasing overall consumption of liquids and avoiding drinking caffeinated beverages that may irritate the bladder," says Dr. Camille Moreno, D.O. She adds that smoking—because, coughing—and being overweight can also contribute to incontinence.
9. Remember there are products to help.
Even while you're working with a physical therapist and doing your Kegels (if your provider has given you the okay!), your bladder leakage is unlikely to go away overnight. In the meantime, there are products on the market designed specifically for women with urinary incontinence. (Meaning: You don't need to use bulky period pads meant to capture liquid of different viscosity.)
Instead, you can choose products designed specifically for bladder leakage.
10. Be kind to yourself.
Having a baby turns your world upside down, in ways both joyous and unexpected. Give yourself time to heal and rejuvenate, and don't rush your recovery out of embarrassment or shame. It can take about three months post-childbirth for your pelvic floor to fully recover. So, see a pelvic floor physical therapist if it's driving you crazy, but also know that it's likely to pass.
And if it doesn't, there are plenty of tools, resources and medical professionals who can help.