Pregnancy has all sorts of side effects. Most are temporary and harmless, like morning sickness and enhanced sense of smell.
But there’s also another pregnancy symptom that is often overlooked: Urinary incontinence.
Just when you thought you emptied your bladder, a single sneeze, cough or laugh may prove otherwise. And at the most inopportune time, too.
It seems like on most days your bladder is just overflowing that you barely have time to get to the toilet.
Here’s what you need to know about pregnancy incontinence (and what you can do about it).
What Is Pregnancy Incontinence?
Pregnancy incontinence is a condition where an expectant mother experiences involuntary (accidental) urinary leakages.
This condition affects approximately half of all pregnant women and at varying degrees. However, patients often report mild to moderate urinary leakages.
The condition may or may not improve after childbirth.
There are many causes that can explain urinary leakages in pregnancy. The most likely reasons being physiological changes and certain medical history.
However, incontinence is not uncommon in non-pregnant cases either. You see the condition a lot in the elderly, for example.
Certain medical conditions are also known to cause urinary leakages such as obesity, diabetes, enlarged prostate, UTIs, and Alzheimer’s.
With pregnancy, incontinence is mostly due to the state of being pregnant instead of a serious medical condition.
Despite this, the condition can affect a mother’s life in various ways but the most significant is psychological. Embarrassment is a common emotion that limits a woman’s life when she has this condition.
However, there are many treatments and preventative tips that a woman can do before and during pregnancy to have a better chance at preventing leakages.
Why Does Pregnancy Incontinence Happen?
Pregnancy incontinence is caused by many factors. All of these factors are a result of the physical changes that a woman’s body goes through as it creates new life.
The first is abdominal pressure from the growing foetus.
Many mothers report an increase in urinary leakage during the second and third trimester.
This period is when the baby has gained significant weight. In fact, the bigger the baby, the more urinary leakages happen.
Another cause is hormonal. As a woman progresses in her pregnancy, her reproductive organs release progesterone.
This is important because progesterone relaxes the muscles, allowing the uterus and pelvic floor to expand and accommodate a growing baby.
Unfortunately, for many women, the loosening of the pelvic floor muscles also makes it harder to hold in urine. This is what doctors theorise is what causes stress urinary incontinence.
If you have had babies previously, you may have an increased chance of having the condition in a future pregnancy.
These three causes are by no means the only ones involved in this condition.
There are many other factors prior to pregnancy that can make pregnancy incontinence more likely to occur (but more on this later).
What Are the Symptoms of Pregnancy Incontinence?
It’s important to understand that there are many types of urinary incontinence.
But the most common one among pregnant women are stress incontinence and urge incontinence.
Stress incontinence is where someone experiences urinary leakage without the urge to urinate.
This usually happens when there is a sudden pressure on the abdominal area. Examples include when coughing, sneezing, laughing or even sitting down and walking.
Urge incontinence is when you experience an immediate, often uncontrollable urge to urinate. This may happen several times a day and may also result in nocturia (waking up multiple times a night to urinate).
Stress incontinence is much harder to control as it happens in the moment. This may result in accidental wetting (also called enuresis).
In urge incontinence, there is a sudden urge to urinate but there may still be time to empty the bladder out properly in a toilet. But wetting or enuresis is still possible in cases of overflow.
However, it is not uncommon for pregnant women to experience both stress and urge incontinence at the same time. The severity can vary greatly between women.
Multiparous women (women who have had multiple vaginal births) may have more urinary episodes compared to primiparous women (those who have had only one pregnancy in the past).
Do Urinary Leakages Affect Quality of Life?
Pregnancy incontinence is by no means dangerous or harmful to the mother and baby. It is simply an inconvenient symptom of pregnancy.
However, just because it’s not fatal or chronic doesn’t mean there are no consequences to a woman’s overall quality of life.
For instance, multiple studies have shown the condition can have a serious impact on the mother’s mental and social wellbeing.
Urinary leakages can cause a lot of shame and embarrassment. Often resulting in the mother isolating herself from any social situations or get-togethers.
All human beings require social interaction for good health. Someone who has isolated themselves from society may experience depression, which is not beneficial for either mother or baby.
There are other ways that incontinence can affect a mother’s physical health as well.
In cases of stress incontinence, pregnant mothers may forgo exercise to avoid accidents.
Nocturia, as a result of urge incontinence, may also affect a mother’s sleep. This often results in sleep deprivation, which is also harmful for health.
There are several cases, however, where the condition can present a dangerous risk to the mother and baby.
In cases of urgency incontinence, the patient may run or rush to the toilet in an effort to empty the bladder. This increases the risk of accidents and falls, possibly resulting in fractures or broken bones.
So, mums need to take great care in this matter to avoid any unwanted emergencies.
How Common Is Pregnancy Incontinence?
Research shows that around 40% of pregnant mothers in Malaysia experience incontinence, especially stress incontinence.
The same seems to be true in other countries, where a majority of cases involve stress incontinence rather than urgency or mixed.
In general, compared to men, women tend to have the condition—even outside of pregnancy.
However, the likelihood of you experiencing this condition relies on several factors.
Yes, physical changes from pregnancy are unavoidable but medical history is also important to look at.
For instance, women who have been pregnant before have a much higher risk of developing urinary leakages in future pregnancies.
Most especially those who have had vaginal or instrumental or assisted deliveries.
Even just having one pregnancy before greatly weakened your pelvic floor muscles.
The connective tissues, nerves and muscles that make up the area between your genitals to your anus.
So having multiple pregnancies will create cumulative damage to this area, making it that much more likely for you to experience incontinence with succeeding pregnancies.
Some research shows that there is less chance with Caeserean deliveries.
However, postpartum and pregnancy incontinence is still possible.
Another risk is childhood enuresis.
If the mother has had a history of bedwetting as a child, then the risk of pregnancy incontinence later as an adult is greater.
The same goes if she has had a medical history of urinary problems outside of pregnancy such as nocturia and UTIs or urinary tract infections.
How Do Doctors Treat Pregnancy Incontinence?
Luckily, those suffering from pregnancy incontinence do not have to suffer in silence.
There are a few treatments that are effective against the condition that a doctor may prescribe to you.
That said, many women may avoid going to the doctor for pregnancy incontinence. The main reason is usually shame or embarrassment.
If their condition is starting to affect their quality of life, they must seek medical advice as soon as possible.
The first treatment is usually a pessary.
A pessary is a prosthetic device inserted into the vagina to provide support to the pelvic muscles.
Pessaries have shown great benefits for stress incontinence in pregnancies.
Dietary changes may also be necessary. Avoid carbonated or caffeinated drinks (which you should be doing anyway when you’re pregnant).
Additionally, do keep a urination diary so you know your patterns.
Your doctor may also recommend certain incontinence products that may help catch any urinary leakage.
These can include adult diapers or tampons that can catch any leaks that might come out during your daily activities. So, a holistic approach is often required.
Doctors usually avoid pharmacological treatments in cases of pregnancy incontinence.
Many types of medications such as anticholinergic drugs and Beta-3 adrenergic agonists are often used to treat incontinence in non-pregnant patients.
However, these are not safe for expectant mothers.
In cases of severe incontinence postpartum, a doctor may recommend surgical intervention to address the problem. But very few choose to take this route.
Can You Prevent Pregnancy Incontinence?
As they say, prevention is the best cure. And this adage couldn’t be truer in the case of pregnancy incontinence.
Preventing the condition is much more effective than treating it later.
The number one way is through pelvic floor exercises. you may know these by another name: ‘Kegels’.
Research shows that Kegels have amazing benefits for urinary incontinence.
The way you do Kegels is basically squeezing or contracting your pelvic floor muscles.
Your pelvic floor muscles stretch all the way across your urethra, vagina and anus. Your perineum, basically.
Squeeze for 3 to 5 seconds then relax for 3 to 5 seconds. Doing it lying down, sitting, squatting and in other positions may offer different benefits.
Bladder training is also another method.
This is where you time your urinations throughout the day instead of going immediately when you feel the urge.
However, the caveat being that you apply these changes and tips before you get pregnant. Or at the very least, at the earlier stage of pregnancy.
Say Goodbye to the Wetness, Mummies!
Pregnancy incontinence can definitely be a wet blanket on an otherwise amazing pregnancy.
But don’t let this condition rain on your pregnancy parade.
The most important thing is prevention.
You must first understand your risk for developing urinary incontinence before you even get pregnant.
This allows you to take the correct preventive and precautionary measures to minimise the effect that this condition may have on your quality of life.
Doing so may ensure you a more productive and happier pregnancy throughout.
You’ve got this, mummies!
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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