Is Incontinence Caused by Pregnancy and Childbirth?
Urinary incontinence is common during pregnancy. Here, we answer common questions about incontinence during and after pregnancy — and what you can do to help avoid it.
Do Most Women Leak Urine When They’re Pregnant?
For some pregnant women, the symptoms may be mild and infrequent, but for others it may be more significant. For women of childbearing age, this can often be quite challenging, especially when it wasn’t expected.
Leaking urine during pregnancy is quite common, so most women will experience some incontinence. Stress incontinence occurs because the baby puts added pressure on the pelvic organs, including the bladder. So when a pregnant woman coughs, laughs, or does physical activity, she may notice some leakage. If she has already had children, the chance of experiencing incontinence increases with each pregnancy.
Will Incontinence Improve Right After I Deliver?
Most women will stop leaking urine after delivery. However, approximately 10% of women continue to experience stress incontinence even a year after delivery. Since the pelvic muscles can weaken and become stretched during pregnancy and childbirth, problems can develop later.
Can Childbirth Weaken the Bladder?
Yes, it’s possible that childbirth can weaken the bladder. During labor and delivery, the muscles and tissues supporting the uterus, bladder, and rectum have the chance of being stretched, strained, or even torn. Even the nerves can become stretched and injured, which lead to the muscles not working properly. Of course, every woman is different so some women may have no damage from labor and delivery, while other women have some damage to the muscles, tissues, and nerves.
Pelvic prolapse may occur from injury during delivery and the weakened support of the bladder, rectum, or uterus. Pelvic relaxation occurs when the muscles and supporting tissues above the vagina, which hold the bladder, drop down into the vagina. Prolapse can also cause the urethra — the tube that is used to urinate — to drop. The drop from the normal position of the bladder and urethra, combined with the weakened nerve signals, may affect the bladder’s function. This can result in urine leakage.
Do Kegel Exercises During Pregnancy Prevent Incontinence?
Kegel exercises can lessen the symptoms of incontinence because they help strengthen the pelvic muscles. Practicing Kegel exercises while pregnant has been shown to decrease incontinence, not only during pregnancy but right after delivery as well. Talk to your doctor about Kegel exercises or pelvic therapy during pregnancy.
Can Childbirth Weaken the Rectum?
Yes, it is possible that childbirth can weaken the rectum. Just as with the bladder, the tissues supporting the rectum under the vagina has the chance of being torn during labor and delivery, causing the rectum to bulge up into the vagina. It is normal for women to experience some degree of prolapse after delivery, but these changes typically heal and resolve themselves within a few months. However, if the issues are severe and not resolving themselves, then some repair may be required to restore pre-pregnancy function.
Does Childbirth Lead to Incontinence or Weakened Pelvic Support Later in Life?
During labor, as the baby’s head comes down into the pelvis, muscles and nerves can be affected since the baby’s head is pressed against the pelvic muscles for so long, which can result in a weakened support for the pelvic organs. About half of women who deliver vaginally show almost immediate muscle recovery. Approximately 60% will notice improvement within two months. However, the remaining women whose tissues do not recover completely have a higher likelihood of pelvic prolapse and incontinence later in life. As a woman ages, the normal supporting tissues of the bladder, uterus, and rectum weaken, causing loss of pelvic support, which can result in incontinence.
What Can be Done to Prevent Incontinence as a Result of Childbirth?
There are proactive decisions a woman can make that can help decrease the likelihood of pelvic injury during labor and delivery, including having a C-section. Choosing to deliver via cesarean section may be the right choice for the mother if the baby’s head is in the wrong position, she’s delivering a large baby, has small pelvic bones, or she experiences prolonged labor.