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Urinary incontinence after childbirth: Things to understand

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Urinary incontinence occurs when a person passes urine accidentally. The risk of urine incontinence increases if you give delivery vaginally. It’s a frequent side effect after childbirth, and it normally goes away as the body heals.

According to a 2019 study, between the second trimester of pregnancy and the first three months following childbirth, one-third of people develop urine incontinence.

The symptoms, risk factors, treatment, and prevention of postpartum incontinence are discussed in this article.

When to consult a doctor

While pregnant, a little degree of urinary incontinence is common, and it might continue for a few weeks after childbirth without causing worry. If people are worried or if it persists 6 weeks after delivery, they should consult a doctor, midwife, or nurse.

If urinary incontinence is affecting a person’s quality of life or mental health, it is also critical to seek medical help. Professionals in the medical field can assist a person in developing a treatment plan to alleviate symptoms and enhance their quality of life.

Postpartum incontinence

baby and mother

Females have incontinence twice as often as guys. This might be due of the hormonal changes that occur during pregnancy, delivery, and menopause, according to the Office on Women’s Health.

The bladder is supported by the pelvic floor muscles. Hormonal and structural changes occur throughout pregnancy and after birth, and the strength of the pelvic floor muscles declines.

In the course of giving birth, some people might injure their pelvic floor muscles. During childbirth, especially a vaginal delivery, the nerves that regulate the bladder might be injured.

The inability to control one’s bladder after giving birth is known as postpartum incontinence. This can start throughout pregnancy, but it’s more common after a baby is born.

Females suffer from two forms of urinary incontinence: stress and urge incontinence.

When the bladder is affected by stress or pressure, stress incontinence occurs. The bladder and urethra are put under strain by weak pelvic floor muscles. Urine might flow as a result of sneezing, laughing, or coughing.

Overactive bladder is another term for urge incontinence. Urine leakage happens when a person has a strong desire to pee but is unable to access a bathroom.

Mixed incontinence occurs when a person with urine incontinence has both forms of incontinence.

Symptoms

Urinary incontinence causes people to leak urine accidentally. Other signs and symptoms to look out for include:

  • going to the bathroom more than eight times a day or more than twice per night
  • urinating while sleeping
  • spasms and pressure in the pelvic area

The following activities might cause urine leakage as a result of stress incontinence:

  • lifting something heavy
  • standing up
  • exercising
  • laughing
  • bending over
  • coughing
  • sneezing

Depending on the severity of incontinence, the strenuousness of the activities that cause leaks will vary.

Leaking urine and a sudden or uncontrolled need to pee are two indications of an overactive bladder.

Risk factors

According to the Australian Department of Health, people are more likely to develop urine incontinence after giving birth if they:

  • are having their first baby
  • develop bladder issues while pregnant
  • are expecting a baby with a high birth weight
  • already have incontinence before they give birth
  • experience difficulties during delivery, such as requiring stitches, tearing, or needing forceps
  • experience a long labor

According to research from 2021, vaginal birth is the leading cause of stress incontinence.

When compared to vaginal birth, people who had a cesarean delivery may have a slightly lower chance of developing stress urinary incontinence.

Management and treatment

To address urinary incontinence, people might attempt a variety of lifestyle and medication therapies.

Absorbent pads

It’s possible that a person will need to wear absorbent underwear or special underwear intended to catch any leaks.

Depending on the severity of the leaks, they might range from little panty liners to adult diapers. They might be re-usable or one-time-use only.

They absorb urine invisibly and prevent it from seeping through a person’s clothing, regardless of the kind.

Exercises for the pelvic floor muscles

Pelvic floor muscle exercises, often known as Kegel exercises, can help strengthen the pelvic floor muscles.

People should consult a midwife or healthcare practitioner about the ideal timing to begin Kegel exercises after birth, according on the circumstances.

Pessaries

One method of therapy is to place a pessary into the vaginal canal to support the urethra and prevent leaks.

There are custom-made pessaries available, as well as those that can be purchased over the counter. Some pessaries are single-use disposables, while others may be used for a longer period of time.

Outlook

If a person develops urinary incontinence as a result of labor and delivery, it usually resolves when the muscles have had time to repair.

If urinary incontinence lasts longer than 6 weeks after childbirth or if a person has specific concerns, they should discuss with their doctor, nurse, or midwife.

The pelvic floor may never fully heal for some people. However, by speaking with a healthcare expert about the issue, a person can reduce the chances of urinary incontinence becoming permanent.

Urinary incontinence remained for 12 years after birth in three-quarters of females, according to a 2016 longitudinal research including 3,763 people.

Prevention

After giving birth, a person can take efforts to reduce their chance of having long-term urinary incontinence. These are some of them:

  • Maintaining a moderate weight: Obesity has also been associated to incontinence, according to the National Health Service (NHS) in the United Kingdom. As a result, people who are overweight may be able to minimize their risk of incontinence by decreasing weight.
  • Performing Kegels: Even before becoming pregnant, people can begin these workouts. Structured pelvic floor muscle training can help avoid urinary incontinence after childbirth and during late pregnancy, according to a 2020 study.
  • Maintaining healthy bowel movements: Constipation can cause urinary incontinence by putting pressure on the bladder and urethra. To avoid constipation, people should consume a sufficient amount of fiber-rich meals.

Conclusion

Urinary incontinence is prevalent after delivery, affecting around one-third of people during the second and third trimesters of pregnancy and three months following birth.

It usually happens as a result of hormonal and anatomical changes that occur during pregnancy and delivery.

Urinary incontinence normally goes away when the body recovers following delivery, although it might continue longer in rare situations. However, if it lasts longer than 6 weeks after childbirth or if you have specific concerns, you should see a doctor.

Sources:

  • https://www.pregnancybirthbaby.org.au/bladder-weakness-after-birth
  • https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.14275
  • https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5779640/
  • https://pubmed.ncbi.nlm.nih.gov/25846816/
  • https://www.nhs.uk/conditions/urinary-incontinence/
  • https://www.medicalnewstoday.com/articles/urinary-incontinence-after-childbirth
  • https://pubmed.ncbi.nlm.nih.gov/30649605/
  • https://www.womenshealth.gov/a-z-topics/urinary-incontinence
  • https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7486687/
  • https://www.urologyhealth.org/urology-a-z/s/stress-urinary-incontinence-(sui)
  • https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7203602/