On top of all the things you expected with having a baby—no sleep, breastfeeding woes, hormonal shifts—you’ve also experienced some unexpected leakage. Here’s everything you wanted to know about postpartum incontinence but might be embarrassed to ask.
Q: Why am I leaking urine after having a baby?
A: You’re experiencing postpartum incontinence, which is a form of stress incontinence. This means that when your bladder experiences pressure from activities like laughing, sneezing, running, or lifting, it leaks a little. Usually, this happens because childbirth often tears or weakens the pelvic floor; when those muscles are weakened or indisposed, they have trouble keeping the urethra closed as expected to hold urine in the bladder.
Q: But I had a C-section!
A: Even if you didn’t give birth vaginally, you may still experience postpartum incontinence. This is especially true if you experienced prenatal incontinence, which is extremely common late in the pregnancy because a growing baby crowds out and places undue pressure on the bladder.
Q: How common is postpartum incontinence?
A: It’s quite common. Up to 50 percent of women experience some postpartum incontinence. One study found that among women who experienced prenatal incontinence, postpartum incontinence occurred in half of those who delivered vaginally and 23 percent of those who had a C-section. But postpartum incontinence is also common among women who didn’t leak during pregnancy: 20 percent of women who delivered vaginally experienced postpartum incontinence, as did 8 percent of women who had C-sections.
Q: What causes postpartum incontinence?
A: Essentially, postpartum incontinence happens when the pelvic muscles surrounding the urethra stretch and weaken during pregnancy and delivery, so they have a harder time doing their job of keeping the urethra closed. That means that when the bladder experiences stress or urge, pee is more likely to slip out. Other factors can contribute to the likelihood of postpartum incontinence, including diabetes, obesity, the use of forceps during delivery, a large baby, multiple vaginal births, smoking, or genetic predisposition.
Q: Will postpartum incontinence go away?
A: Some women see postpartum incontinence disappear a few months after giving birth as the pelvic floor strengthens. Other women say it sticks around for years. Five years after giving birth, one-third to one-half of women experience some degree of leaking.
Q: What can I do about postpartum incontinence?
A: Doing regular Kegel exercises can really help manage postpartum incontinence, and sometimes relieve it altogether. In the meantime, there are a variety of products, from light liners to overnight pads to absorbent underwear, that are specially designed for urinary leaks and make it easier to maintain your usual routine.
Q: What should I not do if I’m experiencing postpartum incontinence?
A: Don’t dehydrate yourself! Many women think drinking less water will lead to fewer leaks or urges, but that’s not really true. Plus, dehydration comes with its own slew of problems—and when you’re recovering from pregnancy, hydrating is especially important. Keep drinking the recommended eight glasses a day and seek out healthier ways to address the problem instead. Another thing: Many women find themselves avoiding social interactions or leaving the house because they’re ashamed or embarrassed. If you find yourself thinking this way, see a doctor, who can help you find ways to handle the incontinence and the anxiety that comes with it. In other words, don’t let a little leaking disrupt your life or your care for your baby.
Q: If I see my doctor about it, what will she recommend for postpartum incontinence? Can she actually help?
A: Most likely, she’ll recommend a course of Kegel exercises and show you how to do them correctly. Depending on the severity of your incontinence or your level of discomfort, she may also refer you to a pelvic floor physical therapist for specialized treatment or suggest a bladder sling surgery, in which a mesh net is inserted to support your urethra. She’ll also help you work through general diet and health factors to minimize irritation and pressure on your bladder