Dealing with postpartum incontinence: Causes, symptoms and solutions

Becoming a new parent is undoubtedly one of life's most beautiful and transformative experiences. However, it also comes with its share of challenges, some of which can be quite unexpected. One such challenge that many new mums face is postpartum urinary incontinence.

What is urinary incontinence

Let's start with the basics. Urinary incontinence refers to the unintentional loss of urine, and it's a condition that affects people of all ages and backgrounds. While it can happen to anyone, postpartum incontinence, as the name suggests, occurs in women after giving birth.

What causes postpartum incontinence

Postpartum incontinence is often the result of the tremendous changes a woman's body undergoes during pregnancy and childbirth. Some of the primary causes include:

1. Weakened pelvic floor muscles: The pelvic floor muscles are responsible for supporting the bladder and maintaining urinary control. During pregnancy and childbirth, these muscles can become stretched and weakened, leading to incontinence.
2. Hormonal changes: Pregnancy causes hormonal fluctuations that can impact the muscles and tissues that control urination. These changes can make it more challenging to control the bladder effectively.
3. Pressure on the bladder: As the baby grows in the uterus, it exerts increasing pressure on the bladder. This constant pressure can weaken the muscles and cause incontinence issues.
4. Vaginal delivery: Women who have a vaginal delivery are more likely to experience postpartum incontinence than those who have a cesarean section. The stretching and potential trauma to the pelvic floor muscles during vaginal birth can contribute to urinary incontinence.

Does having an episiotomy cause incontinence?

An episiotomy is a surgical incision made in the perineum (the area between the vaginal opening and the anus) during childbirth to widen the birth canal. While episiotomies were once a common practice, they are now performed less frequently due to potential complications.

It's worth noting that episiotomies can contribute to postpartum incontinence, as the incision may affect the integrity of the pelvic floor muscles and the surrounding tissues.

Postpartum urinary incontinence symptoms

Recognising the symptoms of postpartum incontinence is essential for addressing the issue promptly. Common symptoms include:

1. Leakage: One of the most apparent signs is unintentional urine leakage, which can occur when you cough, sneeze, laugh, or engage in physical activities.
2. Frequent urination: Many new mums experience an increased need to urinate frequently. This can be due to pressure on the bladder or a heightened sensitivity to it.
3. Urgency: You may feel a sudden and intense urge to urinate, making it challenging to hold it in until you reach the restroom.
4. Incomplete emptying: Some women may find it difficult to completely empty their bladder, leaving them feeling like they still need to urinate after visiting the restroom.
5. Nocturia: This term refers to the need to wake up at night to urinate, which can be particularly disruptive to your sleep.

Why am I constantly peeing after giving birth?

If you find yourself constantly running to the bathroom after giving birth, you're not alone. There are a few reasons why this happens:

1. Swelling and healing: After childbirth, your body is healing from the physical trauma of delivery. Swelling and inflammation in the pelvic region can irritate the bladder, making you feel like you need to urinate frequently.
2. Hormonal changes: Postpartum hormonal fluctuations can cause the bladder to become oversensitive, leading to frequent urination.
3. Uterine contractions: Your uterus is working to return to its pre-pregnancy size, and these contractions can put additional pressure on the bladder, making you feel the need to urinate more often.
4. Pelvic floor weakness: Weakened pelvic floor muscles may contribute to the sensation of constantly needing to urinate, as they may struggle to support the bladder effectively.

Does postpartum incontinence go away on its own

The good news is that many cases of postpartum incontinence do improve or resolve over time, especially with the right interventions. However, it's not guaranteed to go away on its own, and it can persist for months or even years if left untreated.

How do you fix postpartum incontinence

If you're dealing with postpartum incontinence, there are several strategies and treatments available to help you regain control of your bladder:

1. Pelvic floor exercises (Kegels): Kegel exercises involve contracting and relaxing the pelvic floor muscles to strengthen them. Regular practice can significantly improve bladder control. To perform Kegels, simply squeeze the muscles you would use to stop the flow of urine, hold for a few seconds, and then release. Repeat this several times a day.
2. Physical therapy: Pelvic floor physical therapy, conducted by a trained therapist, can provide specialised exercises and techniques to target and strengthen the pelvic floor muscles effectively.
3. Lifestyle changes: Maintaining a healthy lifestyle can make a big difference. This includes maintaining a healthy weight, staying hydrated, and avoiding excessive caffeine intake, which can irritate the bladder.
4. Bladder training: Gradually extending the time between bathroom visits can help retrain your bladder to hold urine for longer periods.
5. Medications: In some cases, your healthcare provider may prescribe medications to help control overactive bladder muscles.
6. Surgical intervention: In severe cases where other treatments are ineffective, surgical procedures such as a sling or Botox injections may be recommended to provide additional support to the bladder.

Remember that it's essential to consult with a healthcare professional to determine the best approach for your specific situation. They can provide a tailored treatment plan and monitor your progress.

Exercises for postpartum urinary incontinence

As mentioned earlier, Kegel exercises are among the most effective exercises for postpartum urinary incontinence. However, there are additional exercises that can complement your routine:

1. Bridge exercise: Lie on your back with your knees bent and feet flat on the floor. Slowly lift your hips off the ground, engaging your glutes and core muscles. Hold for a few seconds and then lower your hips back down. Repeat this exercise several times.
2. Squats: Stand with your feet shoulder-width apart. Lower your body into a squatting position, as if you were sitting in an imaginary chair. Keep your back straight and chest up. Return to a standing position and repeat.
3. Pelvic tilts: Lie on your back with your knees bent and feet flat on the floor. Tighten your abdominal muscles and tilt your pelvis upward, pressing your lower back into the floor. Hold for a few seconds and release. Repeat this movement several times.
4. Flutter kicks: Lie on your back with your legs straight. Lift your legs a few inches off the ground and alternate kicking them up and down in a fluttering motion. This exercise engages your lower abdominal muscles and can help strengthen your pelvic floor.

Incorporate these exercises into your daily routine, gradually increasing the intensity as your muscles become stronger. Be consistent, and remember that it may take some time to see significant improvements.

In conclusion, postpartum incontinence is a common challenge that many new mothers face, but it doesn't have to be a permanent one. With the right exercises, lifestyle changes, and, if necessary, medical interventions, you can regain control of your bladder and enjoy a better quality of life after childbirth.

Don't hesitate to seek guidance from a healthcare professional to create a personalised plan for managing postpartum incontinence and addressing any concerns you may have.

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This article was first published in theAsianparent.