How to prevent and manage pregnancy incontinence

Updated December 2022 | 3 min read
Expert contributor Dr Dominic Lee, urologist, the Urological Society of Australia and New Zealand
Words by Tatyana Leonov

What does pregnancy and postpartum incontinence involve and are you at risk?

During your pregnancy, your health professional might bring up the topic of pregnancy incontinence – a not so often talked about but relatively common consequence of pregnancy and childbirth.

There are different types of incontinence, the main two being ‘urge incontinence’ and ‘stress incontinence’.

Urge incontinence is the sudden need to urinate; stress incontinence is the uncontrolled leaking of urine during activities like coughing, laughing and anything that pushes down on the bladder.

Typically, stress incontinence is more commonly connected to pregnancy and childbirth. This is different for women who have an overactive bladder. For women who have an overactive bladder, they feel the need to urinate because their bladders have uncontrollable spasms.

If your bladder is leaking while pregnant, there are things you can do to help prevent or manage incontinence.

Is incontinence normal during pregnancy?

Different scientific studies report that anywhere between 18% to 60% of pregnant women will experience stress incontinence.

“There are a number of factors that put you at higher risk,” urologist Dr Dominic Lee from the Urological Society of Australia and New Zealand explains.

“If you’re older when you conceive incontinence is more probable, there is also a higher risk if you’re overweight.”

“Labour, too, can affect the postpartum outcome; for example, if a woman has an assisted delivery – i.e. forceps are used – the chance of incontinence after childbirth (postpartum) is increased.”

Some studies have shown that a caesarean delivery can decrease the odds of postpartum incontinence compared to a vaginal birth for a woman’s first birth. However, there are risks associated with caesarean delivery that outweigh this benefit when both mum and baby are healthy, including a longer recovery time for the mother.

“When a woman delivers a second child it’s hard to say whether a caesarean section decreases incontinence odds. By the third pregnancy, regardless [of whether] a woman has a vaginal birth or a caesarean section, the outcome is the same when we talk about postpartum incontinence,” Dr Lee explains.

Preventing pregnancy incontinence

Pregnancy and postpartum incontinence is less likely if you:

• start your pregnancy at a healthy body weight
• gain weight following the recommended guidelines
• eat healthily
• keep active during your pregnancy.

Strong pelvic floor muscles can also reduce your risk of incontinence, and the Continence Foundation of Australia encourages all pregnant women and women planning to fall pregnant to educate themselves about training these muscles.

“Pelvic floor muscle function is very important for maintaining continence, as well as sexual response and preventing prolapse,” says Fiona Rogers, a women’s health physiotherapist.
“Pelvic floor muscles respond to regular exercise just like other muscles, so in order for them to perform their job women need to keep their muscles strong and flexible.”

Dr Lee recommends that all pregnant women attend antenatal classes to learn how to properly perform pelvic floor exercises, and emphasises it’s essential you continue to practise the exercises throughout pregnancy and beyond.

After birth, you can register for an online course with The Pelvic Expert, which includes nutrition advice as well as pelvic floor exercises. You can also see a women’s health physio to help with your pelvic floor muscles.

Managing incontinence during pregnancy

The reality is that even if you eat a healthy diet, exercise often and regularly practise your pelvic floor exercises, you might still find yourself with stress incontinence (or urge incontinence, or both) in the later stages of pregnancy and post birth.

Dr Lee explains that in most cases, pregnancy-associated incontinence will resolve itself three to six months after childbirth as you recover and your muscles regain their strength.

For some women, however, incontinence will continue. If it happens to you, see your GP for a referral to a specialist urologist or gynaecologist.

“Urinary incontinence is common,” says Rogers, but you can do something about it. “Don’t be embarrassed to ask for help sooner rather than later.”