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Urinary incontinence or accidental leakage can occur during any stage of pregnancy and is common. It happens for several reasons and is usually manageable, however, it can be uncomfortable and may be slightly embarrassing to deal with.
It is important to remember that it is a common issue and that you are not the only one going through this.
When Does Stress Incontinence Occur?
Stress incontinence is most common during any stage of pregnancy. This can happen during:- Coughing
- Sneezing
- Laughing
- Any physical activity like walking
How Common Is Urine Leakage While Coughing During Pregnancy?
It is extremely common to experience stress incontinence during pregnancy. It is most common during the third trimester when the baby has grown to its heaviest, placing more pressure on your bladder. It is also common to experience incontinence after childbirth, especially in cases of vaginal deliveries. Vaginal deliveries can worsen bladder problems.Let us look at some of the reasons why incontinence occurs during pregnancy:
- Hormonal changes: Hormonal changes can relax the pelvic floor muscles, causing urine to leak during coughing, laughing, sneezing or basic physical activities like walking or exercising. An increase in progesterone loosens the ligaments and joints in the pelvis. These include the ligaments responsible for supporting the bladder, which is what leads to urine leaking out. Additionally, there is a decrease in the production of relaxin, increasing the chances of incontinence.
- Baby’s weight: As the baby gets heavier, the uterus expands to make space for it. This puts a lot of pressure on the bladder, resulting in a more urgent and frequent need to urinate. Sometimes, urine can leak out because of this reason. The weight of the baby can also weaken the pelvic floor muscles, making incontinence a possibility.
- Weakened pelvic floor muscles: Weakened pelvic floor muscles are common during pregnancy for a few reasons. Pregnancy hormones can make the pelvic floor muscles more flexible causing the connection between the pelvic bones to loosen. Additionally, constipation, which is very common during pregnancy, can put extra pressure on the pelvic floor muscles. This weakening can cause urine incontinence.
- Changes in Blood Volume and Fluid Dynamics: Your blood volume increases during pregnancy. This leads to the kidneys producing more urine. Sometimes, this can lead to incontinence.
- History of Constipation or Straining: Constipation causes you to strain your pelvic muscles a lot, which weakens them in turn. This can cause urine incontinence.
- Impact of Braxton Hicks Contractions: Braxton Hicks contractions can cause your uterus to put pressure on your bladder and make urine accidentally leak out.
- Increased Sensitivity of the Bladder: Hormonal changes and the size of the baby can cause increased bladder sensitivity during pregnancy. Sometimes urine incontinence gets triggered due to this.
- Effects of Increased Relaxin Production: During pregnancy, there is an increase in the production of relaxin, which leads to the ligaments in the pelvic area loosening. This can in turn lead to incontinence.
- Postural Changes: Sudden changes in your posture can cause incontinence during pregnancy.
- Reduced Mobility or Physical Activity: Reduced mobility or a sedentary lifestyle during pregnancy can cause urine incontinence. Make sure you get moderate exercise every day.
- Previous Abdominal Surgeries or Conditions: If you have had pelvic surgeries or any other conditions that can cause you incontinence, your incontinence may get worse during pregnancy.
Signs And Symptoms of Urine Incontinence
Most people experience an accidental drip at some point in their lives. During pregnancy, such accidents are more common. These changes can be noticed as early as the first trimester. As your pregnancy progresses, you might notice yourself losing bladder control more frequently. Symptoms of urine incontinence include:- Urine leaks when you laugh, cough, sneeze, or exercise: Your urine leaks out when coughing, sneezing, or during any other movements like exercise
- Feeling the sudden urge to urinate and being unable to hold it: You feel the sudden urge to urinate and are unable to control it
- Having to take more trips to the toilet: You have to make more trips to the toilet
- Leaking urine while going to the toilet: You end up leaking urine on the way to the toilet
- Waking Up Frequently at Night: You find yourself waking up frequently at night to urinate
- Dribbling After Urination: Despite urinating, you dribble urine after you stop
- Inability to Completely Empty the Bladder: You are unable to completely empty your bladder, causing you to go to the toilet again
- Incontinence During Sexual Intercourse: You leak urine during sexual intercourse
- Pressure or Heaviness in the Pelvic Area: You feel sudden pressure or heaviness in the pelvic area, causing you to go to the toilet
- Leakage When Changing Positions: You leak urine while changing positions
- Sensation of Bladder Spasms: You have sensations of bladder spasms, which lead to urine leakage
- A feeling of dampness: Feeling damp due to urine leaking
Risk Factors For Urine Incontinence During Pregnancy
Some women have a higher risk of facing urine incontinence issues during pregnancy. If you have faced bladder control issues earlier in life, before you got pregnant, it is more likely that your bladder issues will get worse during pregnancy. Incontinence is a lot more severe for women who have had conditions that affect the bladder, like urinary tract infections. Here are some other factors that could increase the likelihood of urine incontinence:- Obesity: Being overweight or obese can increase the risk of urine incontinence. Losing weight can reverse these issues, however, check with your doctor to see what is safe for you
- Age: A few studies suggest that people who are over the age of thirty at the time of their first pregnancies have a higher risk of urine incontinence
- Vaginal deliveries: If you have previously given birth vaginally, it can cause urine incontinence issues in your other pregnancies and even after childbirth
- Delivering large babies: Babies who are larger and heavier at the time of birth can increase your risk of nerve damage during a vaginal delivery, causing urine incontinence for later pregnancies or after childbirth
- Episiotomies: An episiotomy is when the doctor makes a small incision near your vaginal opening to make it easier for the child to be delivered. While this is done to make delivery easier and reduce the risk of UI, it has been known to increase the risk of weakened pelvic floor muscles
- Diet and lifestyle: Consuming specific foods and drinks can increase the risk of urine incontinence. Consuming more caffeinated beverages and carbonated beverages can cause your bladder to contract, making you feel the sudden urge to urinate. Spicy food can also trigger this response
- Multiple Pregnancies: If you have been pregnant multiple times, and given birth vaginally, your pelvic floor muscles are weakened and you may have a higher chance of urine incontinence
- History of Pelvic Surgery: Having a history of pelvic surgery can increase your risk of urine incontinence as your pelvic floor muscles are weakened due to this
- Chronic Cough or Respiratory Issues: Chronic coughing can weaken the pelvic floor muscles, adding a lot of strain to them and sometimes even causing small tears in the muscles. This can cause urine incontinence
- Prolonged Labour or Difficult Delivery: Delivery complications like prolonged labour can weaken the pelvic floor muscles and damage the nerves in the pelvic area, hence causing trouble in bladder function
- Family History of Incontinence: If you have a family history of urine incontinence, you will have higher chances of having it
- Gestational Diabetes: Gestational diabetes can cause nerve damage in the pelvic area, leading to urine incontinence
- Smoking: While smoking cannot directly impact incontinence, smokers often have persistent coughs. The constant coughing can put a strain on the pelvic muscles, leading to incontinence
- High-Impact Exercise: High-impact exercises like running, jumping rope or any exercise that causes you to suddenly change your direction can put pressure on the pelvic floor muscles, leading to bladder control issues
- Constipation: Constipation can cause you to strain and put pressure on the pelvic area, which causes the muscles to weaken, leading to urine incontinence
- Low Physical Activity Levels: A sedentary lifestyle with low to no physical activity can cause severe urine incontinence
- Use of Certain Medications: Certain medications like blood pressure medication, alpha-blockers, sedatives, diuretics and sleeping pills can cause urine incontinence. Check with your doctor about any of these medications
Preventing And Managing Urine Leakage During Pregnancy
While this is an uncomfortable issue to have, it is manageable. You can do several things to manage your bladder problems during pregnancy.- Kegel exercises: Kegel exercises, also known as pelvic floor exercises, are a group of exercises that strengthen the muscles supporting the bladder, uterus and rectum. To do kegel exercises, you will first have to empty your bladder and find your pelvic floor muscles. Next, tighten the muscles by squeezing and lifting, however, do not tighten the buttock or thigh muscles. Hold each contraction for 3-5 seconds. Repeat this exercise ten times, thrice a day. Some other exercises like the bridge position and squats can help as well.
- Avoid caffeine: caffeine is a diuretic, which means it increases the amount of water your kidneys release from your bloodstream, leading to frequent urination. Sometimes, this can cause urine incontinence.
- Limit fluid intake before sleeping: Reduce the amount of fluids you drink before going to bed so you do not have to make frequent trips to the toilet at night.
- Consume more fibre: Eating a diet rich in fibre can reduce the chances of constipation, which causes more strain on your pelvic floor muscles
- Wear pads: Wear pads or leak-proof underwear. It can feel embarrassing to need this additional help, however, it is very important to remember that other pregnant women are going through the same.
- Maintain a Healthy Weight: Issues like being overweight can trigger incontinence by putting pressure on the pelvic muscles. Try to maintain a healthy weight by exercising moderately every day.
- Bladder Training: Bladder training is a type of behavioural therapy that helps with incontinence by increasing the amount of fluid the bladder can hold. This is done by slowly increasing the amount of time between bathroom breaks, till you can go three to four hours without needing to urinate.
- Proper Hydration Balance: Hydration and drinking enough water can help with incontinence, however, drinking too much or too little water can worsen the condition.
- Pelvic Support Devices: Pelvic support devices like a urethral insert can help with incontinence. You can use these if your incontinence is becoming hard to manage.
- Breathing Techniques During Exercise: During exercise, make sure you are breathing properly to allow your muscles to contract and release without too much pressure on them
- Avoid Heavy Lifting: Lifting heavy objects can add unnecessary strain to your pelvic muscles, triggering incontinence
- Wear Comfortable, Breathable Clothing: In case of urine leakage, comfortable, breathable clothes are easier to deal with. They will not stay damp for too long. Additionally, loose clothing does not add pressure to your bladder
- Practice Proper Posture: Maintain proper posture while sitting or standing. Try to shift the weight entirely on your feet.
When To See Your Doctor For Urine leakage During Pregnancy
Mild urine incontinence during pregnancy may be embarrassing, but it isn’t concerning and happens to a majority of pregnant women. The key is to understand when it is a more serious condition like urinary tract infection that is causing the symptoms. While UI is caused by muscles and nerves in the pelvic region weakening, UTI is an infection caused by the presence of microbes in the urinary tract. UTIs can be dangerous as they can lead to bloody, cloudy urine accompanied by a fever. If you have these symptoms along with an urgent need to urinate frequently, call your doctor immediately.FAQs on Urine Leakage When Coughing During Pregnancy
- Will my bladder control improve after pregnancy?
Yes, bladder control does improve after pregnancy as the baby no longer puts pressure on your bladder, however, factors like a vaginal birth have to be kept in mind, as they can damage pelvic nerves and lead to more incontinence. Speak to your doctor about this for more specialised advice. - Can urine incontinence affect my baby?
Pregnancy-related physical changes cause urine incontinence but this does not affect the baby. Urine incontinence usually goes away a few months after giving birth. - Will my previous vaginal delivery increase my risk of urine incontinence in this pregnancy?
Having vaginal births in the past can cause your pelvic floor muscles and pelvic nerves to weaken, hence increasing the chances of urine incontinence. Speak to your doctor about this and to understand your chances of avoiding it.
