Everything You Need To Know About Pregnancy Incontinence / HARTMANN Information Centre

The HARTMANN Team

Everything You Need To Know About Pregnancy Incontinence

Women’s bodies are truly amazing things and the changes they go through to grow a baby and then give birth really are wonderful, but there can also be some drawbacks. Unfortunately, for many women, pregnancy and incontinence go hand in hand. Urinary incontinence is a problem that can affect women during pregnancy and after birth, and despite most women struggling with the problem at some stage, it remains a topic that isn’t discussed nearly enough. Talking about factors that contribute to the problem, recognising how widespread the issue is and offering practical solutions to remedy pregnancy incontinence can all help to stop women from unnecessarily suffering in silence. With this in mind, we’re sharing everything you need to know about pregnancy incontinence to help inform you about a problem that’s a lot more common than you’d think.

What Is Pregnancy Incontinence?

Most pregnancy incontinence is stress incontinence. This means you lose the ability to control your bladder and suffer involuntary urine loss in situations where its put under extra stress. For example, when you run, sneeze, cough or lift a heavy object. It could happen simply if you stand up quickly from a seated position.

An overactive bladder is a less common issue that can also affect mums to be. When you suffer from an overactive bladder, uncontrollable spasms lead to a more frequent need to go to the toilet. Both of these issues can be uncomfortable and inconvenient but it’s important to remember you’re not alone in suffering these types of symptoms.

Pregnant Women

What Causes Pregnancy Incontinence?

So what is it about pregnancy that makes it such a powerful recipe for incontinence? There are a few factors that often come together to cause the issue. Firstly, during pregnancy a woman’s hormones change to allow joints and muscles to relax more easily. This is designed to aid the delivery of her baby when the time comes. Unfortunately, this can make the muscles around the urethra less effective. These muscles are responsible for cutting off the flow of urine from our bladder and when contracted, it helps prevent urination until you reach a restroom. When they’re not performing at their best, it follows that some leakage may occur or flow of urine may start before a woman manages to reach the bathroom.

The pressure from the baby itself can also be a factor, which can become particularly noticeable in the third trimester. The muscles across the woman’s pelvic floor provide support for the baby and can weaken under the pressure. For many women pregnancy incontinence can therefore worsen at this stage of pregnancy.

There are some other risk factors that you should also be aware of that can make it more likely that you will suffer from urinary incontinence during pregnancy. These include:

  • Being overweight
  • Gaining more than the recommended amount of weight during pregnancy
  • If you’re aged 35 or over
  • If there’s a history of incontinence in your family

Factors that can make you more likely to have some degree of incontinence after birth, include:

  • Use of forceps to assist birth
  • Having a big baby
  • Episiotomy
  • Damage to nerves that leads to muscle weakness
  • A long labour

In the event of an epidural or spinal block during delivery, a woman’s nerves are likely to be numb and after birth she may initially be unaware of when she needs to go to the toilet. It could also take a little time for urinary function to normalise after a catheter has been used.

How Many People Are Affected By Incontinence During and After Pregnancy

It’s hard to put an accurate figure on how many women are affected by incontinence during pregnancy and after birth because it’s still seen as somewhat of a taboo subject. Research carried out by the National Childbirth Trust (NCT)[1] found that a third of women who suffered from the problem after they’d given birth were too embarrassed to discuss It with their partner. Almost half (46 per cent) didn’t feel comfortable talking about the topic with friends. Women who do suffer are therefore less likely to realise that others are experiencing the same problems. There were also a significant number of women (38 per cent) who stated they felt self-conscious discussing the issue with health professionals and so the unfortunate reality is that many women simply don’t seek help when they should.

The World Health Organization estimates that bladder problems impact the lives of over 200 million people worldwide[2]. Closer to home the NHS[3] estimates that between three and six million people in the UK suffer with urinary incontinence to some degree. However, England’s Chief Medical Officer, Sally Davies, recently suggested that as many as seven million women[4] in the UK may be suffering from incontinence.

Stress Women

How Can You Avoid Pregnancy Incontinence?

Before trying to conceive you may want to try and lower any potentially controllable risk factors such as being overweight in order to try and lower the likelihood of you suffering with pregnancy incontinence. During pregnancy, women are advised to carry out pelvic floor exercises to strengthen the muscles at the bottom of the pelvis. You can find an introduction to pelvic floor exercises here. Many prenatal exercise classes such as yoga or Pilates will incorporate specific exercises aimed at strengthening your floor. So, if you’d like to give some structure to your exercise plans and learn techniques you can practise at home, they, along with some antenatal classes, can be a good place to start.
It’s also wise to try not to get caught out by visiting the bathroom as frequently as possible and trying to empty the bladder as fully as possible when you do.

How Can You Treat Pregnancy Incontinence?

 

Pelvic floor exercises

 

It’s so important to start pelvic floor exercises as soon as possible after birth. For many women, the only guidance they receive on the topic is a leaflet they’re given on the hospital ward shortly after they’ve given birth. As a new parent with a demanding newborn baby, getting to work on re-strengthening your pelvic floor could therefore easily slip your mind.

Make pelvic floor exercises a priority by starting them as soon as 24 hours after birth. If you’ve had stitches after labour it’s wise to lie down to reduce pressure on them. Start out gently with just a few gentle and short contractions, building the frequency of the exercises as and when you feel able. You should aim to reach four or five sets of exercises per day, holding the muscles for longer pauses as your strength builds. Women who have given birth by C-section are also advised to carry out pelvic floor exercises since pregnancy itself can substantially weaken your muscles.

Pregnancy incontinence is both manageable and treatable but it’s imperative you take action to counter it as soon as possible and seek medical advice if required. For most women, the issue subsides within a few weeks or months but if left unchecked, it has the potential to develop into a long-term problem. With this in mind, don’t feel shy about mentioning any issues to your GP, midwife or health visitor. If it’s still causing you problems at the six-week check up after birth, be sure to mention it to your doctor.

 

Incontinence products

 

Most problems can be successfully treated through exercise and in the meantime, here at HARTMANN we have a great range of products that are designed to help you discreetly manage leakage. These include pull up pants and pads shaped for comfort, so whether you want to want to feel drier and more comfortable at night time to help you get a more restful sleep or you want peace of mind when you head out for a run, take a look at our collection of incontinence products for women and we’re sure you’ll find something suitable.

Diet and lifestyle

 

fruitSince being overweight can exacerbate urinary incontinence problems, losing pregnancy weight safely and gradually may be one of your health goals. Speak to your GP for advice and try and follow a healthy and varied diet. In particular, ensure you include plenty of fibre intake to help prevent constipation. Straining during bowel movements puts extra pressure on your pelvic floor, which can contribute to muscle weakness. You may also want to avoid drinks that can irritate the bladder such as caffeinated coffee or tea and fizzy drinks. But please don’t be tempted to reduce your fluid intake, as doing so could lead to dehydration. And if you’re a breastfeeding mum, you’re likely to get very thirsty when you feed your baby.

Medication and Surgery

 

Heath professionals will usually suggest exercise and dietary changes to treat pregnancy incontinence in the first instance. This could include referral to a specialist physiotherapist. In the case of more chronic issues, some medical intervention may be advised. This might include the use of medicines such as Duloxetine or injections of filler or bulking agents to bulk up the bladder. Colposuspension is a type of surgery that is sometimes carried out to lift the neck of the bladder and reduce stress. In the past, some women in the UK have been fitted with a plastic mesh to support their organs and reduce the impact of incontinence. However, after many women reported pain as a result of the procedure this is now under review[5].

Summary

 

  • Don’t forget that though pregnancy incontinence is very common, it’s not something that you should accept. If you experience problems during or after pregnancy, seek the advice of health professionals.
  • Hormone changes combined with pressure placed on the pelvic floor muscles during pregnancy often result in stress urinary incontinence that can cause problems when you sneeze or run.
  • Being overweight, having a family history of incontinence or being aged 35 or over when pregnant increases your chance of suffering pregnancy incontinence.
  • Carrying out pelvic floor exercises before and after birth is the best way to prevent and solve issues, whether you have a vaginal birth or a C-Section.
  • When you suffer from leakage, reach for reliable incontinence products tailored to your needs.
  • Fizzy and caffeinated drinks can exacerbate the problem.
  • In chronic cases of urinary continence, health professionals may recommend medication or surgical solutions.

 

 

[1] Nct.org.uk. 2016. Breaking the taboo of incontinence after childbirth. [Press release]. 05 September. [Accessed 21 March 2018]. Available from: https://www.nct.org.uk/press-release/breaking-taboo-incontinence-after-childbirth

[2] Chancellor, MB. 1999. Mapping the Future for Incontinence Treatment Worldwide: Highlights from the First International Consultation on Incontinence June 28–July 1, 1998, Monaco. Reviews in Urology. [Online]. 999 Summer; 1(3) pp.145–147. [Accessed 22 March] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477522/

[3] NHS Inform. 2017. Urinary Incontinence. [Online]. 22 December. [Accessed 21 March 2018] Available from: https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/urinary-incontinence

[4] Elkins, L. 2018. 7 million women suffer incontinence: Now, the UK’s top doctor has revealed her own ordeal to break the most embarrassing taboo of all. Mail Online. [Online]. 05 March [Accessed 21 March 2018]. Available from: http://www.dailymail.co.uk/health/article-5465455/7-million-women-suffer-incontinence-embarrassing-taboo.html

http://www.dailymail.co.uk/health/article-5465455/7-million-women-suffer-incontinence-embarrassing-taboo.html

[5] BBC News. 2017. Vaginal mesh: England review into scale of harm. [Online]. 30 January. [Accessed 21 March 2018]. Available from: http://www.bbc.co.uk/news/health-42871621

 

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