Is It Normal to Leak During Pregnancy? It Depends.

Urinary incontinence that significantly affects the quality of life is experienced by an estimated 54% of pregnant women. Because this is so common, we may think that this is an inevitability that won’t improve until after we give birth. 

Urinary incontinence may be caused by pregnancy-related factors that we can’t change. For example, the baby and the amniotic fluid take up space in our abdomen and press against our organs, creating pressure – this means that our bladder can hold less urine and we will need to empty it more often. As well, this pressure may be stronger than the strength of the sphincter muscles of our bladder, leading to leakage of urine at times when we don’t want to be leaking. 

The good news is that some of the causative factors of urinary leakage during pregnancy can be changed – and making a few changes may reduce or eliminate incontinence.  Here are some examples of what we can work on:

How we breathe: some breathing patterns result in increased pressure within the abdomen, which would further compress the bladder. Your pelvic health physiotherapist can help you to practise more helpful breathing strategies, resulting in decreased pressure on your bladder.

How our ribcage moves: if our ribcage is stiff, we may have difficulty adopting a more helpful breathing pattern. Increasing mobility of your ribcage through exercise and through manual physiotherapy techniques can allow your ribcage to move in a way that will complement helpful breathing patterns.

How we digest: constipation may be a culprit. If we hold our breath and bear down during evacuation of our bowels because of constipation, we will be adding to the pressure felt by our bladders. Solutions to constipation include dietary changes, ensuring that you are well hydrated, strategies to stimulate your “rest and digest” nervous system (your parasympathetic nervous system), and strategies to help during the moment of evacuation of your bowels. 

How we feel: our emotions can create tension at our pelvic floor. When our nervous system is ramped up through emotions such as fear, anger, and anxiety, there is a direct message to our pelvic floor muscles to contract. This means that we may be holding too much tension in our pelvic floor muscles – and if this happens, we can’t use these muscles in an optimal way to help with urinary continence.  Stress and anxiety management strategies can help with this.

How our hormones are changing: Hormonal changes during and after pregnancy can result in less hydration within our urethra (the tube that carries our urine from our bladder to the outside of our body). If the inner lining of our urethra is too dry, it is easier for urine to leak out. There are products available to help replenish the moisture in the area – your pelvic health physiotherapist, your doctor and/or your naturopathic doctor can provide recommendations that are most suited to your particular situation. 

We can’t affect every cause of pregnancy-related urinary incontinence – however many relatively simple changes can make a big difference!

Schedule your appointment to find out how pelvic health physiotherapy can help you.