Urinary Incontinence: Why Can’t I Control My Bladder After Delivery?

The three types of incontinence are

1. Stress Incontinence

This happens due to pressure on the bladder while coughing, sneezing, laughing, or with heavy, strenuous activity.

2. Urge Incontinence

In this type, there is a sudden urge to urinate, which results in leakage on the way to the toilet.

3. Mixed Type Of Incontinence

This is a mixture of both stress and urge incontinence.

Why Can’t I Control My Urine After Delivery?

Now that your pelvic floor has become weak owing to pregnancy and childbirth, it will be difficult for you to exercise control of the muscles and sphincters at the bottom of your bladder to keep the urethra closed so that urine does not leak out.[2]

When you sneeze, cough, laugh, or lift something heavy, pressure builds on the bladder, and the nerves and ligaments that control the urethra are unable to stop the urine leakage due to overstretching of injury in the pelvic floor. After delivery, as the uterus contracts, it sits just above the bladder, making it even harder to control leaking urine. This makes women leak a few drops, or sometimes the entire bladder, in one go.

Who Is At More Risk To Develop Urinary Incontinence After Birth?

Having a vaginal birth makes you more susceptible to suffering from urinary continence after childbirth. Though it has been found that women who avoided labor altogether and had planned C-sections also complained of losing bladder control, the numbers are still lower than those of women who delivered naturally.

• Having an assisted vaginal birth or having an injury can also make you prone to stress incontinence. 
• Some studies also indicate that women who have a prolonged pushing stage may also have stress incontinence. [3] 
• Having a large baby can also be another factor. 
• Urinary incontinence is also higher for mothers who have many children, and obesity and smoking also put you at a higher risk of having urinary incontinence.

How Long Will Urinary Incontinence Last After Childbirth?

There is no definite answer for this one. For some women, the leakage may stop within a few weeks after delivery, while for others it may linger for a few months or even longer. In some cases, it becomes a long-term problem.

It is important to mention it to your doctor when you go for your post-natal checkups. Urinary incontinence is not a by-product of having a child, so seeking medicinal support is a definite ‘yes’.

How Can I Regain Control Of My Bladder After Delivery?

It will take some work, but it will be surely helpful.

Regaining control of the bladder after delivery may need some work on the new mom’s part. Here are a few things you may consider:.

• Do 3 sets of 30 Kegels every day for three months, after which it may just become second nature to do you
• Develop a sensible pregnancy weight loss plan, all that you have on your body puts extra pressure on your bladder
• Avoid constipation with an intake of a fibrous diet and light exercise. Eat healthy foods and maintain healthy bowels. This will ease pressure on the bladder.
• Train your bladder by starting to use the loo every 30 minutes at first and then increasing the intervals.
• Dehydration should be kept at bay by drinking at least 8 glasses of water or fluids every day.
• Avoid caffeine, which is a diuretic, as well as alcohol, which can again dehydrate you. Smoking is also a huge no
• You can use sanitary pads to avoid getting wet, but tampons should be avoided during the entire postpartum period.
• When the urge to sneeze, cough, or laugh strikes, start Kegels or cross your legs to stop wee leakage.
• Also check for a urinary tract infection, especially burns or pains when you pee.
• If nothing helps, your doctor may refer you to a physiotherapist. In rare cases, surgery may be needed.

Continue to do Kegels even after you feel you have started to regain bladder control. [4] If you stop suddenly, you may find that your problem might return. Pelvic floor exercises will also help heal your bruises and stitches and aid in a quicker recovery. You can start as soon as you feel fit for them.

Above all, maintain your confidence and do not get distressed if you leak sometimes. Your body has been through a huge experience, and it will be some time before it starts functioning as usual. Rest a lot, eat a healthy and balanced diet, and try to get some exercise. Your incredible journey as a mother has just begun, do not let these small issues bother you way too much.

Treatment Options For Urinary Incontinence After Childbirth

 You can talk to your gynecologist about the concern, but in case that does not help, then you should consider seeing a specialist. 

A urogynecologist or a pelvic floor muscle therapist can help. Treatment entirely depends on the type and severity of urinary incontinence. There are three main types of treatment that you can choose after consulting your healthcare provider:

1. Lifestyle Changes

A few changes in your everyday life can help with urinary incontinence. Regular exercises that strengthen the pelvic floor muscles can really help. A good diet aimed to reduce excess weight can be of help too.  Practice bladder training to stretch out the time between loo visits.

2. Medical Management

There are a few medications available that can help reduce the leakage of urine. They basically help in stabilizing the muscle contractions of the bladder. They can help in bringing back the normal function of the bladder. Talk to your healthcare provider about which medicine can benefit you according to your needs.

3. Surgical Management

Your doctor will suggest certain procedures if other options fail to manage. Some of them are:

• Bulking Agents:  This involves an injection through which a permanent substance is injected, which increases the size of the urethral lining.
• Botulinum Toxin Injection:  This is a cosmetic agent that can also be used in the bladder to relax the muscles. This helps reduce incontinence. [5]
• Sling Procedures: Here either a strip of your tissue or some synthetic material is used to support the urethra. [6]

When To Consult A Doctor?

In most women, urinary incontinence gets better a few months, after delivery. As the muscle strength starts regaining and the tissue starts repairing, the leaking of urine starts getting better. For some women, this recovery can take months, while for others, the pelvic floor never fully recovers. This calls for seeing your doctor as soon as possible. Early intervention into this problem can help it become a lifelong issue. If you feel that you are making a lot of frequent trips to the loo at night, and it is disturbing your sleep, then it is best to see a doctor. 

FAQs

1. Is It Normal To Have An Urgency To Pee After Childbirth?

Yes, it is very normal to have an increase in urgency to pee after childbirth. The weak pelvic floor muscle results in this condition and affects the majority of females.

2. Why Am I Peeing So Much After Delivery?

Due to excessive stretching of the pelvic floor muscles and tissues, the pelvic floor is unable to hold urine for a longer time. In a few cases, there might be some tear or damage to the pelvic floor during delivery. 

3. How To Control Bladder After Childbirth?

Doing certain lifestyle changes including diet control, reducing caffeine intake, and doing regular pelvic floor muscle strengthening exercises, can help in regaining bladder control.

References

1. Prevalence of urinary incontinence – [https://www.bmj.com/content/281/6250/1243.short]
2. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment – [https://link.springer.com/article/10.1007/s00192-013-2061-7]
3. Factors involved in the persistence of stress urinary incontinence from postpartum to 12 years after first delivery – [https://onlinelibrary.wiley.com/doi/abs/10.1002/nau.24442]
4. The Effect of Kegel Exercises and Pelvic Floor Physiotherapy on the Improvements of Stress Urinary Incontinence and Urge Incontinence in Women with Normal Vaginal Delivery – [https://www.ingentaconnect.com/content/ben/cwhr/2024/00000020/00000004/art00002]
5. Management of urinary incontinence – [https://journals.sagepub.com/doi/abs/10.1177/2053369120927112]
6. Incontinence-specific quality of life measures used in trials of sling procedures for female stress urinary incontinence: a meta-analysis – [https://link.springer.com/article/10.1007/s11255-015-1020-2]