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Pregnancy & Postpartum Incontinence - The Whole Picture

There's more to it than the baby's position or a weak pelvic floor. There are many reasons why leaking can occur during pregnancy and postpartum. Read here to learn more.

Leaking during or after pregnancy is common. But it’s not normal. There are things you can do and factors to be aware of to prevent and reduce leaking during this timeframe.

Let’s talk first about pregnancy first.

Many body changes occur that can increase the risk of leaking, and are more likely to be of impact during the third trimester. This includes:

- Direct pressure from the baby pressing against the bladder and/or decreased space for the bladder to stretch as it fills
- Increased pressure onto the bladder from weight gain
- Increased pressure and strain onto the pelvic floor from constipation during pregnancy, and less room for the bladder to fill when constipated
- Loss of strength and/or coordination due to lowered activity level
- A pattern of increased bearing down in cases where a person has difficulty moving
- Joint or muscle pain that can lead to changes in core support during movement, exercise, and sneezing/coughing
- Change in posture that can lead to changes in core support during movement, exercise, and sneezing/coughing

Taking part in a prenatal fitness program, pelvic floor training, and/or pelvic health physical therapy, and addressing any pre-existing injuries or pain, can improve your ability to stay strong and comfortable throughout pregnancy without leaking. If you already have urinary leaking, then these activities can treat leaking before childbirth, and can improve your outcomes after childbirth. Research shows that individuals who take part in prenatal pelvic floor muscle training report less urinary incontinence at 35 weeks pregnancy, and at six weeks and six months postpartum, as compared to those who do not participate in pelvic floor training.


What about Postpartum?

Any initial leaking should resolve or improve significantly within the first six weeks to three months after childbirth. Symptoms are more likely to go away when the first six weeks can be spent focusing on rest and nourishment (healthy food, abundant hydration, daily walks, lots of naps, and of course, baby bonding). But sometimes leaking happens postpartum and continues for a while, or even seems to become a part of life. What can cause this? Factors that can contribute to urinary leaking after childbirth include:

- Doing activities that are too intense for your phase in recovery (examples: lifting older children, heavy housework, being on feet all day)
- Returning to certain exercises sooner than is appropriate, especially high impact like running or Crossfit
- Scar tissue and muscle dysfunction at the perineum or abdomen (vaginal or Cesarean birth)
- Weakness of the core muscles, including the pelvic floor
- Tightness and/or pain in the pelvic floor
- Birth injuries that resulted in difficulty moving or a prolonged recovery


In summary, here are the top recommendations gathered from physical therapy pelvic health experts. During pregnancy, partake in pelvic floor exercise, and get help for pain or leaking when it first starts. For postpartum, try to carve out a really high quality early postpartum plan, giving you the best possible ability to rest and recover physically and mentally without excess demands; and gradually return to your highest level of activity (even if you feel great!).

​** Note: this content serves as educational only. It does not constitute medical evaluation, treatment, or advice. Please consult with your medical provider(s) as needed, before partaking in changes to your medical, fitness, or health care practices.

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