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pregnancy incontinence

WHAT’S UP WITH PEEING DURING PREGNANCY?

pregnant woman drinking water, pregnancy incontinence and what to do about it

WHAT’S UP WITH PEEING DURING PREGNANCY?

In our usual Planet Mama spirit of normalising and shedding light on the WHOLE bump to baby journey, this week we wanted to talk about peeing in pregnancy. 

The constant need for a wee is in fact one of the earliest signs of pregnancy. However, leaking urine (AKA incontinence) is also a common and unwanted issue during pregnancy, with about 53% of women reporting a negative effect on their quality of life. Unlike incontinence postpartum, we don’t believe it gets enough airtime. So here is our deep dive into pregnancy incontinence.

WHAT IS PREGNANCY INCONTINENCE?

Urinary incontinence is when you wee or leak urine without meaning to. Maybe you’ve experienced it when you’ve sneezed or coughed? It can start pretty early on in pregnancy, due to pregnancy hormones and the growing placenta lying on the bladder. It might even improve somewhat but then get worse again as the baby grows and places pressure on the pelvic floor and bladder too.

There are a few types of urinary incontinence:

  • stress incontinence: loss of urine due to physical pressure on the bladder
  • urgency incontinence: loss of urine due to an urgent need to urinate, commonly caused by bladder contractions
  • mixed incontinence: a combination of stress and urgency incontinence
  • transient incontinence: temporary loss of urine due to a medication or a temporary condition, such as a urinary tract infection or constipation

If you are experiencing any of the above, read on to learn why you may have incontinence in pregnancy and what you can do to help

WHAT CAUSES PREGNANCY INCONTINENCE?

Let’s take a moment to think about your anatomy. Your bladder sits right above your pelvic bones and is supported by your pelvic floor. It relaxes and fills with urine throughout the day and then the sphincter releases when you’re able to go to the toilet. During pregnancy, your pelvic floor muscles are put to the test due to:

Pressure – This can be due to the growing weight of your baby placing pressure on your bladder, or intra abdominal pressure i.e. when you cough, sneeze, exercise or laugh.

Hormones – Pregnancy hormones can affect the lining of your bladder and urethra.

Pelvic Floor – Either too tight or too weak pelvic floor muscles. Quite often the Pelvic Floor becomes on high alert in pregnancy due to a combination of postural changes and anxiety.

Medical conditions – Some medical causes for incontinence include diabetes and anxiety medicine.

Urinary tract infections (UTIs) – UTI’s can be aggravated during pregnancy.

HOW CAN YOU HELP YOUR LOO SITU?

In most instances, making a few lifestyle changes can dramatically improve your symptoms and help you manage your bladder urges.

Here are a few lifestyle and exercise changes that can help:

Pelvic Floor Exercises: Specific exercises are great at balancing  your pelvic floor and helping you manage your symptoms. We want to work on strengthening and also releasing.

To work on your pelvic floor, draw your awareness to the space between your coccyx and your pubis. Take an inhale and then on a long exhalation visualise drawing this space together and lifting up. Hold this Squeeze for 10 seconds before relaxing. Aim to do 5-10 sets of these exercises per day. Make sure you fully release in between each set so that you keep a lovely balance and don’t hold your breath. You can start doing these traditional pelvic floor exercises whilst static and then progress to whilst moving around, challenging the muscles a bit more.

Connection Breath Strategies: Practise breathing deep into the bottom of your lungs and engaging with your pelvic floor and deep core abs as you exhale. Use this breath in day-to-day life, particularly as you get up out of bed or chairs, so you can avoid bearing down on your pelvic floor.

Avoid carbonated or caffeinated drinks: Avoid carbonated drinks, coffee and tea. These beverages may make you feel like you need to use the bathroom more often. Try drinking more water or decaffeinated beverages where possible.

Avoid drinking at night: Limit your beverages late in the evening to avoid frequent trips to the bathroom and leaking at night.

Eat a high-fibre diet: Eat foods that are high in fibre to avoid constipation, which puts added stress on your pelvic floor.

Maintain a healthy weight: Extra weight, especially around your abdomen, increases pressure over your bladder. Losing weight after labour can also help with incontinence after pregnancy. 

ARE SOME WOMEN MORE AT RISK FOR PREGNANCY INCONTINENCE?

Women who already have an overactive bladder or urgency incontinence are likely to have symptoms that continue or worsen during pregnancy.

Other risk factors include:

  • older age
  • being overweight
  • having previous vaginal delivery
  • having previous pelvic surgery
  • smoking, which leads to chronic coughing

REACH OUT TO A WOMEN’S HEALTH SPECIALIST

If you are really struggling with your incontinence during or after pregnancy, please reach out to a women’s health specialist and they can assess your pelvic floor and create a specific plan bespoke to you. There are also some really useful resources on the NCT website, the NHS and Royal College of Obstetricians and Gynaecologists

A WORD FROM OUR EXPERT, SARAH PARKER PHYSIO:

“Pregnancy incontinence is another form of leaking that shouldn’t just be accepted and put up with. Always get help! Leakiness doesn’t always mean weakness too so having an assessment can treat it properly. Pelvic floor exercises aren’t always to answer” www.sarahparkerphysio.com

Lettie, Founder of Planet Mama x