We get it. Nobody really wants to admit they’re experiencing urinary incontinence during pregnancy. This is a time where we’re already being poked, prodded and ‘inspected’ more than ever, so adding another ‘ailment’ to the list (and such an embarrassing one, too!) is nobody’s idea of a good time.
But you know us here at WUKA- we like to have the difficult conversations, so that you don’t have to. And here are the facts: accidentally peeing yourself or leaking some urine during pregnancy might happen. It’s nothing to be ashamed of (we know there are a few taboos we need to smash surrounding this topic) and yet many of us are. So let’s break it down, delving deeper into why pregnancy incontinence occurs, and what we can do about it.
What is urinary incontinence?
Urinary incontinence is where you’re not able to hold urine in when you laugh, cough, sneeze or perform physical actions such as running or jumping. It can also present as feeling the sudden and urgent need to pee, and having to get up in the night to use the loo too.
There are two types of urinary incontinence. Stress incontinence is where the bladder is put under pressure, for example during pregnancy- we’ll go into more detail about that later on.
Urge incontinence is where you feel a sudden and urgent need to pee… another symptom that seems common in pregnancy too! The problem is that sometimes you just can’t hold the pee in, and leaks occur before you get to the bathroom.
Urinary incontinence is a very common condition that affects more women than men, and can be an issue for many during pregnancy and after childbirth.
According to a report from the Royal College of Midwives (RCM), it’s estimated to affect between 14-17% of women. But figures cannot be accurate here due to the stigma attached and the amount of women who do not report their symptoms, along with a lack of data on Black Minority Ethnic women. And in some cases, treatment is not sought until around 10 years after the symptoms first appeared.
What causes incontinence in pregnancy?
So what is it that causes incontinence in pregnancy? We spoke to WUKA expert, Anja, author of the best selling book Teaching Yoga for the Menstrual Cycle. She told us that people can experience pregnancy incontinence for a variety of reasons, and to varying degrees.
But incontinence during pregnancy shouldn’t be confused with needing to pee more than usual- a common side-effect of pregnancy for many, especially in the third trimester as the baby grows bigger. Anja agrees, advising:
“Feeling you have to pee more frequently and urgently during pregnancy is normal. There are several reasons for this.
Most obviously there is a lot of pressure on the bladder. The uterus sits on top and slightly to the back of the bladder. With a growing baby or babies, amniotic fluid and a placenta, its no surprise the bladder is feeling the pressure.”
So if you’re pregnant and feel like you’re up and down to the loo every two minutes, now you know why!
But how do we know if the more frequent trips to the loo can be put down to a normal part of pregnancy, or a problem with incontinence? Anja explained that the added pressure on the bladder can cause temporary incontinence, and that hormones can also play a role here too.
“In pregnancy the hormone human chorionic gonadotropin (HCG) is secreted. HCG also increases blood supply to the pelvis, and can give the bladder the wrong impression- that it needs to be emptied. So it feels like we have to pee, but we don’t actually need to.
Another hormone that increases is progesterone. Progesterone slows things down and relaxes the muscles. This can cause constipation. And constipation can put extra pressure on the other pelvic organs. When we’re constipated, we might start to strain during bowel movements, which leads to more pressure on the pelvic floor and the bladder.
With the extra pressure and the hormonal changes it is very common to feel the urge to urinate more frequently.”
What exercises are helpful during pregnancy to manage incontinence?
Knowing that incontinence during pregnancy can be totally normal doesn’t make it any less of an issue, so its a good idea to do everything you can to keep your pelvic floor muscles strong and healthy.
Anja told us,
“Having an awareness of the pelvic floor muscles and the pelvis in general is really helpful. Not just to prevent incontinence but also to prepare for labour, birth and postpartum healing.
You need to be able to both relax and engage the pelvic floor. In fact, the pelvic floor generally knows when to do so on its own. It’s just that we have a lifestyle that might challenge the natural mobility of the pelvic floor.
It is really important to stay active if you already have an exercise routine, with the support of a qualified instructor trained in prenatal exercise. If you don’t move much right now, then start slowly. Even just walking or substituting your office chair with a gym ball is a good start.
I would suggest going to a prenatal yoga class where there is a focus on pelvic health either in-person or online. In a pregnancy yoga class we will focus on movement to support the pelvis and pelvic floor as well as prepare for birth.
The simple breathing techniques we discussed in Exercises to help with urinary incontinence. Here we also explore cat-cow stretches. This movement naturally contracts and stretches the pelvic floor – and we can choose to use the breath to bring more awareness too.
Start on the hands and knees. Arch the back by lifting the sitting bones and imagine the sitting bones widening and the pelvic floor relaxing. Look forward as you inhale in the position. On the exhale round the spine towards the sky, drawing the sitting bones and tailbone inwards. Looking down or towards your knees. You can create an engagement of the pelvic floor drawing in and up on the out-breath.
Continue this movement with the awareness of the pelvis and pelvic floor.”
How can incontinence during pregnancy be prevented?
While this diagram clearly shows just how much pressure a growing baby can put on the bladder, not everyone will experience incontinence during pregnancy, and luckily there are some things that you can do to prevent it from happening too. But remember this: just as some of us will get stretch marks and others won’t, and just as some of us suffer with morning sickness while others seem to breeze through… we’re all different. If you do experience incontinence, there is absolutely nothing to be embarrassed or ashamed about. You didn’t fail. You did nothing wrong- and you’re definitely not alone.
It’s worth pointing out here too that you can follow preventative steps, and still experience urinary incontinence. Being prepared is the best defence, whichever direction your journey takes you.
Anja agrees, adding:
“If you know you are wanting to conceive, then prepare your body. Get to know your body and your pelvic floor before the hormonal changes and the pressure of a growing uterus.
We are focusing on the pelvic floor in this blog but everything is connected. How you move your body in general, your activities and exercise routine before and during pregnancy can also affect your pelvic floor and the potential for incontinence.
So if you are active and have a mobile and healthy pelvic floor before pregnancy it is easier to maintain it.
Some of the causes can not be prevented. That is part of the physiology of pregnancy. But we can strengthen and learn to release unnecessary tension in the pelvic floor – even in late pregnancy. This will help to encourage better bladder control.”
Tips for managing incontinence during pregnancy
So what should you do if you are experiencing urinary incontinence during pregnancy? The RCM says that a third of expectant and new mums do not practise pelvic floor exercises, despite this being one of the best ways to not only prevent incontinence, but to improve the condition both during pregnancy and after childbirth.
A further report by the RCM suggests that as many as 60% of all UK women have at least one symptom of poor pelvic floor health, further highlighting that this is not a ‘small issue’ affecting just a few women.
If you’re not sure where to start, speak to your GP or midwife, or enlist the help of a trained ante-natal fitness coach.
On a practical level, our new
Drytech™ incontinence pants might just become your new best friend. Made to absorb light leaks and dribbles, these pants are soft and super comfy, helping to keep you dry and odour free. Using Polygiene OdourCrunch™ technology and Polygiene StayFresh™ technology you definitely don’t need to worry about odour or feeling ‘wet’- these pants will keep you fresh and comfy.
Another bonus of our new Drytech™ pants? They’re made with our innovative stretch technology, so they gently expand to accommodate your growing shape, and you can wear them after birth comfortably too. And like our Stretch period pants, they have a super absorbent gusset made up of many layers, ready to take in whatever leaks might slip out.
Available in both midi brief and high waist style, these pants come in just two sizes- XS- L and XL- 4XL- and in three colour ways- black, light nude and coral– you can wear a pair and keep a couple handy. Wear them like your normal pants, don’t be afraid of leaks when they occur, and rest assured that we’ve got your back- now, and after birth too.
How can I stop urine leakage during pregnancy?
Pelvic floor exercises are an excellent way to help prevent urine leakage during pregnancy. Remember that the added pressure on the bladder from your expanding uterus cannot be prevented, so keeping the muscles strong will certainly help.
When does pregnancy incontinence start?
For some, needing to pee more often is one of the very first signs of pregnancy- sometimes even before the blue line appears on the test! According to the organisation Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) up to half of all pregnant women experience incontinence during the second and third trimesters, from around 14 weeks gestation.
Does pregnancy incontinence go away?
Pregnancy incontinence should settle down within a few weeks after birth. Regular pelvic floor exercises are so important, so speak to your GP or midwife about them now.
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