After nine months of pregnancy and a rollercoaster of experiences with a changing body, it’s easy to chalk up bladder leaks after delivery to one more outcome of childbirth. While that’s true for many women, other conditions could be responsible for urinary incontinence —the inability to control the release of urine from one’s bladder —if a woman is having difficulties controlling urination two months post pregnancy or more.
The problem is common and nothing to be embarrassed about, says Jan Baker, APRN, a nurse practitioner at University of Utah Health Care who sees several cases every year related to new moms who experience urinary incontinence after baby’s arrival.
The condition is caused by “the stretching and tearing of supporting structures including ligaments, tendons, nerves and muscles,” resulting in a weakened pelvic floor, says Baker. The extent of the stretching or tearing varies in each person. Incontinence often resolves itself within a couple months when the structures have repaired.
According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age, although women over age 50 are the most likely to develop the condition. In many cases, UI is often temporary—such as during or after pregnancy for a short while — or results from an underlying medical condition.
The most common form of incontinence in women post pregnancy is stress incontinence, which consists of losing urine when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Another common form of urinary incontinence post pregnancy is known as urge incontinence —described as an intense urge to urinate, followed by an involuntary loss of urine. Many women will experience a mixture of both forms, which medical professionals refer to as mixed incontinence.
Urinary incontinence can affect a woman in many different ways. It’s more than just an awkward issue that makes it hard to not leak urine. The impact of incontinence on a woman’s personal life can be distressing. Women often avoid going out because they are embarrassed by their frequent bathroom usage. The problem can greatly affect a woman’s sex life, especially when suffering from stress incontinence. Many patients will talk to providers about the changes in relationships that take place in their intimate lives as a result of urinary incontinence, says Baker.
“[Women with incontinence] have to rearrange their lives. They have to buy pads, which can be expensive. It can irritate their skin. They are all emotionally challenging things to deal with especially after just having a baby,” notes Baker. “It has added to the stress of having a baby in general.”
There are several different ways to treat urinary incontinence.
The most important thing is to allow the muscles to repair themselves, says Baker. While some cases of urinary incontinence will disappear a few weeks after a woman gives birth, women should seek medical treatment if they are still experiencing leakage after two months.
Pelvic floor exercises, commonly known as kegal exercises, can often improve urinary incontinence. The exercises strengthen the urinary sphincter and the muscles that help control urination. A physical therapist or professional recommended by a physician can provide insight on whether a patient is properly contracting muscles to help improve the condition.
Baker also suggests keeping a bladder diary for those dealing with urinary incontinence, which can help normalize fluid intake. Often times women, out of wanting to remain hydrated, can drink several liters more than is necessary causing their bladders to remain over filled. A bladder diary can help to realize this problem, she says.
Another option available to treat urinary incontinence is what’s known as a vaginal pessary, says Baker. The device can be put in the vagina to support the structures that help prevent urinary continence. The device can serve as a bridge to allow activities like walks and hikes while a woman rehabilitates her muscles, says Baker.
It takes only one baby for the problem to occur, and Baker says the subject of urinary incontinence should not be taboo. She encourages women to ask their physicians about the problem
“Bring it up!” say Baker. “And providers should remember to ask whether a patient is experiencing urinary leakage,” she adds.
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