Postpartum Recovery Series Part 5

Managing Urinary Incontinence After Childbirth

Urinary incontinence is the unwanted leakage of urine, also known as accidental bladder leakage. There are a few main types. Stress urinary incontinence is leakage associated with activities, such as lifting, exercising, coughing, sneezing, or laughing. Urge urinary incontinence is leakage associated with the urge and people often experience leaking on the way to the toilet. There is also mixed incontinence which is a combination of the two types. Continence is managed by the complex interaction of bladder physiology, central nervous system, and the pelvic floor muscles. When there is dysfunction in any part of the three systems, incontinence may occur. 

What causes incontinence during pregnancy?

There are many causes for incontinence during pregnancy and postpartum. Some of the proposed factors are:

• hormonal changes,
• pelvic floor muscle and connective tissue modifications,
• bladder neck widening (due to the weight of both the uterus and the growing fetus),
• anatomical injuries during delivery.^{1, 2}

A hormone called relaxin is produced during pregnancy to help soften the muscles and ligaments in preparation for delivery. As the uterus and baby grow throughout pregnancy more load is placed on the pelvic floor muscles causing the pelvic floor muscles to become weaker.³ Also constipation, which is commonly seen in pregnancy, puts an additional load on the pelvic floor.⁴ Furthermore, the pelvic floor has additional strain placed on it during labor; the pelvic floor muscle is stretched five times its original length.⁵

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be. It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Femina PT (née Fusion Wellness & Physical Therapy) is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals. I love you ❤️