Pregnancy often brings many changes to the body, and one common experience is urinary leakage. This involuntary loss of urine, known as urinary incontinence, affects a significant number of pregnant individuals, with estimates suggesting that 40% to over half of people experience bladder control problems during this time. It is a normal physiological adjustment for many as the body adapts to pregnancy.
Why It Happens
Urinary leakage during pregnancy stems from hormonal shifts and increased physical pressure on the bladder and pelvic floor. Hormonal changes play a role in preparing the body for childbirth. The placenta secretes hormones like relaxin and progesterone, which cause ligaments and connective tissues, including those in the pelvis, to become more flexible. This increased flexibility, while beneficial for delivery, can also lead to a loosening and weakening of the pelvic floor muscles that support the bladder and urethra.
As pregnancy progresses, the growing uterus places increasing pressure on the bladder. This external compression reduces the bladder’s capacity to hold urine, making it feel full more quickly and leading to a more frequent urge to urinate. The increasing weight of the developing fetus further strains the pelvic floor muscles, requiring them to work harder to support the pelvic organs. This added load, combined with hormonal softening, can lead to the muscles stretching and weakening, which makes it harder to control the flow of urine, particularly during activities like coughing, sneezing, laughing, or exercising.
Managing Leakage During Pregnancy
There are several practical approaches to manage urinary leakage during pregnancy, starting with targeted exercises. Pelvic floor exercises, commonly known as Kegels, involve contracting and relaxing the muscles that support the bladder, uterus, and bowel. To perform a Kegel, imagine stopping the flow of urine or tightening the muscles around the vagina and rectum. Hold the contraction for three to ten seconds, then fully relax for an equal duration, repeating this process about 10 times, multiple times a day. This can strengthen these muscles, improve bladder control, and reduce leakage.
Adjusting daily habits can also help manage leakage. Timed voiding involves following a schedule for bathroom breaks rather than waiting for the urge, which helps prevent the bladder from becoming overly full. Attempting to urinate every two to three hours can be an effective strategy. Maintaining adequate fluid intake is important, but timing it can be beneficial; consume most fluids earlier in the day and reduce intake closer to bedtime to decrease nighttime urinary frequency.
Identifying and avoiding bladder irritants can also alleviate symptoms. Common irritants include caffeinated beverages, acidic foods like citrus and tomatoes, spicy foods, and carbonated drinks, which can stimulate the bladder and increase the urge to urinate. Using absorbent pads or liners can offer practical protection and comfort throughout the day.
When to Talk to Your Doctor
While some urinary leakage is common during pregnancy, certain signs warrant a conversation with a healthcare provider. If the leakage is continuous, occurs in large volumes, or does not smell like urine, it could be amniotic fluid rather than urine. Amniotic fluid is clear and odorless or may have a slightly sweet scent, unlike urine which has an ammonia-like odor.
Any fluid leakage accompanied by pain, burning during urination, a strong or foul odor, cloudy urine, or fever indicates a urinary tract infection (UTI). UTIs are more common during pregnancy due to changes in the urinary tract and require prompt treatment to prevent more serious complications. If urinary leakage significantly impacts daily life or causes distress, or if there is any concern about the type or amount of fluid being leaked, consult a doctor. They can assess the situation, rule out other conditions, and recommend appropriate interventions.