Experiencing involuntary urinary leakage, or urinary incontinence, is completely normal during pregnancy. This common condition affects a significant number of pregnant individuals. While it can be frustrating, it is a well-documented physiological change related to the body’s adaptation to pregnancy. Discussing this openly helps normalize the experience and encourages expectant mothers to talk to their healthcare providers.
The Normalcy of Bladder Leaks During Pregnancy
Experiencing involuntary bladder leaks is an extremely common part of pregnancy, with studies suggesting that between 30% and 70% of individuals are affected at some point. The most frequent type is stress urinary incontinence (SUI), which describes the leakage of urine when sudden pressure is placed on the bladder. This pressure often comes from everyday actions like coughing, sneezing, laughing, exercising, or bending over. Some pregnant people may experience urge incontinence, characterized by a sudden, intense need to urinate followed by an involuntary loss of urine. A combination of both types is known as mixed incontinence, and while stress incontinence is typical, it should still be brought up with a doctor or midwife.
Why Pregnancy Causes Bladder Leaks
The underlying reasons for this leakage are a combination of mechanical pressure and hormonal changes within the body. As the pregnancy progresses, the growing uterus and developing fetus place increasing physical weight directly onto the bladder and the pelvic floor muscles. This rising pressure is the primary mechanical factor that promotes stress incontinence, especially in the later stages of the third trimester. Hormones also play a significant role in weakening the body’s support structures.
The hormone relaxin, which increases during pregnancy, works to loosen joints and connective tissues throughout the pelvis in preparation for birth. This loosening includes the ligaments and tissues that support the bladder and urethra, leading to increased bladder neck mobility and reduced urethral closure force. Increased levels of progesterone also contribute by causing a relaxation of smooth muscles, which affects the tone of the bladder and urethra. This combination of physical weight and relaxed supportive structures makes the pelvic floor less effective at sealing the urethra.
Practical Steps for Managing Leakage and When to Call the Doctor
Managing Leakage
Managing urinary leakage begins with strengthening the muscles that support the bladder and urethra. Pelvic floor muscle exercises, often called Kegels, are a primary treatment and prevention strategy throughout pregnancy. To perform a Kegel, squeeze the muscles used to stop the flow of urine or passing gas, holding the contraction for three to five seconds. Fully relax for the same amount of time. Aim to complete 10 to 15 repetitions, three times per day, focusing only on the pelvic floor muscles without flexing the abdominal or thigh muscles. Another helpful technique is “the knack,” which involves consciously squeezing the pelvic floor muscles immediately before and during moments of increased abdominal pressure, such as a cough or sneeze. Lifestyle adjustments, like limiting bladder irritants such as caffeine, can also help reduce the frequency of leaks.
When to Seek Medical Attention
It is essential to distinguish between a routine urine leak and a situation requiring immediate medical attention. A sudden gush or continuous trickle of fluid that is clear, pale, and has a sweet or neutral odor may be amniotic fluid, which is a sign of ruptured membranes. Urine, in contrast, is typically yellowish, has a distinct ammonia smell, and leaks in spurts with movement. Contact your healthcare provider immediately if you suspect the fluid is amniotic fluid, especially if you are before 37 weeks of pregnancy. Medical attention is also necessary if you notice signs of a Urinary Tract Infection (UTI), such as pain or stinging when urinating, a fever, or a persistent ache in the lower back. These symptoms indicate an infection that needs prompt treatment, as UTIs can cause or worsen incontinence.