Urinary incontinence, the involuntary loss of urine, affects up to 62% of people during pregnancy, particularly as the pregnancy progresses into the later stages. This common symptom is often temporary and manageable, but it can cause anxiety or embarrassment. Understanding the underlying physical changes and knowing what steps can be taken to manage it can help you feel more in control.
Why Urinary Leakage Happens During Pregnancy
The physiological changes that support a growing baby are directly responsible for the temporary loss of bladder control. Two primary factors contribute to this issue: hormonal shifts and mechanical pressure.
Hormonal changes, specifically the increase in hormones like relaxin and progesterone, cause the connective tissues and ligaments throughout the body to soften and loosen. This natural process prepares the pelvis for childbirth, but it also weakens the pelvic floor muscles that support the bladder and urethra. When these muscles are weakened, the urethra’s closure pressure is reduced.
The second cause is the increasing mechanical pressure from the developing fetus and expanding uterus. As the baby grows, the uterus pushes down directly onto the bladder, reducing its capacity to hold urine. This pressure can lead to stress urinary incontinence (SUI), the most common type during pregnancy. SUI typically involves leaking a small amount of urine when intra-abdominal pressure increases, such as during a cough, sneeze, laugh, or exercise.
A less common type is urge urinary incontinence (UUI), involving a sudden, intense need to urinate that results in leakage before reaching the toilet. Both types of incontinence often become more noticeable in the third trimester as the fetus reaches its heaviest weight.
Simple Steps for Managing Bladder Control
Taking proactive steps can significantly reduce the frequency and severity of urinary leakage. The most effective approach involves strengthening the supporting muscles and making simple lifestyle adjustments.
Regularly performing pelvic floor muscle exercises, often called Kegels, is one of the most beneficial actions you can take. To perform them correctly, imagine you are trying to stop the flow of urine or prevent yourself from passing gas, engaging only the muscles around the vagina and rectum. Contract and hold these muscles for three to five seconds, then fully relax for the same amount of time. Aim to repeat this sequence about ten times, three times a day, making sure to breathe normally and avoid tightening the abdominal or buttock muscles.
Bladder training teaches the bladder to hold urine for longer periods. This involves intentionally increasing the time between trips to the toilet, starting with small increments like 15 minutes, and gradually working toward a two-to-four-hour interval. Distraction techniques, such as focusing on slow breathing or performing a mental task, can help manage a sudden urge until the scheduled voiding time.
Dietary changes can also reduce bladder irritation that contributes to leakage. Limit or avoid common bladder irritants like caffeine, carbonated drinks, alcohol, and acidic foods such as citrus fruits. Maintain adequate hydration by drinking plenty of water, as concentrated urine can irritate the bladder lining. Spread fluid intake throughout the day and avoid consuming large amounts of liquid before bedtime to minimize nighttime trips to the bathroom.
When Leakage Signals a More Serious Issue
While most urinary leakage during pregnancy is normal, certain symptoms warrant immediate contact with a healthcare provider. It is important to differentiate urine from amniotic fluid, especially later in pregnancy.
Amniotic fluid is typically clear, straw-colored, and may have a slightly sweet or musky odor, whereas urine smells like ammonia. If the fluid leakage is a sudden gush or a continuous, uncontrollable trickle that soaks through clothing, it may indicate a rupture of the amniotic sac, known as your water breaking. This requires prompt medical attention.
Leakage accompanied by other symptoms could signal a Urinary Tract Infection (UTI). Signs of a UTI include pain or a burning sensation during urination, cloudy or bloody urine, fever, or pain in the lower back. Severe pelvic pain or difficulty walking alongside leakage should also be evaluated by a medical professional.