Bladder Issues During Pregnancy

Your body goes through many changes with pregnancy including the need to frequently urinate.  Additionally, as your baby grows, it puts pressure on your bladder. A sneeze, cough or even a hearty laugh adds even more pressure on your bladder and can trigger the release of urine.

More than 50% of first time pregnant women and up to 85% of second-timers develop some degree of bladder weakness.  Bladder weakness may begin in the first trimester but it’s more common in the third trimester when the baby’s growth accelerates. Then the expanding uterus leans up against the bladder almost continuously. Approximately 40% of pregnant women also may experience a sudden, uncontrollable need to urinate (called urge incontinence).

Bladder weakness usually goes away quickly once baby is born.  Typically, it clears up within a few days to a few weeks after birth as muscle tone returns and hormone levels drop to normal.  A few women may continue to have some weakness ongoing. However, diet, exercise, biofeedback, bladder retraining, medications, and several other treatments are available to help minimize or eliminate lingering bladder weakness.

The following is adapted from the Medical College of Wisconsin article Do Pregnancy and Childbirth Affect Bladder Control?

When Do You Need Medical Help?

If you still have a problem after 6 weeks, talk to your doctor. Without treatment, lost bladder control can become a long-term problem. Accidental leaking can also signal that something else is wrong in your body.

Bladder control problems do not always show up right after childbirth. Some women do not begin to have problems until later, often in their 40's. You and your health care team must first find out why you have lost bladder control. Then you can discuss treatment. After treatment, most women regain or improve their bladder control. Regaining control helps you enjoy a healthier and happier life.

Can You Prevent Bladder Problems?

Yes. Women who exercise certain pelvic muscles have fewer bladder problems later on. These muscles are called pelvic floor muscles. If you plan to have a baby, talk to your doctor. Ask if you should do pelvic floor exercises. Exercises after childbirth also help prevent bladder problems in middle age. Ask your health care provider how to do pelvic exercises.

How Does Bladder Control Work?

Your bladder is a muscle shaped like a balloon. While the bladder stores urine, the bladder muscle relaxes. When you go to the bathroom, the bladder muscle tightens to squeeze urine out of the bladder.

More muscles help with bladder control. Two sphincter muscles surround the tube that carries urine from your bladder down to an opening in front of the vagina. The tube is called the urethra.  Urine leaves your body through this tube. The sphincters keep the urethra closed by squeezing like rubber bands.

Pelvic floor muscles under the bladder also help keep the urethra closed.

When the bladder is full, nerves in your bladder signal the brain. That's when you get the urge to go to the bathroom. Once you reach the toilet, your brain sends a message down to the sphincter and pelvic floor muscles. The brain tells them to relax. The brain signal also tells the bladder muscles to tighten up. That squeezes urine out of the bladder.

What Do Pregnancy And Childbirth Have To Do With Bladder Control?

The added weight and pressure of pregnancy can weaken pelvic floor muscles. Other aspects of pregnancy and childbirth can also cause problems:

Strong sphincter (bladder control) muscles prevent urine leakage in pregnancy and after childbirth. You can exercise these muscles to make them strong. Talk to your doctor about learning how to do pelvic floor exercises.

Which Professionals Can Help You With Bladder Control?

Professionals who can help you with bladder control include:

Points To Remember