What is incontinence?

Incontinence is a loss of the ability to control your bowel and bladder. Incontinence can either be urinary (when you wee from the bladder) or faecal (when you poo or pass wind from the bowel). It can range from a small leak to a complete loss of control of the bladder or bowel.

What causes incontinence during pregnancy?

Women who are pregnant or who have had a baby are considered at greater risk of urinary incontinence. The pelvic floor muscles are the muscle group that support the bladder, uterus and bowel and these muscles are weakened during pregnancy and childbirth as a result of changes that occur during pregnancy. If your pelvic floor muscles are weakened then the internal organs are less well-supported, which can lead to difficulty controlling your urine, faeces (poo) or flatus (wind).

When am I more likely to experience incontinence during my pregnancy?

Since incontinence is caused by a weakening of the pelvic floor muscles there is no specific time at which incontinence is more likely to occur. However, as the baby grows there is added strain on the muscles, which can cause more severe symptoms. Birth (both vaginal and caesarean) causes the pelvic floor muscles to stretch, increasing the likelihood of incontinence.

Am I more likely to experience incontinence if I had it before pregnancy?

Urinary incontinence is commonly linked to pregnancy and childbirth, but if your pelvic floor is already weak, you are more likely to have incontinence. Other risk factors include constipation (which also puts strain on the pelvic floor); impaired mobility or neurological (nerve) or musculoskeletal (muscle) conditions such as stroke, dementia or arthritis; and other health challenges, such as diabetes, heart disease or obesity.

How is incontinence treated during pregnancy?

It is always better to try to prevent incontinence rather than treat its symptoms. A good place to start is to maintain a healthy diet and do regular exercise since this promotes good bladder and bowel health, which can improve and sometimes even cure incontinence.

Pelvic floor exercises can also help strengthen the muscles of your vagina, urethra and anus. Before beginning to exercise these muscles, it is important to make sure you are using the pelvic floor muscles correctly. Speak to a continence professional or a physiotherapist for guidance.

The exercises can be performed lying down – up to week 16 of your pregnancy –or while sitting or standing, and ideally you should aim for 3 to 6 sessions daily.

The Continence Foundation of Australia have produced this video on how to do pelvic floor exercises:

Could incontinence be a sign of something more serious?

Urinary incontinence can lead to faecal incontinence as the muscles progressively weaken. A weak pelvic floor can also cause sexual difficulties such as reduced vaginal sensation. Incontinence can be a sign of a prolapse — where the internal organs are no longer supported by the pelvic floor and the bladder or uterus can slide down into the vagina. If you suspect you have a prolapse, you should also look out for a distinct bulge in the vagina or deep vaginal aching.

Will my incontinence continue after I’ve had the baby?

Most women’s pelvic floor muscles return to normal within 3 to 6 months after childbirth, but in some women the overstretching and tears (known as avulsion) during birth will affect continence, particularly after a vaginal birth.

It is important to take time to work out the cause of the incontinence as it is often stress-related or due to pelvic muscle weakness that is not unconnected to the birth. Contact your doctor, midwife, continence nurse or physiotherapist for more guidance on how to strengthen your pelvic floor.

Where to get help

If you are concerned about incontinence:

• Call the Continence Foundation of Australia on 1800 33 00 66
• Ask your GP — Click here to find a doctor near you
• Check in with your midwife
• Call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse