What is incontinence?

Incontinence is the involuntary leakage of urine (wee), faeces (poo) or wind. It can be a small leak or total loss of control of your bladder or bowel.

Incontinence might be:

• leaking urine when you cough, sneeze, laugh or exercise
• not being able to control when you pass wind
• having a strong need to use the toilet

What causes incontinence during pregnancy?

You have a greater chance of experiencing incontinence when you’re pregnant.

Changes that happen to your body during pregnancy can cause your pelvic floor muscles to weaken. Your pelvic floor muscles are the muscle group that support your bladder, uterus and bowel.

If your pelvic floor muscles are weakened, then your internal organs are less well-supported. This can lead to difficulty controlling your:

• urine
• faeces (poo)
• flatus (wind)

A weak pelvic floor can also cause sexual problems such as reduced vaginal sensation.

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

Some studies have found that more than 1 in 2 people have urinary incontinence during their pregnancy.

This rate is highest in the third trimester of pregnancy. This is because, as your baby grows there is added strain on your muscles.

If you have urinary incontinence during pregnancy, you will likely experience urinary incontinence after your baby’s birth too.

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

If your pelvic floor is already weak, your incontinence is likely to continue during pregnancy.

Other risk factors for incontinence are:

• constipation(which also puts strain on the pelvic floor)
• obesity
• smoking
• impaired mobility — making it difficult to reach the toilet in time
• neurological (nerve) and musculoskeletal (muscle) conditions — such as multiple sclerosis (MS) or arthritis
• other health challenges — such as diabetes, heart disease and sleep apnoea

Your risk of incontinence also increases if you consume drinks that irritate your bladder. These include:

• caffeine containing drinks
• fizzy drinks
• alcohol
• juices
• drinks that are artificially sweetened

How is incontinence treated during pregnancy?

It’s always better to try to prevent incontinence rather than treat its symptoms.

A good place to start is to promote good bladder and bowel health by:

• eating a healthy diet
• doing regular exercise

This can improve and sometimes even cure incontinence.

Pelvic floor exercises can also help strengthen the muscles of your:

• vagina
• urethra
• anus

Before beginning to exercise these muscles, it’s important to make sure you are using your pelvic floor muscles correctly. Speak to a continence professional or a physiotherapist for guidance.

You can do these exercises lying down — up to week 16 of your pregnancy. The exercises can also be done while sitting or standing. 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.

You may also want to use incontinence pads or underwear. These can be single use or reusable.

Could incontinence be a sign of something more serious?

Incontinence can be a sign of a prolapse — where your internal organs are no longer supported by the pelvic floor.

This lets your bladder or uterus slide down into your vagina. If you suspect you have a prolapse, you may have a distinct bulge in your vagina or deep vaginal aching.

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

Most people’s pelvic floor muscles go back to normal within 3 to 6 months of childbirth.

Certain things about the birth can make bladder and bowel problems more likely such as having:

• your first baby
• a large baby
• a long second stage of labour
• a difficult vaginal delivery with episiotomy (stitches after being cut)
• a perineal tear with stitches near your vagina
• an assisted birth where your baby was helped out by a vacuum cap or forceps

You can seek more guidance for how to strengthen your pelvic floor through your:

• doctor
• midwife
• continence nurse
• physiotherapist

Resources and support

If you are concerned about incontinence:

• call the Continence Foundation of Australia on 1800 33 00 66
• ask your doctor — click here to find a doctor near you
• check in with your midwife