What causes urinary incontinence after childbirth, how common is it and what treatments are available?
There are both surgical and non-surgical treatments available for urinary incontinence
MILLIONS of women give birth every year but having a baby can cause long-term complications and side-effects.
The human body changes immensely during pregnancy and post-birth, and for some women there are lingering issues which persist long after they’ve had their child.
What causes urinary incontinence after childbirth?
One side-effect of having a baby is urinary incontinence.
There are different variations of incontinence, including stress, urge, overflow and total incontinence.
Various factors can increase the chances of urinary incontinence, including having a vaginal birth.
The use of forceps or other interventions can also trigger it as they can injure pelvic nerves and muscles.
Stress incontinence can be caused by the weakening, or damage to, the pelvic floor muscles or urethral sphincter, which both control urination.
Urge incontinence is often the result of over activity of the detrusor muscles which control the bladder.
Pregnancy and menopause can also trigger it, along with weak bladder muscles, overactive bladder muscles and nerve damage.
NHS guide to incontinence
- stress incontinence– when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
- urge incontinence– when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
- overflow incontinence (chronic urinary retention) – when you're unable to fully empty your bladder, which causes frequent leaking
- total incontinence– when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
Overflow incontinence is usually caused by an obstruction in the bladder or a blockage, which prevent it emptying fully.
Total incontinence can stem from a spinal injury, a bladder fistula or some people are born with it.
For women who have given birth, the most likely form of incontinence they suffer is stress induced.
How common is it?
The says that: “After having a baby, it's quite common to leak a bit of pee if you laugh, cough or move suddenly.”
The (NCT) says almost half of women experience urinary incontinence.
But despite it being a common problem, their research found a third of women, 33 per cent, were embarrassed to discuss the issue.
And nearly half, 46 per cent, were not comfortable talking about it with their friends.
And the claims that around a third of women will experience urinary incontinence in the first year after having their baby.
What treatments are available?
Initially it is likely your GP will prescribe some exercises to help with the condition.
Pelvic floor exercises can help with bladder control, which involve exercising, and ultimately tightening, your pelvic floor.
These exercises help strengthen the muscles around your bladder, vagina and anus.
The NHS says: “Your pelvic floor muscles are the muscles you use to control the flow of urine as you urinate.
“They surround the bladder and urethra, the tube that carries urine from the bladder outside the body.
“Weak or damaged pelvic floor muscles can cause urinary incontinence, so exercising these muscles is often recommended.”
NHS guide to pelvic floor muscles
- Squeeze and draw in your back passage as if you're holding in wind.
- Squeeze around your vagina and bladder tube (urethra) as if you're stopping the flow of urine or squeezing during intercourse.
- Now relax. This is a short squeeze. Rest for a second, then repeat these squeezes until you feel the muscles get tired.
- After a short rest, squeeze again as above. This time, hold the squeeze for as long as you can, but no longer than 10 seconds, then relax.
- It's important to keep breathing normally while you do these exercises. Make sure you don't pull in your stomach or squeeze your buttocks when you squeeze.
- Aim to build up to 10 repeats of each exercise, four to six times a day.
If non-surgical treatments don’t work, there are surgical options.
The most common type of incontinence for women post-birth, stress incontinence, can also be treated by medication duloxetine.
This has side-effects and your GP will prescribe it if they think this is the best option.
There are surgical procedures which include the tape procedure, transobturator tape procedure (TOT) and retropubic tape procedure or tension-free vaginal tape procedure (TVT).
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There is also the option of a colposuspension, which has two forms open colposuspension and laparoscopic (keyhole) colposuspension.
Women can undergo a sling procedure, have urethral bulking agents injected, or have an artificial urinary sphincter fitted.
For more information on pregnancy and your post-birth body visit the website.