Pregnancy Incontinence: What to Expect & How to Manage

Pregnancy marks an incredible time of transformation for a woman's body. While some women notice symptoms early on, others might not experience any signs for weeks. One common early symptom is frequent urination. As the pregnancy advances and the uterus expands, this can progress to occasional urine leakage—a condition known as pregnancy incontinence.

Learn what to expect and how to manage pregnancy incontinence to stay informed and comfortable throughout your pregnancy journey.

What Is Pregnancy Incontinence?

Pregnancy incontinence is a type of urinary incontinence that occurs during gestation, characterised by the involuntary leakage of urine. While not often openly discussed, it affects many expectant mothers and may persist for a few weeks after childbirth.

Common types of pregnancy incontinence include:

• Stress Urinary Incontinence

  : This occurs when physical pressure from coughing, sneezing, laughing, exercising, lifting, or sudden movements causes the bladder to leak urine.

• Overactive Bladder

  : This causes a sudden, urgent need to urinate, often leading to leakage before reaching the toilet.

What Causes Incontinence During Pregnancy?

Pregnancy incontinence is a common experience, stemming from several significant changes in a woman's body during gestation. The primary factors that contribute to it include:

• Weak Pelvic Floor Muscles

  : The pelvic floor muscles bear more weight as the pregnancy progresses. This constant downward force can gradually weaken the muscles, making it harder to hold in urine.

• Hormonal Changes

  : Progesterone and relaxin are two pregnancy hormones that help relax the bladder and urethra. However, this necessary relaxation also makes the pelvic floor muscles less firm and supportive, which can lead to difficulty in controlling the flow of urine.

• Increased Pressure on the Bladder

  : As the baby grows, the uterus expands and compresses the bladder. This leads to more frequent urination and increases the risk of leakage.

• Urinary Tract Infections (UTIs)

  : Pregnant women are more susceptible to UTIs. This infection can irritate the bladder, leading to increased urgency, frequency, and sometimes incontinence.

What Are the Risk Factors for Pregnancy Incontinence?

While pregnancy incontinence is common, certain factors can increase a woman's likelihood of experiencing it or make the symptoms more severe. These risk factors include:

• Obesity or Overweight

  : Excess weight, especially around the abdomen, increases abdominal pressure on the bladder and pelvic floor.

• Older Maternal Age

  : Women aged over 35 at the time of their first delivery tend to have a higher risk of stress urinary incontinence.

• Previous Vaginal Deliveries

  : Women who have had multiple vaginal deliveries are at higher risk due to progressive stretching and potential damage to the pelvic floor muscles and surrounding nerves.

• Previous Pelvic Surgery

  : Past surgeries involving the bladder, uterus, or pelvic floor could potentially affect bladder support or nerve function.

• Smoking

  : Chronic coughing due to smoking can repeatedly stress the pelvic floor muscles.

• Diabetes

  : Neurological conditions like diabetes can impair nerve signals to the bladder, increasing the risk of urinary incontinence during pregnancy.

How to Manage Pregnancy Incontinence

Given that pregnancy incontinence arises from natural physiological changes during gestation, complete prevention is not always feasible. However, its symptoms can often be effectively managed through several lifestyle changes:

• Perform Kegel Exercises

  : Strengthen the muscles that support your bladder, uterus, and bowel. These are crucial for bladder control.

• Practice Bladder Training

  : Gradually teach your bladder to hold urine for longer periods.

• Maintain a Healthy Weight

  : Follow your doctor's recommendations for healthy pregnancy weight gain to avoid putting excess pressure on your bladder and pelvic floor.

• Eat High-Fibre Foods

  : Incorporate fibre-rich foods into your diet to reduce your risk of constipation during pregnancy, which can exacerbate incontinence.

• Stay Hydrated

  : Drink enough fluids to prevent dehydration, but be mindful to avoid bladder irritants such as caffeine, artificial sweeteners, and carbonated drinks.

Pregnancy incontinence is a common experience affecting many expectant mothers. While it can be uncomfortable or inconvenient, it is highly manageable. With proactive steps and guidance from a gynaecologist, pregnant women can maintain comfort and confidence throughout their pregnancy.

If you are experiencing pregnancy incontinence, we encourage you to consult with our female gynae in Singapore for personalised advice and support. You may contact us at (65) 6681 6699 to schedule an appointment with Dr Chen Chern Yi.