First lesson: it is way more common than you might think…
Urinary incontinence is unintentionally losing urine and we often associate it with getting older. However, ‘stress incontinence’ is a really common form of incontinence to affect women during pregnancy. It’s when you leak a little urine when you laugh, sneeze, cough, run, jump or even lift heavy things.
As many as two-thirds of women with ‘stress incontinence’ also experience ‘urge incontinence’, which is caused by an overactive bladder. You get the sudden urge to go, even though your bladder may nearly be empty and, as a result, leak before you can get to the bathroom. It’s frustrating, we know…
What causes stress incontinence during pregnancy?
Stress incontinence during pregnancy is caused by the growing uterus resting on the bladder and its supporting ligaments, causing the ligaments and surrounding muscles to stretch. When those structures become more relaxed, they're less effective at supporting the bladder, which in turn can lead to bladder weakness.
Another cause of stress incontinence during pregnancy is the hormones that make your tissues and joints more elastic and ready for delivery. These hormones can weaken the muscles that control the release of urine from your bladder and this stops them from working correctly. Constipation, which is common in pregnancy can also put a strain on your pelvic floor.
After you give birth to your baby, your pelvic floor muscles stretch and weaken even further. You may also experience increased incontinence immediately after birth if you had an epidural as it makes it harder to know when you need to go. It’s worth remembering that it’s very common for new mums to experience some incontinence in the first year after having their baby.
How much you leak and how long this will last will depend on how you gave birth, what happened during labour and whether you had incontinence problems during pregnancy. For some women, the problem goes away within a few weeks of giving birth. For others, it can continue for some months.
If you're still experiencing leaks when you have your post-natal check at about six weeks after your baby is born, talk to your midwife or doctor as incontinence is curable.
Pelvic Floor Exercises are Essential!
The pelvic floor is a set of muscles, ligaments and tissues that stretch across your pelvic bones; they support your pelvic organs which include your uterus, vagina, bladder and bowels.
During pregnancy strain can be placed on the pelvic floor leading to incontinence for new mums so regardless of how your birth goes, or even if it’s a caesarean, your muscles can be seriously challenged by simply being pregnant!
Taking a few minutes every day to do exercises can help strengthen the pelvic floor and these movements should be started in the early stages of pregnancy and as soon as you feel comfortable after the birth of your baby. If you’re struggling with stitches then you can do the exercises lying down to start until you feel comfortable.
The movements can be done pretty much anywhere, and the best part is, only you will know you’re doing them!
NEVER be tempted to do your pelvic floor exercises when on the toilet urinating as stopping the flow mid-stream could lead to the bladder not being completely emptied and urinary tract infections being contracted.
For more pelvic floor exercises talk to your midwife or GP as they’ll be able to tailor exercises based on your needs.
As most of us know, the earliest sign is a missed period but this could also be down to stress or other factors. The easiest and quickest way to answer your question is to take a home pregnancy test, which can be taken from the first day of your missed period. They're usually pretty reliable but if you're unsure, contact your GP and get booked in.
In most cases it's totally safe to have sex when pregnant, though you may want to avoid putting too much pressure on your bump and breasts! If you have a high-risk pregnancy or have had any bleeding then it's worth consulting your midwife or doctor first, just to be on the safe side.
Unfortunately the answer is yes. As the bleeding is mostly the lining of the womb it's totally normal to have vaginal bleeding after a caesarean, just as you would for a vaginal birth.
We would advise against this straight after birth as your vagina needs time to heal and using internal protection could increase the risk of infection. You're best to wait for your 6 week check, where your midwife will inform you if you're okay to use tampons.
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