There are some physical aspects of pregnancy and post birth which many women find hard to discuss. Generally, this comes down to two reasons - embarrassment and fear. And wetting, formally known as incontinence, is one of those topics which is often kept silent.
Wetting is a common condition for women both during pregnancy and in the first few months after birth. In fact, although 30-50% of women experience some degree of wetting, many choose to keep this a secret, even from their partners.
If you are wetting yourself, there is no need to feel embarrassed – help is available from many sources, you just need to ask.
Urinary incontinence is when wee leaks from the bladder involuntarily. It can happen to women and men, though is more common in women, especially those who’ve had children or have been through menopause.
Incontinence can be ‘light bladder leakage’ with only small amounts escaping from the bladder, or larger amounts to the point of completely wetting underpants and clothing. What’s important to know about incontinence is that it’s not under the person’s control.
You are likely to have incontinence if your underpants are wet with wee and you frequently feel damp. If you need to buy incontinence pads and wear them ‘just in case’ you also fit the definition of being incontinent.
You may find you’re more likely to wee involuntarily when you’re laughing, sneezing, coughing, exercising and standing upright from a sitting position - these are all more common times to experience ‘stress’ incontinence. Involuntary wetting is also more common when there’s increased pressure on the bladder and surrounding pelvic organs. Though sometimes wetting can also happen without any triggers.
Some women with mild incontinence are able to ‘hold onto’ their wee by sitting down or crossing their legs. Others have a sudden ‘urge’ to go to the toilet and almost empty their bladder before they get there.
Another type of incontinence is when the bladder doesn’t fully empty, so wee trickles out when there is pressure put on the bladder. Wetting at any or all of these times are reason to suspect you have incontinence.
We don’t always know what causes incontinence, but the most common reason is weakening of the pelvic floor muscles. These work like a ‘hammock’ of muscles, ligaments and tissues which support the organs in the pelvis, including the bladder.
During pregnancy, the muscles in and around the bladder become stretched and weakened. Pregnancy hormones also have a softening effect and during labour and childbirth, the pelvic floor muscles become further weakened and may be damaged.
Having a forceps delivery, a large baby e.g., >4 kgs, a long second (pushing) stage of labour can all add to the risk of pelvic floor damage. Heavy lifting, being overweight and having a long-term cough can also increase the risk of incontinence.
Squeezing and drawing in the muscles around your bottom (anus) and vagina at the same time will help your pelvic floor muscles to become stronger. Don’t worry if, at first, you struggle to hold tight for only a short time. With practice and repetition, you’ll get to the stage of completing increasing sets of timed exercises.
This helps to ‘retrain’ the bladder to fill with normal amounts of wee. Many of us go to the toilet ‘just in case’ which does not help to support healthy bladder function. Over time, this can create extra sensitivity to even small amounts of wee in the bladder, triggering the need to go even when it’s not really necessary.
Bladder retraining also focuses on behavioural change in putting off going to the toilet for increasing lengths of time until the bladder is full.
Written for Poise by Jane Barry, midwife and child health nurse, 03/06/2021
Whilst you are training your pelvic floor POISE can help keep you comfortable and dry and protected from leaks.
Get a free sample here.