The Doctor’s Orders; How to Deal with Urinary Incontinence After Childbirth

Guess what? If you struggle with bladder leaks, you aren’t alone. In fact, 1 in 3 women who have given birth struggle with postpartum urinary incontinence. Just because it is common does not mean you have to put up with it, though. If you are one of the many mamas experiencing this, there are some things you can do to help from exercising to avoiding certain foods. We grabbed two incredible experts and asked them what new moms can do when dealing with urinary incontinence after childbirth.

How to Deal with Urinary Incontinence After Childbirth

For this Q&A we chatted with Samantha Spencer, PT, and Aleece Fosnight, PA with a specialization in urologic care. Here’s what they said you need to know about urinary incontinence!

1. What are some examples of pelvic floor exercises that postpartum moms should be doing to manage incontinence?

Samantha Spencer says to keep in mind that stress incontinence and urge incontinence may require different approaches. 

Stress incontinence often improves with a combination of pelvic floor strengthening and coordination so the muscles fire at the right time. Exercises might include pelvic floor contractions (quick flicks and longer holds), core work that includes pelvic floor coordination, sit-to-stand with coordinated pelvic floor recruitment, and mini-jump squats while working on coordination with your landing. 

Here are some resources where you can find examples:

  • Tush Push 
  • Sit to Stand
  • Pelvic Floor Coordination
  • Maintaining Pelvic Health Postpartum

Urge incontinence usually requires more of a mixed approach. Yes, strength is important, but so is the ability to RELEASE those muscles. When we need to pee, we often clench and tense those pelvic floor muscles! You may find that practicing the release and “downtraining” your whole nervous system may help you get through an urge without leaking. Practice diaphragmatic breathing and releasing your lower belly and pelvic floor muscles as you inhale. Try to do this daily for a couple of weeks – lying on your back, sitting up, and child’s pose are all great positions to practice. Then, next time you have an urge, practice those deep breathing exercises and see if you can allow the urge to pass before rushing off to the bathroom. 

Aleece Fosnight also had some great exercise recommendations:

  • Kegels are when you lift and squeeze the pelvic floor muscles. 10 reps three times a day are a good start and then working your way up to 50-75 squeezes a day can help keep the pelvic floor muscles strong
  • Hip exercises are often forgotten but are key to maintaining pelvic health and pelvic floor muscles for women. Clamshells and reverse clamshells with resistance bands are a great way to strengthen the hips. 
  • Adductors and abductor exercises are also helpful. Take a small exercise or yoga/Pilates ball and place it between your knees and squeeze. For abductors, use a resistance band around lower thighs and perform side steps.
  • Strengthening your core (including abdominals and lower back) is a great way to improve the pelvic floor muscles. 
  • Expert Tip! Take caution with crunches postpartum. If a woman has diastasis recti (ab separation secondary to pregnant uterus) those exercises can weaken the muscles and cause worsening of the separation.

If I do these exercises, when should I start to see improvement?

Both experts agree, you may see improvement right away or it may take several weeks to notice a real change.

Issues with urgency sometimes get better almost right away if you address bladder irritants and work on down training and releasing those pelvic floor muscles. 

Stress incontinence requires a little more time to resolve because the muscles are building strength. Once you’ve figured out how to properly contract and relax your pelvic floor muscles and coordinate them with the rest of your body, you should start to see improvement in your symptoms within a couple of weeks that continues to improve over several months. 

2. Certain foods and drinks can irritate the lining of your bladder. Can you give us a list of some of these foods that should be avoided?

Here is a list of foods that should be avoided:

  • Citrus (orange, grapefruit, lemon, and lime)
  • Spicy foods
  • Tomato-based products
  • Caffeine
  • Carbonation (including plain seltzer!)
  • Alcohol
  • Artificial sweeteners
  • Dairy

3. When should new mom’s with urinary incontinence seek medical help? Are there certain things that are normal vs. not normal? 

As Samantha Spencer says, urinary incontinence is a signal that your pelvic floor is not functioning as it should. For that reason, it’s always a good idea to check in with a medical provider or a pelvic physical therapist if you’re having incontinence of any kind. 

There are some times when incontinence is more common, but it’s still a good idea to mention it at your next scheduled doctor’s appointment. For example, up to one-third of pregnant people will have some degree of incontinence during late pregnancy and early postpartum, and some of that is simply due to the increased pressure of pregnancy and the early recovery process after birth. Research shows that if you’re having incontinence during pregnancy, getting support from a pelvic floor specialist may help you recover more quickly postpartum and reduce your risk of lingering incontinence after birth. 

If you’re noticing incontinence for the first time after birth, you’ll definitely want to seek support if it does not resolve by 3 months postpartum. 

Signs that you’ll want to seek care immediately include sudden severe low back pain, worsening numbness, tingling, or altered sensation in the pelvic area, hips, or lower body, and loss of bowel or bladder control without sensation. These signs and symptoms may indicate a more serious condition. It’s always a good idea to call your healthcare provider if you’re unsure about your symptoms. 

4. Will urinary incontinence get better on it’s own?

Both experts agree if not properly evaluated and treated, incontinence can get worse! So, it is very important to see a pelvic floor physical therapist to be sure you’re working in the right direction based on your own body’s needs. 

After the first 12 weeks postpartum, research shows that urinary incontinence will not continue to improve without intervention. You can start by working on pelvic floor muscle contract and relax exercises at home, but as stated above, it’s always a good idea to schedule an evaluation with a pelvic floor physical therapist.

If we ignore incontinence when we’re young, these symptoms may get worse after menopause. Estrogen plays a big role in the health and strength of our pelvic floor muscles, and many menopausal women report an increase in symptoms of leakage, pressure, and other signs of pelvic floor dysfunction. It’s best to go ahead and set yourself up for success in the long term! 

5. Can pregnant moms do anything to help prevent postpartum urinary incontinence?

Absolutely! Here is what Aleece Fosnight recommends:

  • Using a pregnancy support belt can help take some of the pressure off of the pelvic floor muscles and help support the hips as hormones are causing loosening of your joints, including the hips.
  • If you see a pelvic floor PT, they can use KT tape to help support sacroiliac joints, support your growing belly, and help with diastasis recti.
  • Stretching is also a great way to prepare hips and pelvic floor for vaginal delivery.
  • Continuing to exercise keeps muscles strong and supportive – do make modifications as needed to not cause injury or trauma.
  • Kegels can be a simple way to keep pelvic floor muscles strong even at the end of pregnancy and can be implemented on day one of delivery.

Expert Bios

 Aleece Fosnight is a PA with a specialization in urologic care and Medical Advisor at Aeroflow Urology.

Samantha Spencer is a physical therapist specializing in pelvic health, with an emphasis on prenatal and postpartum transitions. She is also a medical advisor at Aeroflow Breastpumps. You can find her Rookie Mom’s Q&A discussing Postpartum Exercise here or connect with her on Instagram & Facebook.

Leave a Reply

Your email address will not be published. Required fields are marked *