Understanding incontinence during and after pregnancy

January 13, 2020

Healthcaretoday, pregnant, incontinence, mom to be, pregnancy journey, maternity, new mom life, urine leak, pregnancy tips, healthy pregnancy, pelvic floor, kegel exercises, stress incontinence, feminine laser,

By Dr Patricia Lim Su Lyn,
Obstetrician and Gynaecologist,
KPJ Tawakkal Specialist Hospital.

Pregnancy is a beautiful journey for every woman, but it also comes with its own set of challenges. One of the most common issue that women face during pregnancy is incontinence. This is when a woman experiences involuntary leakage of urine, usually when sneezing or coughing.

Incontinence during pregnancy is caused by two main factors. Firstly, the heavy uterus with the growing baby puts pressure on the bladder, causing urine leakage. Secondly, the hormones released during pregnancy loosen the urethra and pelvic floor muscles, making it difficult to control urine flow.

Pelvic floor exercises
Stress incontinence, where urine leaks during physical activities like sneezing or coughing, is the most common type of incontinence experienced by pregnant women. If a woman experiences this during pregnancy, it is highly likely that she will continue to experience it after pregnancy as well. To prevent this, pelvic floor exercises are recommended during pregnancy itself.

Pelvic floor exercises, also known as kegel exercises, involve contracting and relaxing the muscles that control urine flow. This exercises should be done at least 80 times a day. However, some women, especially older women, may not know how to do these exercises correctly. In such cases, a 'bio-feedback' device can be used. This device is inserted into the vagina, and the woman is asked to squeeze her pelvic floor muscles to check if the pressure is sufficient.

There are also other devices available in the market that can help with pelvic floor exercises. However, it shouldn't be used during pregnancy as they may introduce infections. After pregnancy, these devices can be used to strengthen the pelvic floor muscles.

Returning to the pre-pregnancy state
It takes about six weeks for the hormones to leave the body and for the body to return to its pre-pregnancy state. If incontinence still persists after this period, the woman should consult her doctor. The doctor will first rule out any anatomical problems or infections and then suggest suitable treatment options.

Kegel exercises are highly recommended for incontinence, but they require dedication and may take three to six months to show results. For a quicker solution, a feminine laser that stimulates collagen and strengthens the bladder neck may be used. However, this treatment is not permanent and may need to be repeated if the woman gets pregnant again.

In severe cases of incontinence, a sling procedure where a surgical mesh is inserted to support the bladder neck, or a tummy laparoscopy or open surgery is conducted.