Why Do I Leak Urine After Having a Baby?

Bladder leakage after childbirth is common and usually related to changes in the pelvic floor that occur during pregnancy and delivery.

How Pregnancy Affects the Pelvic Floor

During pregnancy, the growing uterus and womb stretch the abdominal muscles and support tissue in the abdomen to accommodate the growing baby. This added pressure also stretches the pelvic floor muscles. When women give birth vaginally, the pelvic floor muscles stretch and lengthen to accommodate the baby’s head moving into the vagina; further weakening this muscle group.

Pregnancy and childbirth also can disrupt the way the abdominal and pelvic floor muscles work together to coordinate pressure in the abdomen when a woman lifts weight or moves. If these muscles do not work together to balance pressure in the abdomen, increased pressure in the abdomen from running can be transferred to the pelvic floor and cause urine leakage.

Hormonal changes in the postpartum period may also increase your risk for leaking. Breastfeeding may decrease your estrogen levels temporarily. This is normal and reversible once you stop breastfeeding. The lower levels of estrogen may lead to symptoms like genitourinary syndrome of menopause. You may notice more leaking, vaginal dryness, and vaginal discomfort or pain. This is not a reason to stop your breastfeeding journey. Vaginal estrogen support in the form of a cream or pill is safe to use and may help your symptoms.

Postpartum Symptoms

Women may experience leakage during exercise, coughing, or sneezing, as well as sudden urgency to urinate.
These symptoms are usually more frequent in the early weeks after delivery and improve with time. Some women also experience pelvic pressure, a vaginal bulge, vaginal pain, and an urge to urinate frequently.

Treatment Options

Pelvic floor rehabilitation is essential after giving birth. A pelvic floor physical therapist is an expert who can help you coordinate the muscles of the abdomen and the pelvic floor. These muscles must work together to regulate pressure in the abdomen. The key to strengthening the pelvic floor is not just STRENGTH or “Kegel” exercises. The key is CONNECTION and COORDINATION. Typically, pelvic floor rehabilitation starts after six weeks postpartum, as the physical therapists will want you to be cleared by your medical provider first.

If pelvic floor physical therapy does not help with your urinary leakage, seek care with a Urogynecologist. A Urogynecologist can help you find more options to decrease leaking. This may involve using a vaginal support device or a pessary. A Urogynecologist can also discuss procedures and surgeries which may help.

At UroLuxe we are here to help. You do not need to live with leaking.