Learn about risk factors, duration and treatment.
About one-third of those who have a baby will experience some form of postpartum incontinence. Some people will be more at risk than others. The duration of incontinence after childbirth and treatment options will vary from person to person, depending on several factors.
“Postpartum urinary incontinence is definitely something that is not regularly talked about, but it’s super common,” said Dr. Chelsea Fechter, an OB-GYN with Vanderbilt Women’s Health.
Types of postpartum incontinence
Two types of postpartum incontinence exist: stress and urge.
“Stress incontinence is when women involuntarily leak urine when they laugh, cough, sneeze or stand up — anything that increases abdominal pressure,” Fechter said.
“Stress incontinence is when women involuntarily leak urine when they laugh, cough, sneeze or stand up.”
Urge incontinence is when the urge to urinate comes on suddenly and someone can’t make it to the bathroom in time, she said.
Of the two types, stress incontinence is more common after pregnancy.
“As you can imagine, when you give birth, when you push for long periods of time, it stretches the pelvic floor muscles that are responsible for keeping urine inside the bladder,” Fechter said.
Risk factors for postpartum incontinence
The type of delivery can be a risk factor.
“Women who have incontinence throughout their pregnancy are more likely to have incontinence after they give birth.”
“Women who have vaginal deliveries have a 50% increased risk of urinary incontinence compared to those who have a cesarean section,” Fechter said. “That said, vaginal birth is still our preferred delivery method for the health of both mom and baby.”
Other risk factors, Fechter said, include having a larger baby, needing to push for a long time, and needing forceps or vacuum assistance during delivery. Pre-pregnancy weight and weight gain during pregnancy also play a role in the risk of having incontinence after childbirth.
“Additionally, women who have incontinence throughout their pregnancy are more likely to have incontinence after they give birth,” she said.
How long does postpartum incontinence last?
The duration of postpartum incontinence symptoms will vary based on some of the above risk factors.
“When women are experiencing incontinence at their three-week visit, then we can start trying some measures to reduce it.”
“I always tell my patients to give it time,” Fechter said. “Your body has to heal from being pregnant and from delivery.”
Fechter and her colleagues encourage their patients who are postpartum to schedule a clinic visit for three weeks after delivery and again at six weeks. She said these visits are to not only see how a patient is healing after giving birth but to also ask if the patient is experiencing incontinence issues.
“When women are experiencing incontinence at their three-week visit, then we can start trying some measures to reduce it,” Fechter said.
Treatment options for postpartum incontinence
Treatment options will depend on the type of urinary incontinence someone is experiencing: stress or urge.
“One thing we do for stress incontinence is Kegel exercises,” Fechter said.
She often directs her patients to videos that can help.
“Some women feel comfortable doing the exercises at home once they learn them, while others really like getting feedback at the physical therapy clinic.”
“We’re also big proponents of pelvic floor physical therapy,” she said. “Some women feel comfortable doing the exercises at home once they learn them, while others really like getting feedback at the physical therapy clinic.”
The duration of physical therapy will vary based on the patient’s need and personal preference.
For urge incontinence, Fechter said she tells her patients to avoid caffeine, spicy foods and other bladder irritants. She also recommends timed voiding. As an example, she said, “Every time you’re about to feed your baby, try to urinate. It’s a good time point to help you remember.”
If these initial treatment options aren’t working for a patient and the incontinence continues, then Fechter will turn to other interventions, some of which are surgical. The important thing to remember is that postpartum incontinence is common, and your doctor will work with you to find the right solutions.
Back to a fuller life
As women’s health and urogynecology experts, the Urogynecology and Pelvic Reconstructive Surgery team at Vanderbilt offers personalized care for females experiencing bladder-related symptoms and conditions. These experts are here to help find answers and treatment so you can live a fuller life. Call 615-343-5700.
