Incontinence in Pregnancy and Frequent Urination

Oh, the joys of pregnancy! You can’t sleep for more than a few hours at a time or get through a whole movie without making a run to the bathroom. Simple things like sneezing or laughing really hard have become enemies because they cause you to leak…and not just from your eyes anymore. Let’s talk about stress incontinence that many women experience during pregnancy and the frequent urination that occurs in nearly all pregnant women.

Incontinence in Pregnancy

Urinary incontinence, quite simply, is urinating when you don’t mean to, or the inability to control urine passing from your body. It’s the little leaks of pee that happen between trips to the bathroom. Incontinence during pregnancy is quite common, with between one third and one half of women experiencing it (1,2).

What Causes It?

The most common type of incontinence in pregnancy is stress incontinence. This is, as the name suggests, urinary incontinence caused by the bladder being under increased stress. Because your uterus is above your bladder, your growing baby puts pressure on your bladder. And since it’s already under pressure, any stress — sneezing, coughing, laughing, straining, doing physical activity — can cause urine to leak.

The baby pressing down from above isn’t your bladder’s only challenge. Your hormones have also caused your muscles to relax, including your pelvic floor muscles. These muscles are responsible for supporting your internal organs. When they’re weak, the bladder can sag, contributing to urinary incontinence in pregnancy (2).

Frequent Urination

Whether or not you experience pregnancy incontinence, you will likely notice that you need to empty your bladder more frequently. Again, the baby pressing on your bladder is one of the major culprits. Not only is your growing babe putting pressure on the bladder, your cramped pelvic area may mean that your compressed bladder can’t expand as much as it does when you’re not pregnant (3). If it can’t hold as much to begin with, you’ll obviously have to empty it more often.

First Trimester

You may be surprised that you need to run to the bathroom more often even early in pregnancy, before you’re “showing.” While the baby is small, the uterus itself is growing. Additionally, increased blood flow to the kidneys can cause them to produce up to 25% more urine (4). This increase in urine along with the bladder starting to get cramped can cause frequent urination in the first trimester.

Urine production peaks and then starts to taper down early in the second trimester (4). Around the same time, your growing uterus lifts out of your pelvis. Factors combined, you will likely not notice frequency of urination being as much of an issue in your second trimester. It will likely return in the third trimester, as the baby gets larger and drops into the pelvis.

Managing Pregnancy Incontinence

You may not be able to prevent little leaks from happening during your pregnancy. The best thing you can do (aside from keeping a sense of humor about it) is wear urinary incontinence pads. Sanitary pads will work, but pads made for incontinence handle urine leaks better. They’re made to absorb more liquid, absorb more quickly, neutralize odor, and neutralize the acid in urine that can irritate skin (5).

Besides wearing pads to absorb leaks, here are a few things you can do to try to minimize the leaks:

• Don’t hold your urine — go when you feel like you need to
• Try to empty your bladder completely — you may find that leaning forward a little helps with this
• Avoid becoming constipated, as that can also cause pressure on the bladder
• Avoid caffeine

Even though you might be tempted, never restrict your fluids to lessen the need to pee. Not drinking enough can be bad for you and for baby, and can increase the chances of getting a urinary tract infection. You may stop drinking an hour or two before bed so that you’re able to get more uninterrupted sleep, but that’s as much as you should restrict your intake. (And if you do this, make sure you’re still getting plenty to drink during the day.)

Strengthening Pelvic Floor Muscles

As mentioned earlier, weakened pelvic floor muscles can contribute to incontinence during pregnancy. Pelvic floor muscles are essentially a sling of muscles that support the organs in your pelvis and abdomen. This is one aspect of the problem that you can actually work on. There are no guarantees that you can avoid bladder leaks altogether, but strengthening your pelvic floor muscles will help over time (2).

Strong pelvic floor muscles also help with an easier postpartum recovery and decrease the chances of you having urinary incontinence after pregnancy (6).

To learn how to do exercises to strengthen your pelvic floor muscles, take a look at Kopa Birth’s Kegel Exercises During Pregnancy post.

Urinary Tract Infections

Sometimes feelings of urgency or frequent urination can be signs of a urinary tract infection, known as a UTI. UTIs are more common during pregnancy for the following reasons:

• The growing uterus can block or decrease the flow of urine from the kidneys to the bladder
• The bladder doesn’t always fully empty
• Urine contains more sugars and proteins and less acid during pregnancy.

While some symptoms of a UTI are also normal in pregnancy (like frequent urination) it’s not normal for there to be pain when urinating, blood in your urine, or extreme urgency in your need to pee. If you have pain, blood, or fever, call your doctor or midwife.

You can minimize the chance of getting a urinary tract infection by not holding your urine, emptying your bladder as soon as you feel the need, urinating after having intercourse, and drinking plenty of fluids (7). If you do get an infection, it can safely be treated by antibiotics prescribed by your doctor.

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!

References:

1. Martínez Franco E, Parés D, Lorente Colomé N, Méndez Paredes JR, Amat Tardiu L. Urinary incontinence during pregnancy. Is there a difference between first and third trimester? Eur J Obstet Gynecol Reprod Biol. 2014 Nov;182:86-90. doi: 10.1016/j.ejogrb.2014.08.035. Epub 2014 Sep 2. PMID: 25262291.
2. Sangsawang, B., & Sangsawang, N. (2013). Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. International urogynecology journal, 24(6), 901–912. https://doi.org/10.1007/s00192-013-2061-7
3. Pregnancy & Bladder Control: Causes, Diagnosis & Treatment. (n.d.). https://my.clevelandclinic.org/health/articles/16094-pregnancy-and-bladder-control
4. Mashack, C. (n.d.). Pregnancy Incontinence Prevention and Treatment Methods. https://www.morelandobgyn.com/blog/pregnancy-incontinence-prevention-and-treatment-methods
5. Jenkins, S. (2021, January 07). Why You Shouldn’t Use A Maxi-Pad For Incontinence. https://www.nafc.org/bhealth-blog/why-you-shouldnt-use-a-maxi-pad-for-incontinence#:~:text=Absorbency.,you%20will%20have%20fewer%20leaks.
6. Simkin, P. (2010). Pregnancy, Childbirth and the Newborn, 4th edition. Meadowbrook Press
7. Glade, B.C., Schuler, J.  (2011).  Your Pregnancy Week by Week, 7th edition.  First Da Capo Press