Incontinence post birth: 11 things experts want you to know about bladder leaks

Bladder weakness might not be the most comfortable topic but it's entirely normal. According to recent research by Always Discreet, seven out of 10 women experience bladder leaks, with 41% linking their leaks to childbirth. Whether you’ve recently had a baby or gave birth years ago, bladder leaks can occur. But don’t worry—there are always ways to manage leaks at any stage of your life.

Sadly, many women feel too embarrassed to talk about this issue. Half of those affected haven’t had the courage to discuss it with their closest friends or family, and 71% wouldn’t even tell their GP. Not talking about it can make it harder to cope and can significantly impact mental health and wellbeing. In fact, according to the NHS,incontinence can double the likelihood of developing postnatal depression.

“Unfortunately, it’s still a bit of a taboo and so women don’t tend to fully understand it, with many avoiding talking about it. The more we speak about it, the better, so women don’t feel alone and silenced by a few little leaks.

Ladies would rather talk about money worries, relationship problems, weight gain and even mental wellbeing above bladder weakness,” says Dr. Anita Mitra, AKA Gynae Geek, gynaecologist and author of The Gynae Geek and Dealing with Problem Periods.

However, there are various types of bladder leaks, and seeking professional advice is crucial to finding the best treatment for your situation. You don’t have to face this alone!

Mother&Baby reached out to leading gynaecologists to break the taboo surrounding incontinence after birth and help women get the support they need to address this issue and avoid suffering in silence.

1. First things first, what is bladder incontinence?

Bladder incontinence is essentially losing control over your bladder. It can range from leaking a bit when you laugh or sneeze to having a sudden, strong urge to urinate that makes it tough to reach a toilet in time.

“There are many different types of bladder incontinence, which is why it is so important to speak to your doctor. If you get the right diagnosis, the doctor can advise on the most effective treatment for you,” says Dr. Anita.

For pregnant and postpartum women, bladder incontinence is quite common. “The most common types are stress and urge incontinence. Stress incontinence happens when you experience leaks due to pressure on your bladder from activities like coughing, laughing, or exercising. Urge incontinence is when you struggle to reach the toilet in time. Women can also experience a mix of both,” explains Dr. Anita.

If you experience any form of incontinence, don't hesitate to seek medical advice. With the right diagnosis and treatment plan, you can manage the condition effectively.

2. What causes bladder incontinence?

“Although having a vaginal delivery can cause further weakening, just being pregnant has a huge part to play in the weakening of your pelvic floor. During pregnancy, the weight of your baby puts prolonged pressure on your pelvic floor, which can cause it to weaken to the point where many women first experience bladder leaks during pregnancy,” explains Dr. Anita.

During pregnancy, bladder incontinence often happens because of hormones and your growing baby pushing on your bladder. Those pregnancy hormones are busy relaxing your muscles and ligaments to get ready for your little one’s arrival, but they also affect the pelvic floor muscles that control your bladder.

In the first trimester, as your uterus starts to expand, it pushes on your bladder, so you might find yourself running to the toilet more often. Then in the second trimester, the uterus moves up and out of the pelvic cavity, giving you a bit of a break. But by the third trimester, your baby grows even more and once again starts pressing on your bladder. After childbirth, your pelvic floor muscles can weaken further, making the problem worse.

3. Why can't I hold my pee after having a baby?

Dr. Pavan Minhas, NHS Obs/Gynae doctor explains, “The main culprit here is weakened pelvic floor muscles. These muscles play a crucial role in supporting the bladder and controlling urine flow. When they become weak, the sphincter—a ring-shaped muscle that controls the opening and closing of the bladder—doesn't function properly.

Pelvic organ prolapse (POP) is another factor contributing to urinary leakage. This happens when the support structures for organs like the uterus or bladder weaken, causing them to bulge into the vagina. Pregnancy and delivery are major risk factors for developing POP, especially if you've had a larger baby, needed forceps during delivery, experienced a long labor, or had a severe tear.”

Regardless of how you deliver, the changes your body undergoes postpartum can lead to relaxation of the pelvic floor muscles, making leakage more likely in some women.

4. How long does urinary incontinence last after childbirth?

For some women, incontinence after birth resolves within a few weeks. However, many continue to experience urinary incontinence for months, or even years, after pregnancy.

Several factors can contribute to ongoing incontinence after childbirth, including your pregnancy history, how you delivered your baby, and the number of children you have. For instance, vaginal deliveries, particularly those involving large babies or prolonged labour, can weaken pelvic floor muscles. Similarly, having multiple pregnancies can increase the likelihood of experiencing bladder leaks.

5. Are bladder leaks only common in older mums?

“Absolutely not, bladder leaks are far more common than you think in younger women. Research from Always Discreet found that almost two-thirds of people aged 18-24 have experienced them. You can experience them at any age for a wide range of reasons such as weight gain, the impact of surgery, or even your diet. The most important thing is to speak to your doctor if you have any concerns because it is not something you simply have to put up with,” Dr. Anita advises.

6. Will I always have incontinence after having a baby?

“In most cases, there is always something that can be implemented to better improve your bladder leaks. There are different types of bladder weakness, so I’d advise a trip to the doctor to help you first establish the cause in order to find the best course of action for your situation. It is equally important to do your pelvic floor exercises after your pregnancy as during. Ideally, I would suggest you do them before, during, and after pregnancy. However, being a muscle, the pelvic floor is never beyond repair. This means it is never too late to start,” Dr. Anita says.

7. How can I stop postpartum urinary incontinence?

Dr. Pavan says, "The best first step for dealing with incontinence is to strengthen your pelvic floor muscles. You should start these exercises during pregnancy, not just after delivery. Even if you're not leaking urine yet, doing these exercises early can prevent problems later on."

While pelvic floor exercises can help considerably in some cases, they won’t always cure all forms of bladder leaks.

“Pelvic floor exercises do help many women see a marked improvement and they’re a particularly effective treatment for those with stress incontinence. This is when your bladder is put under too much stress over a prolonged period and can be brought on during pregnancy or due to weight gain. People experiencing stress incontinence find themselves leaking when they run, cough or laugh for example.

There is no harm in everyone exercising their pelvic floors to start strengthening them up over time! There is also something called the ‘knack’ which you can use when you recognise the triggers that cause your leaks. For example, if you know that sneezing causes your leaks, you squeeze your pelvic floor muscles at exactly the right time to stop it happening. It takes some practise but many women find this helps,” Dr Anita says.

There are various internal vaginal devices available that can be inserted into the vagina to address incontinence. These devices work by supporting the bladder neck or compressing the urethra, which helps reduce or prevent urine leakage. However, the National Institute for Health and Care Excellence (NICE) does not universally endorse their use due to limited objective evidence showing consistent improvement in symptoms like frequency of incontinence episodes.

Dr. Pavan adds, "While some women do feel better using these devices, they might only be helpful in certain cases, especially if other treatments haven't worked "If all other treatments fail, surgery might be an option. But it's best to wait until you're done having children because future pregnancies can undo the benefits of the surgery."

8. What exercises are good for postpartum urinary incontinence?

“I find the best technique is a simple one. You should start by sitting down with your back straight, on the edge of your chair. Then you’ll need to locate your pelvic floor muscle, which can be done when you’re on the toilet, and you tense your muscles to stop yourself from urinating. To exercise the muscle, simply squeeze as if you’re lifting it upward, away from the chair. Lift for one second and release for one second. Repeat this ten times. This is working your fast-twitch muscles," explains Dr. Anita.

9. Will I need surgery to improve my pelvic floor?

"Surgery is an option in certain cases but it’s not the only one. Everyone is different and while some people require physio to see improvement, others may be better suited to medication.

People often underestimate the benefits of simple pelvic floor exercises which, when done properly and consistently, can greatly improve symptoms in a lot of cases,” Dr Anita says.

10. Expert tips to manage incontinence after birth

Here are some easy-to-follow tips from Dr. Anita and Dr. Pavan to help manage incontinence after giving birth:

11. When should I see a GP?

“You will usually be seen by your GP at the six - eight week postnatal check. This would be the ideal time to discuss any symptoms you may be experiencing, if you haven’t already done so. Urinary incontinence is common during pregnancy and postpartum, and you should not feel embarrassed talking to your doctor about your symptoms. They will be able to examine you and advise on management to improve symptoms and quality of life, which may include referral to a women's health physiotherapist,” Dr Pavan advises.

If you have any questions about bladder leaks after childbirth, you can reach Bladder Health UK’s confidential advice line on 0800 4334 600.

About the expert

Dr. Pavan Minhas is a senior registrar in obstetrics and gynaecology. Her mission is to empower women to understand their bodies and advocate for their health, including during pregnancy, ensuring positive outcomes for both themselves and their babies.

Dr. Anita Mitra, the Gynae Geek, is a gynaecology doctor and author of ‘The Gynae Geek’ & ‘Dealing with Problem Periods’. Anita is on a mission to provide reliable yet engaging healthcare information, educate and empower women about how their bodies work and cut through the nonsense about women's health.

About the author

Anne Lora Scagliusi is a Senior Digital Writer at Mother & Baby. She is a Scotland-based journalist with over a decade of international writing experience, specialising in women’s health, maternal mental health, and wellness. Her work has been featured in Vanity Fair, Marie Claire, and Glamour and has appeared on several Vogue global editions. She is mum to a one-year-old bambino and lives between Italy and the UK. You can follow her on Instagram.