One of the unpleasant side effects of having carried and delivered your child is the unexpected—and often inconvenient—spurt of urine that happens when you cough, sneeze, laugh, even breathe.
"Urinary stress incontinence is obviously annoying and potentially embarrassing," says Lianne Herbruck, R.N., C.N.M, a midwife in Chagrin Falls, Ohio, and the author of several studies on the topic. "It's also extremely common, affecting 30 percent to 50 percent of women who have had a baby." So what's a leaking lady to do? Read on:
WHAT CAUSES IT? The stresses of childbearing and delivery are usually to blame. "The weight of pregnancy is a major contributor," Herbruck explains. "During the third trimester, the uterus rests on the bladder and its supporting ligaments, causing the ligaments and surrounding muscles to stretch." When those structures become lax, they're less effective at supporting the bladder, which in turn leads to the dreaded leakage, which is why women do delivered by Cesarean section can also be incontinent. And if you had a vaginal delivery, you're at even higher risk due to the stretching that occurs, coupled with damage to the soft tissues of the perineum. "Vaginal deliveries are one of the biggest risk factors for incontinence," Herbruck adds, "especially if instruments such as forceps or a vacuum are used."
HOW LONG DOES IT LAST? In most cases, the condition goes away on its own within three to six months, after your body has had a chance to recover.
CAN YOU PREVENT IT? "There's no definitive answer on that," Herbruck says, "though once incontinence does occur, you can take measure to improve it and perhaps make it not last as long." She points to Kegels as the solution recommended by many experts., but they must be done often and correctly for them to work. To do a Kegel, contract the pelvic-floor muscles—those around your vagina—as if stopping the flow of urine; hold for a few seconds, then repeat several times, several times a day. But beware: If you discontinue doing them, you may end up right back where you were. "Like any muscle group, if you don't use the pelvic-floor muscles, they go flaccid," Herbruck says. "It's amazing how fast you can lose tone."
HOW TO AVOID ACCIDENTS Be sure to empty your bladder before you feel the need to go. Also, avoid constipation (the pressure of a hard bowel movement can contribute to bladder misbehavior), and drink lots of water. "The more concentrated urine is, the more irritating it is to your bladder," Herbruck explains. Sip water throughout the day—don't overfill your bladder—and strive to drink enough so that your urine is pale-yellow or clear. And cross your legs if you feel a sneeze or cough coming on!
OTHER OPTIONS Specialized physical therapy to improve tone in the pelvic floor may help; so may a device called a pessary, which is inserted like a diaphragm to help support the bladder. Surgery to support the bladder is also an option—though luckily, it's usually not necessary, Herbruck says.