That awkward pregnancy moment when you laugh, cough, sneeze and pee all at the same time.
During the nine (long) months of pregnancy, women’s bodily functions undergo many significant changes and the urinary system is sadly no exception.
The uterus, which rests on the bladder, dramatically increases in size and weight over the 40 weeks. In other words, your baby’s oh-so-cosy home exerts increasing pressure on your bladder and decreases its ‘storage capacity’. As if that wasn’t bad enough, the internal urethral sphincter of the bladder becomes less effective due to hormonal increases, resulting in unplanned leaks.
There are three common types of incontinence that women experience during pregnancy:
1. Urge incontinence
This is often referred to as ‘overactive bladder’ and is characterised by small leaks, involuntary loss of urine, and a strong, sudden need to pee.
2. Stress incontinence
Stress incontinence is urine leakage as a result of coughing, sneezing, laughing or lifting. Extremely common during pregnancy (especially the later stages), this type of incontinence is largely due to pelvic floor weakness.
3. Mixed incontinence
This is the worst of both worlds – when stress and urge incontinence occur together.
Why can’t I laugh without peeing myself anymore?
Stress incontinence in pregnancy is predominantly due to weakness of the abdominal girdle and perineal muscles.
A good visual representation would be a balloon full of water, with a somewhat loose knot. The knot represents the pelvic floor and the balloon represents bladder capacity. When you cough, laugh, lift a weight, or sneeze, the pressure on the abdomen increases, pressing the balloon. If you squeeze the balloon water will try to escape. If the knot is strong, water won’t escape, but if it is loose some will inevitably leak.
What can I do?
The good news is that stress incontinence usually goes away within a few months of giving birth and is also relatively easy to prevent.
Kegel exercises are absolutely key in regaining muscle tone and strengthening the pelvic floor. The important thing is to be consistent about doing them as they don’t have an immediate effect. If you’re religious about ’em, you should notice positive results after about 6-8 weeks.
If you’re particularly concerned about how stress incontinence is affecting you, don’t suffer in silence. Speak to your GP, midwife, or a physiotherapist who will be able to help you with specific pelvic floor exercises and make sure that you are doing them correctly.
