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Pregnancy-related incontinence

Pregnancy-related incontinence problems are common during and after pregnancy. Women can experience the problem one year or longer after having their baby. Rushing to the toilet or leaking when you cough, laugh or exercise is often caused by weak pelvic floor muscles. This summary explains how physiotherapy can help.

Watch: physiotherapy and pelvic floor exercises


In the video above you can hear from a patient, physio and midwife about how pelvic floor exercises can maintain muscle strength following pregnancy and birth

Many women who develop continence issues following childbirth are suffering in silence because of embarrassment over the condition.

The Chartered Society of Physiotherapy and the Royal College of Midwives are launching a joint initiative to prevent and reduce incontinence among women following pregnancy and birth.

In the film above you can learn from a patient, physio and midwife about how pelvic floor exercises can maintain muscle strength following pregnancy and birth.

What is pregnancy-related incontinence?

Do you or someone you care for need treatment? 
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Pregnancy-related urinary incontinence is a common problem. A poll of 1,900 women, conducted by Netmums for the Chartered Society of Physiotherapy and the Royal College of Midwives (RCM), revealed  one out of three women (34 per cent) developed  urinary incontinence during pregnancy and the same number said the problem continued one year on from having their baby.
 
Pregnancy-related incontinence can be treated without drugs or surgery through exercises and advice that improve the strength of your pelvic floor muscles.

How can physiotherapy help?

File 126423The most common cause of pregnancy-related urinary incontinence is weak pelvic floor muscles. Pelvic floor muscles span the bottom of your pelvis, supporting the uterus and helping to control the bladder and bowel.

The increasing weight of your baby, followed by the delivery, may weaken these muscles.

Even if you don’t experience urinary incontinence, NICE guidelines recommend women complete regular pelvic floor exercises in their first and subsequent pregnancies to reduce the risk of the condition developing.

If you do suffer with incontinence, the guidelines also recommend that you should receive at least three months of supervised pelvic floor muscle training as a first-line treatment of the condition.

Physiotherapists advise daily repetitions of pelvic floor muscle exercises. If you have any concerns about these exercises ask your GP for a referral to a women’s health physiotherapist.

Physiotherapists can:

  • teach you how to exercise your pelvic floor muscles correctly
  • Advise you on your lifestyle, such as diet, exercise, and fluid intake, which will help you manage the problem
  • Monitor your progress and modify the exercises accordingly

Physiotherapists are the third largest health profession after doctors and nurses. They work in the NHS, in private practice, for charities and in the work-place, through occupational health schemes.

Pelvic floor exercises for pregnancy-related incontinence

  • Sit or lie comfortably with your knees slightly apart. Pull up the muscles surrounding your back passage, as if you are stopping yourself from passing wind. Now add a squeeze towards the front around your vagina and bladder, as if stopping the flow of urine. Hold the squeeze while you count to four seconds, remembering to breathe normally
  • Rest for a few seconds, then repeat your long squeeze. See how many good quality squeezes you can do before the muscles get tired. Stop when your muscles get tired
  • You may find that holding for four seconds is too easy, or for some women it may be too hard. If this is the case, try holding for more or less time, concentrating on getting a good quality squeeze. Once you know how long you can hold a good squeeze, you can work to build this up over time (see below)
  • When you find this exercise becomes too easy, try holding for a longer count, up to or beyond 10 seconds. You should also gradually increase the number of repetitions you do in each session

How can I help myself?

The best way to help yourself is to make your pelvic floor muscles stronger by exercising them (above).

Practise these exercises several times a day. Do not exercise your pelvic floor muscles while emptying your bladder.

If you’re still having problems, ask your GP for a referral to a women’s health physiotherapist. You can use our Physio2u service to find a local practitioner, or ask the Pelvic Obstetric and Gynaecological Physiotherapy group.

Top tips to help prevent pregnancy-related incontinence

  • Follow the simple exercises every day set out in our free leaflet to strengthen your pelvic floor
  • Try to prepare for coughing, sneezing or any exertion such as getting up out of a chair by tightening your pelvic floor muscles first
  • Drink plenty of non-caffeinated drinks
  • Avoid too much tea or coffee, as caffeine can irritate the bladder
  • Eat a healthy, balanced diet to avoid constipation – straining to empty the bowel will weaken the pelvic floor muscles

Links and further information

Disclaimer

The content on this page is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation. The CSP is not responsible for the content of any external sites, nor should selection be seen as an endorsement of them.

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Last revised on

8 May 2014