Incontinence after c section
Bladder weakness after birth | Pregnancy Birth and Baby
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What is urinary incontinence?
Urinary incontinence describes any accidental or involuntary loss of urine from the bladder. Incontinence can range in severity from a small leak to a complete loss of bladder control. Thankfully, there are ways to improve and even cure urinary incontinence. Seeking help early is recommended.
What causes urinary incontinence?
When you are pregnant, you produce hormones that stretch the muscles and tissues that support the bladder, the bowel and the uterus. This group of muscles and tissues is called the pelvic floor.
When your baby moves down through your vagina to be born, your pelvic floor stretches and it remains stretched for some time.
The combination of hormones and stretched muscles means the muscles that control your bladder are weakened. This can lead to an accidental leak of urine.
Diagram showing where the pelvic floor muscle is located in the female body.How common is urinary incontinence?
Leaking urine (called ‘urinary incontinence’) after childbirth is very common. One in 3 women who have had a baby may experience leakage at some point.
Some new mother may leak urine when they laugh, sneezes, coughs or exercises. This is known as stress incontinence.
You are more likely to develop stress incontinence after birth if you:
- have bladder or bowel problems before pregnancy – they are likely to get worse after the birth
- bladder problems during the pregnancy
- are having your first baby
- are having a large baby
- have a long labour, especially a long second stage of labour
- have a difficult delivery, such as needing stitches, tearing, or needing a vacuum cup or forceps during the delivery
Women who have a caesarean can also develop bladder problems.
Having a caesarean can reduce the risk of severe incontinence from 10% to 5% for the first baby, but after the third caesarean women are just as likely to develop bladder problems as women who give birth vaginally.
When should I see my doctor?
Most women who leak urine after childbirth find that it goes away in the first few weeks, as the stretched muscles and tissues recover.
However, for some women it can take months while others find their pelvic floor never recovers fully.
If you are experiencing urine leakage, you can talk to your, doctor, maternal and child health nurse, continence nurse or a women’s physiotherapist. Remember dealing with it early can reduce the risk of it becoming a life-long problem.
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How is urinary incontinence treated?
The treatment will depend on what kind of incontinence you have and how severe it is.
Straight after birth, you will need to give the pelvic floor time to recover. Ice the perineal area for the first few days and have plenty of rest.
Then you can start with gentle pelvic floor contractions while you are lying down. Hold for 3 seconds, rest for 15 seconds, and repeat 3 times. Try to build up longer holds when you can. Doing these exercises may help prevent longer term bladder problems.
Simple changes to your lifestyle may also help, such as losing your pregnancy weight, eating more fibre, drinking more water and lifting less.
If your urinary incontinence doesn’t get better, talk to your doctor. They may refer you to another specialist. Longer term treatments for bladder weakness are exercises, medication or surgery.
Pelvic floor exercises
The muscles around the bladder, bowel and uterus can be exercised, toned and trained like any other muscles in the body. Doing this before, during and after pregnancy will help prevent urinary incontinence during pregnancy and after the birth of your baby.
They’re easy to do, in any place and at any time.
Here’s an example:
- Breathe in and breathe out.
- Pull the pelvic floor muscles up and in as though you are trying to stop yourself from urinating.
- Hold the squeeze for 10 seconds while breathing normally.
- Relax and repeat in 10 seconds.
- Repeat the squeeze and release 10 times.
- Do this exercise 3 times a day.
The Continence Foundation of Australia have produced this video on how to do pelvic floor exercises:
You can also find out more about pelvic floor strength on the Jean Hailes website.
Bladder training
When you’re pregnant, your growing baby puts pressure on your bladder. This causes the bladder to feel full more quickly than usual, meaning you need more frequent trips to the toilet.
After your baby’s birth, it is a good idea to retrain your bladder. You can do this by trying to hold off from going to the toilet, until your bladder is full.
Medication
If you have urge incontinence, or an overactive bladder, medication can help to relax the bladder muscles.
Surgery
If all else fails, surgery might be an option for some women. Talk to your doctor about what's best for you.
Emotional wellbeing
Urinary incontinence can affect not only your physical health but also your emotional health and general wellbeing. For some women this complication may also be linked to an experience of birth trauma. If you find you are experiencing low mood or are concerned, you are not alone. There are service available to support you.
Living with urinary incontinence
Urinary incontinence can, unfortunately, become a long-term problem for some women. Here are some tips that may help if you are living with it:
- use incontinence pads, which are made for urine leakage, rather than sanitary pads
- take a change of underwear or set of clothes when you go out
- know where toilets are located so you can find them quickly (there are smartphone apps to help you do this)
- cross your legs when sneezing or laughing
- modify your exercise routine to avoid high impact exercises such as jumping
What can I do to prevent bladder problems after birth?
There are some simple steps you can take during pregnancy to help prevent incontinence.
- Drink 6 to 8 cups of fluid a day, unless your doctor tells you otherwise. Avoid drinks containing sugar or caffeine, as these can irritate the bladder.
- Eat a high fibre diet with 2 pieces of fruit, 5 serves of vegetables and 5 serves of cereals/bread per day.
- Make sure you have a healthy weight.
- Stop smoking.
- Exercise for at least 30 minutes most days (see below).
- Do regular pelvic floor exercises.
- Go to the toilet when you have the urge to open your bowels (poo).
- Sit properly on the toilet.
- Avoid constipation, as this strains your pelvic floor muscles.
- Don’t go to the toilet ‘just in case’.
- See your doctor straight away if you have a urinary tract infection.
It’s also important to exercise safely while you are pregnant and after the birth to avoid incontinence. Ideal exercises are walking, low impact aerobics, water aerobics, cycling on a stationary bike, swimming, light weight training or pregnancy exercise classes.
To protect your pelvic floor, avoid:
- heavy weights
- high impact or jerky movements
- bouncing
- contact sports
- excessive twisting and turning activities
- exercises that require you to hold your breath
- exercises that require sudden changes of direction or intensity
- exercises that make you use one leg more than the other, or lifting your hip while you are on your hands or knees
- exercises that involve standing on one leg for a period of time
- activities involving sudden changes in intensity
- exercises that increase the curve in your lower back
Where can I go for more advice and support?
Speak to your doctor or midwife or call the National Continence Helpline on 1800 33 00 66 for more information and support.
Sources:
Continence Foundation of Australia (Pregnancy and childbirth), The Royal Women's Hospital (Urinary incontinence), Department of Health (One in three women who ever had a baby wet themselves), Jean Hailes for Women's Health (Bladder incontinence), Pelvic Floor First (Exercising during pregnancy)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: September 2022
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Related pages
- Pelvic floor exercises
- Looking after your body after having a baby
- Bladder and bowel problems during pregnancy
- What happens to your body in childbirth
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The Connection Between C-Sections and Urinary Incontinence
Posted on
by Michelle Stepp
Finding out you’re pregnant can be a time that is full of excitement and joy! However, sometimes there may be some topics of concern that may come up along your journey. You might have a pre-existing health condition or a problem arises and your doctor may feel that having a traditional vaginal birth may be too risky. Some serious thoughts and conversations might lie ahead and the topic of delivering your child via c-section could be the safest choice.
What is a C-Section and When is it Needed?
What is a c-section?
Cesarean birth, which is often referred to as a c-section, is a surgical procedure performed by a doctor to deliver a newborn through an incision that is made in the abdomen and uterus. It may be a safer option rather than vaginal birth if the goal is to protect the newborn’s health or if the mother has a medical condition that can affect the pregnancy. A c-section can be either scheduled to coincide with the planned due date or it can be an emergency if the mother or baby’s health is in immediate danger.
What are some medical reasons a c-section may be needed?
A c-section may be the best course of action to take due to potential complications that can make vaginal birth unsafe for the mother and/or her baby. A c-section can be necessary for any of the following reasons:
- The baby is too large for a vaginal birth. A very large baby sometimes simply cannot fit through the vaginal opening without causing significant damage.
- The baby is either sideways or breech (feet first instead of head first) in the womb. The position of the baby in this way can be dangerous as there is a risk that oxygen supply through the umbilical cord could be cut off if the baby gets stuck during delivery.
- The mother has a medical condition such as high blood pressure or diabetes. High blood pressure can be risky during pregnancy due to the stress that is put on the heart. When there is a high amount of sugar in the blood, as with diabetes, nerves and blood vessels can be damaged. Both of these medical conditions can make a c-section more favorable for the safety of the mother and her baby.
- If the mother has had a previous c-section, she is at a greater risk for complications during childbirth. There can be scar tissue buildup after each c-section making another incision more difficult and risk damage to the bladder or bowel.
- The mother might have an infection that could potentially be passed on to the baby during vaginal birth.
As a safety precaution, a c-section would be a better choice in this case. - When there are multiple babies in the womb, a c-section is a wise decision so that no harm is done to either the babies or the mother.
Can a C-Section Cause Incontinence?
Childbirth in itself causes strain and tears on a woman’s body. The uterus starts getting heavier as the infant grows and the surrounding structures begin to stretch and weaken. Some women think that having a c-section will prevent them from side effects of vaginal birth like urinary incontinence or fecal incontinence. However, studies have shown that having a c-section doesn’t protect women from suffering from urinary or fecal incontinence. Bladder issues after a c-section are quite common.
After the abdominal incision is made during a c-section, scar tissue is formed from collagen during the healing process. The collagen fibers of this scar tissue can extend deep into the layers below the skin and create bladder problems.
Bladder issues after a c-section such as urinary incontinence can result when this scar tissue attaches to the wall of the bladder. After a woman gives birth, things begin to reduce back down in size, this scar tissue pulls on the bladder making her feel as though she needs to urinate more urgently (urge incontinence) or more often (overactive bladder).
How Long Does Urinary Incontinence from a C-Section Last?
Urinary incontinence from a c-section can take up to six months, or even longer for some women, to get their bladder functioning like normal again. There are several things that a woman can do to help the process along and get it back faster. In the interim, considering the use of incontinence products such as pads, liners, and protective underwear can help women get through the more difficult times.
How You Can Improve Urinary Incontinence Symptoms from a C-Section
Some of the ways a woman can treat urinary incontinence from a c-section to help her bladder get back to its normal function are:
Kegel Exercises
Strengthening the pelvic floor muscles after delivery is an important part of regaining bladder control.
The stronger and more elastic these muscles are, the less stress or urge incontinence is experienced. Starting kegel exercises right after childbirth can greatly reduce urinary incontinence symptoms and get you on the path for normal bladder function sooner rather than later.
A Pessary Ring
A pessary ring is a small, soft, silicone vaginal ring that is inserted into the vagina. Women who can benefit from a pessary ring are those that have urinary incontinence that seems to be persistent. The pessary ring is placed inside the vagina to act as a “speed bump” for the urethra and left there throughout the day. Some women prefer to use a pessary ring only when they engage in activities, while others put it in place in the morning and remove it in the evening. This device can be very helpful for women experiencing bladder issues after a c-section.
Electrical Stimulation Therapy
By sending mild electrical currents to the muscles in the pelvic floor that are involved in urination, these muscles then contract.
By repeating this electrical stimulation pulse, the pelvic floor muscles begin to strengthen, producing a similar effect to what kegel exercises do. A doctor can perform this therapy or the patient can be given a unit to use in the privacy of their own home to help relieve their urinary incontinence symptoms.
Sling Surgery
One of the most common surgeries for urinary incontinence is sling surgery. In this minimally invasive procedure, the surgeon inserts a U- shaped, mesh sling that permanently lifts and supports the urethra like a hammock. This procedure is quick and important to note that it is also permanent, so women that choose this option should not consider any more pregnancies.
Lifestyle Changes
There are many lifestyle changes that can also help women with urinary incontinence to regain bladder control. Many of these might be good to try before choosing some of the more permanent options.
- Remain at a healthy weight. Carrying around extra pounds can put pressure on the bladder and lead to urinary incontinence.
- Maintain a healthy diet. Alcohol, caffeine, and spicy foods tend to aggravate the bladder causing it to contract more often, making urine harder to control.
- Stay hydrated. Try to drink the recommended 8 ounces of water each day. Avoiding water as a way to control the number of times you need to use the restroom can result in a urinary tract infection or dehydration. Both are not good for a healthy bladder.
- Stop smoking. Nicotine causes bladder muscles to spasm and women who smoke also often have a chronic cough. Frequent coughing episodes lead to urinary incontinence because of the pressure continuously put on the bladder.
- Pads, liners, and other incontinence products can help absorb leaks and help with urinary incontinence. There are so many options available to women that are concerned about discreetness and living a dignified lifestyle.
As you can see, there is a connection between c-sections and urinary incontinence but you don’t have to let your bladder control your life.
There are many options available to treat bladder issues after a c-section such as urinary incontinence, even if you feel that you have exhausted all other avenues.
For questions about any of the incontinence products we carry to help with urinary or fecal incontinence, give us a call. One of our Personally Delivered Product Experts is happy to help.
Popular Incontinence Products for Women
Posted in Incontinence ResourcesTagged c-section incontinence, incontinence after c-section, incontinence after giving birth
Urinary incontinence in women after childbirth
One of the manifestations of pelvic floor dysfunction in women associated with overstretching or tearing of the soft tissues of the pelvis during childbirth. It does not have to be a rapid delivery or delivery of a large fetus. Often this is observed after normal childbirth. I must say that a caesarean section also does not completely relieve a woman from the likelihood of urinary incontinence.
Recovery after childbirth can take several months and a long period of urinary incontinence causes a lot of inconvenience. nine0003
There are several types of postpartum incontinence: Stress incontinence, when Involuntary release of urine occurs when coughing, sneezing, or exercising. Imperative, which occurs with a sudden urge to urinate, and the woman does not have time to react in time. Involuntary, when urine is released little by little throughout the day or continues for some time after emptying the bladder.
Why?
Involuntary excretion of urine occurs as a result of dysfunction of the pelvic floor muscles. During childbirth, they stretch, become less elastic. Various factors can provoke urination disorders: trauma during childbirth, inflammation in the genitourinary tract, and features of the connective tissue that a woman has. nine0003
How to confirm the diagnosis?
Sometimes, in order to find an effective treatment, a gynecological examination, urine analysis and ultrasound examination of the uterus and bladder and measurement of the strength of the pelvic floor muscles with a special device - pneumatic digital perineometer iEASE XFT -0010 are enough.
In complex cases, it is necessary to involve a urologist and additional research methods - cystoscopy, urofluometry, MRI, etc. nine0003
What to do?
If the problem does not disappear within a couple of weeks after childbirth, it must be actively addressed:
After making sure that there is no inflammatory process in the kidneys and bladder, physiotherapy exercises and modern physiotherapy can be used . To enhance the effect, autoplasma therapy has been successfully used recently. Given that most women are breastfeeding, the use of drugs is highly undesirable, and often absolutely contraindicated. If conservative methods are ineffective, options for surgical correction should be considered. Full information on surgical methods of treatment can be obtained at the appointment of a urologist. nine0003 The main thing to understand is that urinary incontinence should not be tolerated - it should be eliminated as soon as possible. Our clinic practices a comprehensive approach to solving the problem of urinary incontinence after childbirth. Come to your first postpartum appointment no later than one month after delivery. If you have problems with urinary incontinence, come early. Diagnosis starts with physical examination, tests, ultrasound and pelvic floor strength measurement perineometer iEASE XFT -0010 . Treatment begins with the correction of disorders identified during the examination, plus elementary methods of Kegel therapeutic exercises. In the process of rehabilitation, the mode of electromyostimulation of the pelvic floor muscles, selected according to the first test, is added, it is possible to use parallel magnetic laser therapy and PRP autoplasma therapy. There are two types of incontinence: in one case it is associated with an irresistible urge (as they say, "did not get to the toilet"), in the other case, involuntary urination occurs with an increase in intra-abdominal pressure during physical exertion, laughter, coughing, sneezing, etc. The problem in most cases is not resolved by itself, causing physical and psychological inconvenience and suffering (the need to walk around with pads and diapers) and reducing the quality of life, including intimate life. They are embarrassed to talk about it, and compared to how many people are prone to this problem, only a few seek help. Often they simply do not know who exactly to turn to - they go to a gynecologist, and to a therapist, and to a neuropathologist, while this should be done comprehensively and always with the participation of a urologist. nine0003 1. Slow contractions: tighten the muscles as if to stop urination, slowly count to three. To relax. Special therapeutic exercises also help to strengthen the muscles of the small pelvis. 1. I.P. lying on your back. We exhale, draw in the stomach, pull the knees to the chest. There is no need to despair: although treatment is not a simple process due to the large number of components involved in the formation of this syndrome, it is very effective. In all cases, it begins with conservative methods: medicines, physiotherapy and, of course, the therapeutic exercises we have already mentioned. Refrain from activities that increase intra-abdominal pressure. If conservative treatment does not help, low-traumatic surgical methods come to the rescue in the form of imposing various types of loops. nine0003 Sometimes an episiotomy is done for the benefit of the baby and mother. Healing is very fast due to tissue matching and a powerful hormonal explosion. The main task of the mother, if she has stitches, is to keep them clean. This, of course, is hygiene (washing twice a day, from front to back, you can use a decoction of chamomile or a weak solution of potassium permanganate) and ensuring oxygen access. Associated with the latter is the ban on underwear and pads, which causes violent protest among women in maternity hospitals. One should not underestimate such an important moment as the normalization of the stool on the third day after childbirth. Defecation does not provoke the divergence of the sutures, on the contrary, this stool retention can lead to trouble, so try to achieve a soft and spontaneous stool by the third day, and upon returning from the hospital, consult a doctor to make sure that the sutures are healing correctly, without divergence and suppuration. nine0003 Immediately after delivery, the uterus should empty well, so turn over, give a vertical load. The return of the tone of the soft tissues of the perineum will also be helped by sexual intercourse, which improves tissue nutrition. Please note: they are allowed when the placental site has been restored in the uterine cavity and there is no longer a risk of inflammation. If you feel pain during intercourse, do not hesitate to tell the doctor about it - he will find out the reason and advise the appropriate position. 
Steps to follow:
Urinary incontinence and other health issues after childbirth - Useful articles
There may be mixed forms. The symptom of this disease is frequent urination more than 8 times during the day and 2 times at night, pain, leakage of urine and "urgency" - a feeling that urination will begin now. The causes of the disease can be different: inflammatory diseases of the pelvic organs, injuries after childbirth, concomitant neurological, endocrine and other somatic diseases. nine0003 Therapeutic exercise for incontinence
In women after childbirth, disorders of vascular circulation and nervous regulation in the pelvic area are not uncommon.
If there was a difficult birth, a large fetus, tears, stitches, then the prevention of incontinence should be started immediately, strengthening and restoring the muscles of the pelvic floor, nervous regulation and blood circulation. It is better, of course, to do this before pregnancy. Kegel exercises not only help to cope with involuntary urination, but also increase voluntary control over sexual reactions. nine0003
2. Contractions: tense and relax these same muscles as quickly as possible.
3. Push-ups: tense the perineum and abdominal muscles.
2. I.P. also. Alternately raise straight legs and make circular movements out and in with full amplitude. nine0069 3. From the same position while exhaling, pull up the chest with bent knees and clasp them with your hands.
4. Now we raise the upper part of the body and sit down, wrapping our arms around our knees.
5. At the expense of 1-2-3, raise the upper body and one leg, to which we reach with the same hand. We go down to count 4.
6. Knees bent. At the expense of 1-2-3, we raise the pelvis, squeeze the buttocks, retract the anus. On the count of 4, lower the pelvis and relax.
7. From the same position, we lay bent knees to the right and left of the body. nine0069 8. I.P. standing, with support. On the inhale we rise on our toes, on the exhale we squat, holding on to the chair.
9. In the same position, holding on to the support, we roll from toes to heels and back.
10. I.P. On knees. Sit on your heels, stretch your arms up.
11. From the same position, alternately straighten the legs and pull them back. Shoulders-back-leg at the same time form one straight line.
12. Standing on all fours, alternately pull opposite arm and leg: straighten on the count of times, hold 2-3, return to the starting position on the count of 4.
Be careful not to arch your back. nine0069 13. From the same starting position on count 1 stretch one leg back, on count 2-3 take it to the side parallel to the floor, bending at the knee, on count 4 return to the starting position.
14. I.P. hands on the belt, one foot is on the chair. We lean forward and reach for the raised leg, bending it at the knee as much as possible. Problems in the perineum
During childbirth, injuries to the soft tissues of the perineum are possible.
Doctors pay special attention to this, but the woman herself should be engaged in prevention throughout the entire pregnancy. First of all, this is gymnastics, which prepares the muscles of this area for the birth load. Cure inflammatory processes that reduce the elasticity of the perineum (they include thrush), be careful with nutrition: an excess of sweet and starchy foods, especially in recent months, lead to an increase in the size of the fetus, increasing the risk of trauma, which then backfires problems in sexual life. nine0003 
Uterus and vagina
Some women who have recently given birth complain of vaginal gaping, even asking to "sew it up so that it was like before." Bringing the vaginal ring back to normal is really very important, but this process takes some time. During childbirth, the vagina stretches to let the baby through. Closing occurs within six months, which can be accelerated, for example, by the already mentioned Kegel exercise or the mixing-breeding of the legs. nine0003 
This will improve blood flow, help her take a central position. Any exercises on the press are possible only after the complete cessation of secretions, otherwise an increase in intra-abdominal pressure increases the risk of resumption of bleeding. You can do it 6-8 weeks after giving birth in a prone position so as not to strain the muscles of the pelvic floor. But sitting in the hospital, especially if you have stitches, is not necessary - it is better to eat while standing, and to feed the baby - lying down. nine0003 Hemorrhoids
Another problem after the birth of a baby is hemorrhoids - a frequent manifestation of varicose veins.
