Incontinence early pregnancy sign

Causes, Management Tips, and More

Pregnancy Incontinence: Causes, Management Tips, and More

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Medically reviewed by Michael Weber, M. D. — By Ashley Marcin on February 22, 2017

What is pregnancy incontinence?

Frequent urination is one of the earliest signs of pregnancy. Leaking urine, or incontinence, is also a common symptom during and after pregnancy. About 54.3 percent of pregnant women report negative effects on their quality of life, including travel and emotional areas. Symptoms can increase as the baby grows and last a few weeks after birth.

There are several types of urinary incontinence:

stress incontinence: loss of urine due to physical pressure on the bladder
urgency incontinence: loss of urine due to an urgent need to urinate, commonly caused by bladder contractions
mixed incontinence: a combination of stress and urgency incontinence
transient incontinence: temporary loss of urine due to a medication or a temporary condition, such as a urinary tract infection or constipation

Learn more about why you may have incontinence during or after pregnancy, what it means for you and baby, and how you can cope.

Is it urine or amniotic fluid?

Q:

How can I know if I’m leaking urine or amniotic fluid?

Anonymous patient

A:

Short of going to the hospital to test the fluid, you can check how the fluid leaks. If it’s appearing intermittently and in smaller amounts, it’s probably urine. Most of the time when amniotic fluid leaks, it comes in much larger amounts (often described as a “gush”) and persists continuously. The presence of a white waxy or dark green substance is also indicative of amniotic fluid.

Michael Weber, MD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

What causes pregnancy incontinence?

Your bladder sits right above your pelvic bones and is supported by your pelvic floor. It relaxes and fills with urine throughout the day while the sphincter keeps the organ closed until you can use the bathroom. During pregnancy and childbirth, your pelvic floor muscles are put to the test.

Common causes of pregnancy incontinence include:

Pressure: You may leak when you cough, sneeze, exercise, or laugh. These physical movements put extra pressure on your bladder, which causes stress incontinence. Your baby also puts extra pressure on your bladder as they grow bigger.

Hormones: Changing hormones can affect the lining of your bladder and urethra.

Medical conditions: Some medical causes for incontinence include diabetes, multiple sclerosis, anxiety medications, or a stroke in the past.

Urinary tract infections (UTIs): Between 30 to 40 percent of women who didn’t treat their UTI completely will develop symptoms during pregnancy. Incontinence is a symptom of UTI.

What are the treatment options for pregnancy incontinence?

The first lines of treatment for pregnancy incontinence are lifestyle changes and bladder management. Here are some tips for managing your bladder:

Do Kegels: Kegel exercises to strengthen your pelvic floor. They’re a safe and effective exercise before, during, and after pregnancy. To do a Kegel, focus on the muscles you use to hold in urine. Squeeze them for ten seconds before relaxing. Aim to do five sets of these exercises per day. Learning how to relax your pelvic floor may help during and after labor.

Create a bladder diary: Jot down when you notice the most leaks so you can plan your trips. This is also the first step to bladder retraining. Bladder retraining is about re-teaching your bladder to hold more urine by extending time between trips.

Avoid carbonated or caffeinated drinks: Avoid carbonated drinks, coffee, or tea. These beverages may make you feel like you need to use the bathroom more often. Try drinking more water or decaffeinated drinks.

Avoid drinking at night: Limit your beverages in the evening to avoid frequent trips to the bathroom and leaking at night.

Eat a high-fiber diet: Eat foods that are high in fiber to avoid constipation, which puts added stress on your pelvic floor.

Maintain a healthy weight: Extra weight, especially around your abdomen, increases pressure over your bladder. Losing weight after labor can also help with incontinence after pregnancy.

Read more: Natural remedies for an overactive bladder »

Discuss any big changes with your doctor to make sure you’re doing what’s best for yourself and your baby. While medication and surgery are also options for incontinence, you may want to wait until after your pregnancy.

Tips for preventing UTIs

Do

drink plenty of water, up to eight glasses per day
urinate before and after having sex
wipe from front to back after urination
wear cotton fabrics and loose fitting clothes when possible
change your underwear each day

Contact your doctor if you think you have a UTI. An untreated UTI can lead to a kidney infection, which may also cause early labor and a low birth weight.

Don’t

engage in intercourse while you have a UTI
drink beverages that irritate the bladder, like fruit juices, caffeine, alcohol, and sugar
hold your urine for long periods of time
use strong soaps, douches, sprays, or powders
wear the same underwear for more than a day

Treatment for a UTI involves antibiotics for three to seven days. This treatment is safe for your baby. Call your doctor if you have side effects, such as a fever, chills, or cramps, after taking your medication.

Are some women more at risk for pregnancy incontinence?

Women who already have an overactive bladder or urgency incontinence will likely have symptoms that continue or worsen during pregnancy.

Other risk factors include:

older age
being overweight
having previous vaginal delivery
having previous pelvic surgery
smoking, which leads to chronic coughing

Causes after childbirth

Giving birth can contribute to incontinence after pregnancy. During vaginal delivery, muscles and nerves may be injured. A long labor or prolonged pushing can increase the likelihood of damage to nerves as well. The American Congress of Obstetricians and Gynecologists recognizes that cesarean delivery reduces incontinence during the first year. However, the benefits go away two to five years after delivery.

How is pregnancy incontinence diagnosed?

Tell your doctor if you’re experiencing incontinence. In some cases, it may be a UTI and you may need antibiotics. If you’re near the end of your pregnancy, you may also confuse leaking urine with leaking amniotic fluid. It’s best to check with your doctor so you know the exact cause.

If signs of labor and infection are cleared, your doctor may perform other tests. A bladder scan using ultrasound can help see if your bladder is emptying the whole way. A bladder stress test allows your doctor to see if you have leaking when you cough or bend down.

If your doctor suspects you have a UTI, they will likely ask for a urine sample for lab testing. This may require you go to your hospital’s lab instead of your usual office. Your doctor may also perform special tests to check if the fluid you’re leaking is from your water breaking.

Does incontinence go away after the baby is born?

Some women’s incontinence symptoms go away in the days or weeks after their baby is born. For others, the leaking continues or may get worse. However, incontinence can be managed with first line treatments such as Kegels, bladder retraining, weight loss, and exercise.

Speak with your doctor about your concerns, especially if lifestyle changes don’t work or you’re still experiencing incontinence six or more weeks after delivery. You may want to consider other treatments such as medications and surgery after your pregnancy.

Read more: Female urinary stress incontinence treatments »

How can you prevent pregnancy incontinence?

Remember: Pregnancy incontinence is a common condition, especially as your belly grows or after your delivery. The good news is that the tips listed above are effective ways to manage incontinence.

Keep reading: Prenatal care: Urinary frequency and urgency »

Last medically reviewed on February 22, 2017

Parenthood
Pregnancy
Pregnancy Health

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Bladder control problems in women (Urinary incontinence). (2016, July)
niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women
Committee opinion. (2015)
acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Cesarean-Delivery-on-Maternal-Request
Hooton, T. M. (2016, April 29). Urinary tract infections and asymptomatic bacteriuria in pregnancy
uptodate.com/contents/urinary-tract-infections-and-asymptomatic-bacteriuria-in-pregnancy
Mayo Clinic Staff. (2014, September 16). Stress incontinence: Risk factors
mayoclinic.org/diseases-conditions/stress-incontinence/basics/risk-factors/con-20027722
Poise. (n.d.). How can I identify if I have pregnancy incontinence? Retrieved from
poise.com.au/facts-and-support/pregnancy-incontinence/how-can-i-identify-if-i-have-pregnancy-incontinence/
Pregnancy, childbirth, & bladder control. (2016, February 2)
my.clevelandclinic.org/health/articles/pregnancy-childbirth-bladder-control
Sangsawang, B., & Sangsawang, N. (2013). Stress urinary incontinence in pregnant women: A review of prevalence, pathophysiology, and treatment. International Urogynecology Journal, 24(6), 901-912
ncbi.nlm.nih.gov/pmc/articles/PMC3671107/
Urinary tract infection during pregnancy. (2015, August)
americanpregnancy.org/pregnancy-complications/urinary-tract-infections-during-pregnancy/

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Feb 22, 2017

Written By

Ashley Marcin

Edited By

Austin Anaya

Medically Reviewed By

Michael Weber, MD

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Medically reviewed by Michael Weber, M.D. — By Ashley Marcin on February 22, 2017

10 Early Pregnancy Symptoms - Lifeline Pregnancy Help Clinic

November 19, 2017 by Breanne Hunt

Interesting things happening in your body? Maybe you find yourself exhausted, nauseous, or more emotional than usual. And oh yeah, it’s been awhile since you’ve had a period. These clues start swimming around in your mind and you wonder, are these pregnancy symptoms??

Now let’s be clear: the only way to be certain a woman is pregnant is through a pregnancy test. But if you are pregnant, you may experience a variety of bodily changes, even as early as a week after conception. Every woman is different. Your symptoms could be very different from your best friend’s or your sister’s or even from your own previous pregnancies. Just because you don’t have morning sickness or that famous pregnancy glow, doesn’t mean the possibility of pregnancy is out the window. You may not ever have these pregnancy symptoms, or they could crop up later on.

That being said, there are a variety of changes you are likely to undergo during the early stages of pregnancy.

10 Common Pregnancy Symptoms:

Spotting and cramping

After conception (when the sperm meets the egg), the fertilized egg implants into the wall of the uterus. The uterus is where the baby grows and lives for nine months. When the egg attaches to the uterus, there could be some slight cramping or spotting, known as implantation bleeding. This happens 6-12 days after conception. If bleeding occurs it should be very light and could last a couple days. This bleeding should be lighter and shorter than a normal period.

Missed Period

Once the fertilized egg implants, the body will begin releasing a hormone known HCG. HCG is what urine pregnancy tests are looking for. This hormone tells the ovaries to stop releasing eggs. HCG also tells the body to stop shedding the lining of the uterus (which means no periods). That lining instead turns into a cozy environment for a baby to develop.

Nausea (Morning Sickness)

According to the American Pregnancy Association, 25% of women report nausea as their earliest pregnancy symptom. Though commonly referred to as “morning sickness,” this can happen at any time of the day. Whatever causes this unpleasant symptom hasn’t been found, but it’s likely the body’s reaction to the change in hormones.

Breast Changes

Also as a result of rapid hormone changes, the breasts may feel swollen, sore, or tingly a couple weeks after conception. They may even feel fuller, and the area around the nipples (the areola) might darken.

Increased heart rate

The heart begins to pump faster during pregnancy due to the rise in hormones. Palpitations and changes in heart rhythm are common because of this. As always, talk to your doctor about what is normal during pregnancy and report any chest pain or other changes in your heart rate.

Fatigue

Because of the hormonal changes as well as a drop in blood sugar, blood pressure, and increased blood production, the body might feel more exhausted than normal. This can happen even as early as a week after conception.

Mood Swings

You may feel more emotional than usual during pregnancy. Those good ol’ hormonal changes could cause feelings of depression, anxiety, irritability, or intense excitement.

Skin changes

The pregnancy glow you hear about is caused by a combination of increased blood volume and higher hormone levels pushing more blood through the vessels. This causes the skin to produce more oil than usual, creating a natural gloss and blush. However, this increase in oil could also lead to more acne than you may typically experience.

Frequent urination and incontinence

During pregnancy, the body boosts the amount of blood it pumps. This leads to the kidneys processing more fluid than usual, which in turn causes a fuller bladder.

Food cravings/aversions

Your developing baby needs lots of nutrients, some of which you may not normally eat. Your body will start to crave foods you don’t often find appealing so that you and baby will get all the right nutrients you both need. Some women report a new aversion to certain tastes or smells, which–you guessed it–is due to change in hormones. These aversions should go away around week 13 or 14.

How do I know for sure?

Remember, you could experience all of these pregnancy symptoms or only a couple. Always talk to your doctor about any symptoms that interfere with your everyday life. He or she can help you form a plan to ease these more uncomfortable changes.

Taking a pregnancy test is the first step in confirming a pregnancy. Lifeline Pregnancy Help Clinic offers confidential, no-cost pregnancy tests, as well as a variety of other resources to help you figure out your next steps if the test is positive. Pregnancy brings a lot of changes, physical and otherwise, but you don’t have to walk through it alone. Call Lifeline at 660-665-5688 or click here to request an appointment.

Make an Appointment

References:

WebMD http://www.webmd.com/baby/guide/pregnancy-am-i-pregnant#1

American Pregnancy Association http://americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/

What to Expect http://www.whattoexpect.com/pregnancy/pregnancy-health/early-symptoms-of-pregnancy

What causes urinary incontinence in pregnant women

One of the signs of pregnancy is frequent urination. In process of increase in term the phenomenon is expressed more often, especially at night. Unfortunately, this is often not the only change in the work of the expectant mother's urination organs. Against the background of metamorphoses occurring in the body of a woman, various disorders in the functioning of the kidneys and bladder appear. One of these troubles can be urinary incontinence in pregnant women. The condition causes discomfort but is not a serious health threat. The main symptoms are involuntary excretion of urine in small portions. This usually manifests itself at the moment of tension in the abdominal muscles. If a woman laughs, sneezes or coughs, the laundry suddenly becomes wet. There is no need to be afraid of this, in most cases the condition intensifies in the 2nd or 3rd trimester, but after childbirth the body returns to normal. However, to rule out the presence of serious problems, it is worth consulting with your doctor.

Types of urinary incontinence during pregnancy

Most often, 3 types of urinary incontinence in a pregnant woman appear, and in each case there are characteristic signs.

Stress. It manifests itself with the tension of the abdominal muscles and fluctuations of the diaphragm. That is, it is enough to sneeze, cough or laugh so that a couple of drops of urine appear on the linen. The condition is typical for the first trimester.
Urgent. Symptoms are sudden urge to urinate. They arise so unexpectedly that the expectant mother simply does not have enough time to run to the bathroom. One of the causes of the condition lies in the irritation of the urinary canal. You can also blame the failure of the nervous system and overstretching of the muscles in the pelvis. The condition is typical for the last trimester, but also occurs after childbirth.
Full bladder syndrome. The symptom is the inability to completely empty the bladder. A woman often feels an acute urge to urinate, and after leaving the toilet it seems that urine remains in the ureter. The reason may be hidden in the stretched and therefore sluggish walls of the bladder.

Regardless of the cause of urinary incontinence in a pregnant woman, the condition causes discomfort and stress. This is not a reason to panic, in fact, the situation is not so critical - most often, not the entire volume of urine from the bladder is released, but only a small amount. To calm down in such a difficult period, it is enough to consult a doctor and get an appointment if necessary.

Main causes of urinary incontinence in pregnant women

Given that it is not difficult to find an explanation for urinary incontinence in a pregnant woman, it should not cause much concern. It is only necessary to identify the causes and make sure that this is due to physiology, and not diseases of the genitourinary system. The doctor who leads the pregnancy will help dispel fears.

The main cause is weakened muscles in the pelvic area. Excessive stretching of muscle tissue leads to loss of tone. As a result, the sphincter that holds urine, the walls of the bladder, and other muscles are weakened. This is due to hormonal changes, as well as changes in the size of internal organs. For example, the growing uterus during pregnancy compresses the bladder. As a result, its volume decreases, and urination occurs more often.

Another cause of urinary incontinence in a woman during pregnancy is the impact of a baby's foot on the bladder. This phenomenon does not happen to everyone. Doctors explain its severity by the position and size of the fetus, as well as the physical form of the expectant mother.

The number of previous pregnancies and births is also thought to increase the risk of urinary incontinence. Especially if the pregnancies go one after another, and the woman's muscles simply do not have time to recover.

Other factors associated with urinary incontinence during pregnancy are overweight and a sedentary lifestyle. A protracted birth process provokes a problem already in the postpartum period.

Healthy urinary retention occurs when the following conditions are met:

when the bladder is in a normal position;
immobility of the urethra;
good work of the muscles surrounding the bladder and pelvic floor muscles;
with the functional and anatomical integrity of the urethra and bladder closure apparatus.

What to do to deal with the problem

As mentioned above, urinary incontinence in women during pregnancy is most often associated with physiological changes, so no treatment is required. However, given the responsibility for the health of the baby during this period, you need to consult a doctor and, according to his appointment, take a urine test. This is necessary to exclude or identify urinary infections and diseases associated with them.

If the tests do not show deviations, it remains only to calm down and practice hygiene more often. The doctor will give recommendations on hygiene products - their choice and the frequency of changing underwear. But even without a specialist, we can say that the replacement of pads and panties is carried out as needed. Lingerie should fit the size, and it is better to choose a special cut for expectant mothers so that it does not press anywhere. Decorative details on underwear are not welcome, you should give preference to simple panties made of natural fabric.

If there is a problem, you will often have to wash yourself, go to the toilet on time. Doctors advise you to lean forward slightly when urinating. This will allow the urethra to open completely. At the end, you need to push slightly (without fanaticism) to completely empty the bladder.

Reducing the pressure on the diaphragm can help reduce the risk of urine leakage when sneezing and coughing. To do this, you need to open your mouth, normalizing the pressure.

Examination and treatment

Before dealing with incontinence, it is imperative to establish its cause by contacting a doctor. The doctor, in turn, will prescribe the necessary examination. It usually consists of several stages:

Urodynamic examination. With the help of it, the work of the upper and lower urinary tract is evaluated.
Clinical examination. It includes a routine urine test and urine culture for flora, as well as a study in a gynecological chair - during an external examination, the doctor can assess the mobility of the bladder neck during a cough test or straining, assess the condition of the vaginal mucosa and skin, and also identify a possible genital prolapse.
Ultrasound examination. It is carried out to study the functioning of the renal system, the urethrovesical segment, the condition of the urethra in a pregnant woman with stress urinary incontinence, as well as to confirm the presence or absence of pathologies of the genitals.

In addition to tests and examinations, you will most likely be asked to keep a special diary in which for several days you will record several parameters of urination, such as the amount of urine released per urination, the number of urination per day, all cases of urinary incontinence, the number of used during the day pads and physical activity.

Only after the examination, conclusions are drawn about the methods of treatment, which are often necessary only in extreme cases. If no pathology or inflammatory processes are detected, then most likely no special treatment will be carried out, since after childbirth, incontinence most often goes away on its own or occurs less and less.

If incontinence is due to weakening of the pelvic floor muscles, then the situation can be significantly improved with the help of special exercises. Currently, there are a large number of complexes for intimate gymnastics. One of the most popular was developed by the American gynecologist and MD Arnold Kegel. The simplest and, perhaps, the most effective exercise that can be done several times a day is the repeated tension and relaxation of the "intimate muscles" (slow or intense, without delay).

It is important to know that if you have never strengthened intimate muscles before pregnancy, you need to do this with caution, in no case overdo it.

It is possible that the doctor will prescribe you some herbal preparation that supports the functioning of the bladder and has an antispasmodic, anti-inflammatory and antimicrobial effect.

Treatment with decoctions of herbs (rose hips, sage, dill, lingonberries) may also be recommended. They have not only preventive, but also curative properties.

Pelvic (intimate) muscle training

To reduce the risk of urinary incontinence in a pregnant woman at night and during the day, doctors recommend doing special exercises. These are Kegel exercises that are useful not only for expectant mothers, but for all women, without exception, regardless of age. The bottom line is to alternate tension and relaxation of intimate muscles. It is not difficult to determine the zone for training - during urination, you need to interrupt the process for a couple of minutes. At this moment, those muscles that are involved in gymnastics will just tighten. You need to do exercises before childbirth, during pregnancy and after the baby is born. A simple and understandable set of exercises will reduce the risk of any problems with the urinary system. You can read more about gymnastics in another article.

How to ensure your comfort and peace of mind

So that urinary incontinence in pregnant women in the early, and especially in the later stages (38-39 weeks), does not cause increased discomfort, manufacturers of hygiene products produce special pads. One of the options is German MoliMed urological pads. They are specifically designed to provide comfort during involuntary urination. Features of these pads:

anatomically shaped to prevent urine from leaking out;
absorbent layer that instantly absorbs liquids and odors;
secure fit on underwear;
small thickness so that the pad is not visible under clothing;
safe even for sensitive skin;
the ability to choose a product based on the amount of discharge.

If you need help choosing the right hygiene products, the PAUL HARTMANN Sp. z o.o. hotline will advise you.

How else can you help yourself

Go to the toilet as often as possible during the day. At the same time, you should not reduce your fluid intake. The expectant mother should drink as much as she wants. But you need to try not to drink large amounts of liquid an hour before bedtime.

Many women use disposable pads to avoid trouble. This should be done only when absolutely necessary, since the frequent use of sanitary pads can provoke colpitis, which, in turn, can lead to infection of the membranes, and as a result, a miscarriage or premature birth due to rupture of the membranes.

You can somewhat alleviate the condition with the help of a prenatal bandage. Its regular correct wearing allows you to somewhat ease the load on the bladder, respectively, reduce the number of urges to urinate.

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Men rarely experience urinary incontinence at a young age. If this happens, the cause is inflammation of the prostate gland or congenital anomalies of the reflexes responsible for emptying the bladder. Over the years, the percentage of men suffering from incontinence is increasing. This most often does not threaten life, but can significantly affect its quality.

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Prevention and rehabilitation schools

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New standards of care for sedentary patients

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10 factors in the development of pressure ulcers

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Clinical and economic analysis of the effectiveness of using MoliCare® Premium extra soft diapers for the prevention of dermatitis and pressure ulcers Learn more

General articles

Stroke care

Only 20% of stroke survivors return to work, and one third of all stroke survivors are of working age. Relatives of stroke patients often have a low level of knowledge about the care of seriously ill patients, so it is advisable to train them by medical professionals in special health schools.

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