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Pregnancy Incontinence: Causes, Management Tips, and More
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?
How can I know if I’m leaking urine or amniotic fluid?
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
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.
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:
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.
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
How we vetted 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
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.
Feb 22, 2017
Medically Reviewed By
Michael Weber, MD
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Medically reviewed by Michael Weber, M.D. — By Ashley Marcin on February 22, 2017
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7 Common Signs You're Pregnant That'll Make You Consider Peeing On A Stick
by Michelle Horton
I will never forget laying on my couch, laptop in hand, googling “pregnancy signs” and wondering if my strange symptoms might mean I was actually with child. I didn’t have morning sickness or any of the traditional signs you're pregnant. I just thought I was getting the flu, or maybe my non-stop work schedule was finally getting the best of me because damn I was exhausted. Was this “can’t get off the couch” feeling a sign of pregnancy? I wasn’t sure, and I definitely didn’t want to invest in a pregnancy test just yet.
It turns out I was pregnant, a fact that turned my world around and totally blew my mind. I always assumed I’d know at the moment of conception — I was just so tuned into my body. Turns out I was walking around with a growing fetus for months, with absolutely no indication of what was happening inside my body. And I’m not alone in this uncertainty.
Some women experience the classic pregnancy signs immediately. For others, it takes weeks for the morning sickness and crazy cravings to kick in (if they ever do.) Heck, some women don’t realize they’re pregnant until a doctor delivers the news during the second trimester. But if you’re wondering if you fatigue and and new-found sense of smell could actually indicate a baby on the way, here are seven common pregnancy symptoms to be on the lookout for.
Not only was this my one and only glaring pregnancy sign, but it’s one of the most common symptoms. I reached out to over 300 moms and asked for their tell-tale signs of pregnancy, and the vast majority said something along the lines of, “Oh my God, I was so tired.” Who knew?
It makes sense, though. During the first trimester, What To Expect notes that your body is building a life-support system, including manufacturing the placenta, which can take a lot of energy. Mayo Clinic adds that you’re also experiencing a shift in metabolism and moods, as well as a mega spike in progesterone — all of which can bring on flu-like fatigue. Your extreme sleepiness could also be a symptom of iron-deficiency anemia, which is pretty common in pregnancy. Don’t worry, most women get their groove back in the second trimester.
A Queasy Stomach
Most women know that if you’re inexplicably vomiting every day (which may or may not happen in the morning, by the way), odds are you might be pregnant. According to Healthline, pregnancy nausea can start around week four, but typically hits full force by week six. Morning sickness typically subsides after week 12, but some unlucky ladies experience periodic bouts of vomiting through all three trimesters. And for the very unlucky, extreme sickness could mean you have hyperemesis gravidarum. I experienced one or two weeks of nausea, and I know plenty of friends who sailed right through pregnancy without any sickness. May the odds be ever in your favor.
Strong Sense Of Smell
A change in smells — whether it’s a craving, aversion, or overall heightened ability — is a pretty common (and unexpected) symptom of early pregnancy. Just like so many other pregnancy symptoms, you can probably thank your changing hormones, specifically estrogen, for your bionic smelling skills — although the data on why it happens is generally inconclusive. Study after study, including a 2004 study in Chemical Senses, find undeniable anecdotal evidence to support smell sensitivity in pregnancy, and yet there’s no solid scientific research to back it up.
I always had breast tenderness leading up to my period, so I didn’t think much of my sore pregnancy boobs. “Period must be coming,” I thought. Turns out that’s a very common sign of pregnancy, too. But why? According to Babble, breast tenderness happens because your levels of estrogen and progesterone shoot through the roof, causing our mammary tissues to respond and our breast glands to enlarge.
Major Bitch Mode
It might not be PMS, ladies. According to Mayo Clinic, “the flood of hormones in your body in early pregnancy can make you unusually emotional and weepy. Mood swings also are common.”
You might not think abdominal cramping and light bleeding are actually signs of pregnancy, but that “extra light period” might be the opposite of Aunt Flow’s annual visit. It’s known as implantation bleeding, and it happens when your fertilized egg attaches to your uterus lining, typically 10 to 14 days after conception, according to Mayo Clinic. You might also experience some digestion issues like bloating and constipation during early pregnancy (thanks to progesterone.) You may write this symptom of as a sign of your impending period, but there’s a chance that it won’t come for another nine months.
The fainting pregnant woman might be a cheesy caricature, but there’s some truth in it. As Mayo Clinic explains, because your blood vessels dilate and your blood pressure drops in early pregnancy, it can leave you feeling woozy and unstable. (Word of the wise: Don’t stand up too fast.)
Your pregnancy hormones could cause a slew of other issues — I spoke with moms who reported migraines, heartburn, and constantly needing to pee as go-to pregnancy symptoms, while others said they had zero signs besides waiting around for a period that never showed. So are you pregnant? It’s hard to tell. There’s no cookie-cutter answer for everyone, as much as you wish there was. The only thing to do is head to the drugstore, pee on a stick, and hope for the best.
Frequent urination during pregnancy - Juno
When is considered frequent
Urges are frequent if they occur more than 9 times a day. Usually only a small amount of urine is passed at a time. Pregnant women may have about 20 visits to the toilet per day, while the daily amount of urine can also increase to 2 liters.
Is it an early sign of pregnancy?
HCG slightly increases the volume of urine excreted, so frequent urination begins already in the first weeks of pregnancy. The symptom does not 100% indicate the onset of fertilization - it should be considered in conjunction with other manifestations - primarily with a positive test.
However, keep in mind that with an increase in the daily volume of urine at a very early date, a false negative result is possible. Also, the symptom is less pronounced in ectopic pregnancy due to lower hCG levels, so an examination is required in any case.
If you began to frequent the toilet and there is a delay, then pregnancy is very likely.
Physiological causes of frequent urination in pregnant women
In healthy women, this phenomenon is associated with the body getting used to carrying a baby, as well as with other physiological reasons.
In the first half of pregnancy
The main causes of frequent urination during early pregnancy:
Increased progesterone production. This hormone relaxes muscle tissue, helping to maintain pregnancy. As a result, urine is retained worse, the urge to void becomes more frequent due to the reduced tone of the bladder.
Increased blood supply in the pelvis. Due to the proximity of the bladder to the uterus, its increased sensitivity occurs - filling receptors react more strongly.
Active work of the kidneys. During the bearing of a child, the renal blood flow increases 1.5 times for the constant renewal of amniotic fluid and the timely removal of metabolic products. Accordingly, more urine begins to be produced.
Physiological increase in urination does not cause pain and discomfort, itching and burning. In the presence of negative symptoms, you need to consult a doctor to rule out pathologies.
Second half of pregnancy
The main reason for frequent urge to urinate in the second and third trimester is the increased pressure of the uterus on the bladder. However, diseases can also be the cause:
Infections. Changes in the pelvis in pregnant women and a decrease in protective forces increase the risk of developing urethritis, cystitis, pyelonephritis. Such pathologies are accompanied not only by frequent urination, but also by pain, discomfort in the area of inflammation, and a burning sensation. The woman's health is deteriorating;
Gestational diabetes. An increase in blood glucose in violation of carbohydrate metabolism. The amount of urine separated increases significantly.
Other pathologies include neoplasms in the small pelvis, endocrine and neurological disorders.
Soreness with frequent urination in pregnant women - is it normal or not?
Painful urination is not normal. Unpleasant sensations indicate the development of a pathological process. Pain and discomfort are a sign of urinary tract irritation. Cystitis is very likely if a woman has severely reduced immunity or has chronic diseases of the pelvic organs. Sometimes it can be accompanied by a temperature and requires a mandatory visit to the doctor.
Calls at night
Pregnant women often complain about how tired they are at night "hiking". The situation is explained by the fact that the work of the kidneys depends on the position of the body. In the later stages, the female body is prone to fluid retention and edema, especially when in an upright position. When the expectant mother lies down, the renal blood flow and the outflow of fluid from the tissues increase. As a result, the kidneys excrete more urine.
What is the duration of frequent urination during pregnancy?
The phenomenon begins already from the first days of pregnancy and is especially pronounced up to about 12 weeks. Later, the number of emptyings gradually decreases, because by 4-5 months the body adapts to new conditions. The diaphragm rises, creating more space for the growing uterus and "unloading" the pelvic organs.
Frequent urination during pregnancy in the second trimester may indicate the addition of an infection or the development of inflammation, but it is also possible as a manifestation of the individual characteristics of the organism.
In the third trimester, the opposite phenomenon is possible - fluid retention. However, the closer the birth, the more often the urge to urinate becomes. In the last month of gestation, the uterus descends and puts pressure on the organs of the urinary system.
How likely is miscarriage in the absence of frequent urination?
A woman does not always immediately find out about a missed pregnancy. Fetal movements are not felt in the early stages, so pregnant women "listen" to other signs. In the first weeks, the abrupt cessation of toxicosis and frequent urge to urinate are alarming. These symptoms can indeed indicate the death or developmental delay of the fetus, as well as an ectopic pregnancy, but not always. Toward the end of the first trimester, the kidneys excrete less urine, in some this has been observed since 9‒10 weeks.
How to deal with frequent urination during pregnancy: tips
In the absence of pathologies, the discomfort caused by physiological frequent urination can be reduced as follows:
Stay hydrated. Drink enough, but don't overdo it. Give preference to water over sugary drinks like coffee.
Eat rationally. Eliminate diuretic foods (citrus fruits, spicy foods), as well as things that cause constipation.
Exercise. Strengthen your pelvic muscles by training your vaginal and anus sphincters.
Get more rest. Sleep during the day is very useful, especially in the later stages - after being in a horizontal position, the bladder empties faster, as a result, the load on the kidneys during night rest is reduced.
Maintain immunity. Avoid hypothermia, take vitamin complexes as prescribed by the doctor.
Empty your bladder as much as possible. Do not hold back the urge and try to make sure that all the urine comes out completely. In this regard, it is easier to urinate in the shower.
Control your condition. If other symptoms (pain, fever, burning sensation) appear in addition to frequent urination, tell your doctor immediately.
First signs of pregnancy before delay, early symptoms
Significant hormonal changes occur during pregnancy. This causes a number of symptoms. Some women experience pregnancy symptoms right away, while others may only have a few. About the first signs of pregnancy at an early stage and when exactly the initial signs of pregnancy appear are described in the article.
At what time do the first signs of pregnancy appear
The answer to the question of when the first signs of pregnancy appear is rather ambiguous, because some women do not feel any signs at all during the first few weeks. At what week do the first signs of pregnancy appear in others? When do the first signs of pregnancy appear after conception? Symptoms of very early pregnancy (such as breast tenderness) may appear before a missed period, as early as six to seven days after conception, while other early signs of pregnancy (such as spotting) may appear about a week after ovulation. We will tell you more about the first signs of pregnancy before menstruation and when the signs of pregnancy appear.
What are the earliest signs of pregnancy?
The first signs of pregnancy in the early stages:
delayed menstruation - 29%;
nausea - 25%;
mood swings - from 14 to 23%;
breast changes - 17%;
pain in the lower abdomen - 15%;
depression - 15%;
fatigue, drowsiness - 13%
decrease in immunity - 6%;
the first signs of pregnancy - discharge or implantation bleeding - only 3%.
Physiological first signs of pregnancy
What are the very first symptoms of pregnancy?
The most common physiological signs of pregnancy include:
Tender and enlarged breasts. Signs of pregnancy in the first days after conception include breast changes (1-2 weeks after conception). The area around the nipples, called the areola, may also darken.
Drowsiness and fatigue. Fatigue is also among the signs of pregnancy in the first days after conception. During early pregnancy, levels of the hormone progesterone rise dramatically, which can cause drowsiness.
Nausea with vomiting. When do these signs of pregnancy appear? Morning sickness, which can appear at any time of the day or night, often appears between the second and eighth weeks after conception.
Dizziness and fainting . This may be due to dilation of blood vessels, lowering blood pressure and blood sugar levels.
Spasms. Some women experience symptoms of pregnancy in the early days, such as mild uterine cramps.
Headaches and back pains. Many pregnant women complain of frequent headaches, while others experience back pain.
Insomnia - another first sign of pregnancy before the test. Causes can include stress, physical discomfort, and hormonal changes.
Change in taste preferences. Like most other symptoms of pregnancy, these eating habits can be attributed to hormonal changes.
Temperature. Early signs of pregnancy include fever (37-37.5).
Delayed menstruation. How long does it take for the first signs of pregnancy to appear? If you are of childbearing age and a week or more has passed without your expected period, you may be pregnant. However, this symptom can be misleading if you have an irregular menstrual cycle.
Bloody discharge - the first signs of pregnancy . This bleeding, known as implantation bleeding, occurs when a fertilized egg attaches to the lining of the uterus, approximately 10 to 14 days after conception.
Bloating, heartburn. Hormonal changes can cause stomach and esophageal problems - these are common signs of pregnancy at 2 weeks.
Constipation . Hormonal changes cause the digestive system to slow down, which can lead to constipation (signs of pregnancy after a delay).
Frequent urination. You may urinate more than usual, which is a common sign of pregnancy at 5 weeks. During pregnancy, the amount of blood in the body increases, causing the kidneys to process excess fluid that enters the bladder.
Runny nose. The appearance of this symptom is associated with excessive production of the hormone estrogen.
Exacerbation of chronic diseases. This is a sign of pregnancy after ovulation.
Increased salivation. Also associated with hormonal changes.
Sense of smell enhancement . Signs of pregnancy in the first two weeks may cause sensitivity to certain smells and the sense of taste may change.
Emotional first signs of pregnancy
The first signs of pregnancy before delay (earliest signs of pregnancy) include psycho-emotional symptoms.
These are all emotional signs of early pregnancy that many women report. They describe feelings of heightened emotion or even bouts of crying, which are associated with rapid changes in hormone levels in the body. Also, signs of pregnancy at week 4 can make you feel PMS-style cranky. In addition, about 15% of women suffer from depression or anxiety during pregnancy. And after childbirth, these conditions suffer even more. In this case, it is better to seek help from a doctor.
Do everything you can to improve your mood: get plenty of rest, eat well, get enough sleep, do things you love, and pamper yourself.
However, be aware that mood swings can be caused by a number of conditions other than pregnancy.
Influence of early pregnancy on daily routine
Early signs of pregnancy, mainly those that bring discomfort, can cause a change in daily routine. Here are some tips on what you can do with some of them:
In case of toxicosis, avoid too hot or too cold food - this provokes an attack of vomiting. Eat often - at least 5-6 times a day, but in small portions.
For nausea or vomiting, try ginger, chamomile, or vitamin B6.
Drink plenty of water, in small sips between meals, to replenish lost fluids. Teas, juices, fruit drinks are also suitable.
For back pain, wear shoes or shoe insoles designed for pregnant women and avoid high heels. Sleep on a firm mattress.
For chest discomfort, wear a special bra that supports enlarged breasts.
For constipation, eat more fiber-rich foods such as wheat bran and fresh vegetables and fruits.
If you suffer from headaches and mood swings, try stress reduction techniques such as yoga or meditation.
Be outdoors more often, at least half an hour a day. This helps to reduce the symptoms of toxicosis, calm the nervous system.
Maintain your daily physical activity for as long as it is convenient for you to perform certain activities.
Eat a balanced diet with enough proteins, fats and carbohydrates.
Important! All these tips are advisory in nature, be sure to consult your doctor if you encounter discomfort.
What to do if you find early signs of pregnancy
To make sure the signs of pregnancy are accurate, you can use the following methods to diagnose early pregnancy:
Donate blood for hCG. This method can be used a few days after conception. This type of pregnancy test is done using a small sample of blood that is analyzed in a hospital. It determines whether there is a pregnancy hormone in your body and in what quantity. Its accuracy is 99%.
Use a test strip. It can be used at home from the first days of delay. To determine pregnancy, dip the reagent area of the test strip into the urine. Accuracy: 99%. You can buy Evitest or HomeTest test strips in our pharmacy.
Use jet or electronic test. They can be used at home a few days before your expected period. You need to remove its protective cap, substitute the test under the stream of urine for 10 seconds, and after 3-5 minutes get the result. Accuracy: 97%. In our pharmacy you can buy Evitest or Alpe inkjet tests.
Get your first ultrasound. You can use this method at 3-4 weeks from the start of a missed period.