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Bladder Bounce Back

By Amalah

bounceback_bladder.jpgNobody tells you about peeing, postpartum. The leaking. The “bladder control issues.” The straight-up, unsexy, embarrassing incontinence.

It’s in all the PREGNANCY books — first it’s the hormones ratcheting up the urgency, then it’s an expanding uterus pressing on your bladder, and finally it’s a full-term baby’s head and judo chops. All things that would lead you to believe that everything goes back to normal after you have the baby.

I had some problems, particularly during my first pregnancy. Chronic urinary tract infections, an already-jumpy bladder, a job that often interfered with regular bathroom breaks, and a very large baby. Laughing or sneezing soon became an exercise in terror. But I was prepared for that. I crossed my legs and did my Kegels. The symptoms vanished after the birth, just like I assumed they would.

My second pregnancy was a breeze in that regard, and with a scheduled c-section on the calendar I never really gave much thought to the state of my pelvic floor. I’d be fine, just like the first time.

HA. HAAAAAA. Lordy, I’m doing Kegels right now.

Pregnancy and Your Bladder

So there are varying degrees of awfulness here: there’s the occasional leaking when you sneeze or laugh, which is annoying but generally tolerable. Then there’s the crazy urgency, making every time you have to pee a race to the bathroom and oh God your belt your zipper your pants hurry. And for some women we’re talking honest-to-God zero-control adult-diaper-level incontinence.

If you had problems during your pregnancy, you are MUCH more likely to suffer after the birth as well. Same goes if you’re overweight or a smoker. Vaginal births (and forceps, and bigger babies) also up your chances, though a c-section is no guarantee, particularly if you labored and pushed for awhile before getting the surgery. And then there’s me, who had more problems after a labor-free scheduled c-section. Sometimes it’s just the stress of pregnancy itself, and nothing to do with the birth.

So what should you do, if it happens to you? First, relax. It’s normal. It’s not permanent. It will get better. It might take awhile, but it will get better. Even if you’re dealing with the worst-case scenario, where you can’t stand up and walk across the room without peeing yourself, it doesn’t mean it’s an obstetric fistula and surgery or a life doomed to Depends.

The problem will USUALLY be at its worst during the first two weeks postpartum, while your uterus is still contracting back to its normal size and position off your bladder. Everything I’ve read about postpartum incontinence (that I had to SEEK OUT SPECIFICALLY, because it sure as hell wasn’t in any of those new baby books), mentions a range of “three to six months” before you regain “complete” control. (To which I snort dismissively at, because while I didn’t have any super severe problems, I’m a full year postpartum and still wouldn’t consider my bladder to be in its original factory-new condition.)

Things That May Help

1. Kegels. Yeah. Those things. I vaguely remember having trouble doing Kegels right away — too much pain, feeling generally kind of obliterated DOWN THERE — so do your best and start small, just like ramping up any kind of exercise routine. (Teh Innernet says 30 a day is ideal. If you can do five at first, I declare you Pelvic Floor Champion.)

2. A schedule. Empty your bladder every 30 minutes, rain or shine, urge or no urge. Once you’re a couple of weeks out from the delivery, gradually increase the time between bathroom trips each day. (This is pretty much how I potty-trained my 2.5 year old, by the way. The more you know!)

3. Pads. Big ones. Look, you’re wearing those ginormous pads anyway, at first. Ask for extras from the hospital.

4. Colace. Again, something you’ll be taking post-birth anyway, but constipation puts even more pressure on your bladder.

5. Clenching. As in, crossing your legs and flexing your pelvic and thigh muscles, pre-sneeze or laugh. It’s stupid but it works.

Things That Do NOT Help

1. Alcohol, caffeine, soda, citrus, acidic foods. Avoid these for now.

2. Urinary tract infections. If you think you have one (i.e., there’s burning in addition to the urgency), get it treated ASAP. Drink cranberry juice or take those cranberry tablets.

3. Dehydration. Don’t do the “I’ll drink less/pee less” thing. Not only is dehydration just a terrible postpartum idea in general, you’re actually just upping your chances of a UTI.

And finally, yes, there is a surgical procedure to correct stress incontinence. If months go by and you are still having problems despite daily Kegels, and you test negative for UTIs, then talk to your doctor or midwife. Don’t let them tell you it’s “normal” if you believe you’re struggling with something that’s out of the realm of “normal.” You can also contact a physical therapist, as incontinence is actually something that many of them can treat. (Think post-injury or illness — it’s so very common.)

Ah, the indignities of motherhood. You have to laugh about this stuff…just make sure you cross your legs first.

Photo credit: Flickr/helgasms!

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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anon
Guest
anon

Going anonymous here, I’m in week 5 postpartum and thought, “Hey! My bladder is doing great, no problems so far, no worries!”
…. until I sat down to nurse yesterday and mysteriously and unexpectedly just… peed myself. Boo. Back to doing Kegels.

Della
Guest
Della

Don’t remember with kid #1, but with kid #2, I had almost complete incontinence for the duration of my hospital stay, and my muscles were so sore and essentially paralyzed by the stress that I literally was unable to clench the muscles that you use for a kegel (the ones you use to stop the flow of urine). However, (a) thankfully, I had those HUGE hospital pads in anyway due to lochia/postpartum bleeding, and (b) it pretty much resolved within those three days. I may have had a little leaking during stressful situations (ie had to pee anyway and laughed,… Read more »

Olivia
Guest
Olivia

Weirdly, my bladder seems stronger 6 months after having a c-section than ever before in my life. I’ve always had to take very frequent bathroom breaks, and by the end of pregnancy I was practically living in there. Now I feel “normal” compared to my friends.

Joy
Guest
Joy

I’m five months postpartum and peed myself sneezing yesterday. That was… unexpected. Made the mistake of telling my husband, who then laughed so hard he almost peed himself. It would have been so poetic if only he had.

Caitlin
Guest
Caitlin

wow – there’s a whole lot of non-commenting going on here! clearly a subject that no one wants to fess up to!

melissa
Guest
melissa

So, uh, I am 20 weeks pregnant. Every single time I puke (yes, still doing that), I pee as if i just chugged a gallon of water. Even if I just peed. (I have felt my mouth water ominously, peed in a hurry and then thrown up and it still doesn’t help.) This never, ever happened to me before I was pregnant. Is it being pregnant? Will, uh, exercise help?

geek anachronism
Guest
geek anachronism

I thought I was doing great until my gall bladder REALLY started having issues – I’d vomit so forcefully I’d pee everywhere. That happened on occasion while I was pregnant, but only if I needed to pee as well. Now, I can be empty and STILL pee myself if I throw up. Sneezing, coughing, laughing? No problem. I still remember the nurse and my mother abandoning me while I was in the middle of changing the baby the day after the birth. After ten minutes standing there wondering when they’d come back with clean nappies and desperately needing to pee,… Read more »

Elizabeth
Guest
Elizabeth

Oh my gosh, I’m so glad that you wrote this. I pushed a 9 pounder out about 9 months ago…and things still aren’t back to normal. It’s not bad, just, well, not normal. I thought I had read somewhere that giving birth can mess up things for awhile, but it’s really good to see that confirmed.

Kimberly
Guest

So is this the appropriate place to talk about the, ahem, other type of incontinence? Or is that just a special hell reserved for those of us with third and fourth degree tears?
NOBODY TOLD ME ABOUT THAT.

Kirsten
Guest

Umm. I am am 3 years and 1 month postpartum, and I still have to cross my legs when I sneeze. It also happens when I cough or laugh occasionally. I try to laugh it off, but that might make me pee more!

France
Guest
France

I’m not sure whether this exists in the US, but in France (and many other European countries), there is a special type of physiotherapy (called “rededucation perineale”, you figure it out) which many women go through post-partum, specifically to deal with this issue (also, not to rub it in, but the first ten sessions are reimbursed by the national healthcare system).
Perhaps this is something to look into, at least if problems persist?

Cindy
Guest
Cindy

Incontinence STINKS!!! With my first, I had vag. birth – the first night, I woke up at 3 am with the slight feeling of having to pee. I stood up and BAM – completely full bladder pouring right onto the floor. If I had my own room, it would have been ok, but the hospital was packed and I was sharing with 5 other women – one of which decided that 3 am was the perfect time to shower and brush her teeth. As I stood there peeing myself, crying, humiliated, she was very sympathetic and brought me towels, but… Read more »

sp
Guest
sp

did it went aways with kegal exercise?I am also having same issue.I am 6 weeks of postpartum.let me know what you did to fix the issue.

Beth
Guest
Beth

Long time lurker, but I had to jump in on this post to add to France. Indeed, there are physical therapists who specialize in pelvic floor physical therapy, which your insurance will cover if your OB/GYN or urologist will write you a prescription for it. (It’s counted just like ‘normal’ PT, like rehabbing a shoulder or knee injury.)
I don’t have kids, but do have 2 linked conditions (interstitial cystitis / pelvic floor dysfunction) and PT for this has really helped. My PT sees a lot of women who need to rehab their pelvic floor after birth or pregnancy.

Lori
Guest
Lori

Ok I’ll fess up. Am 9 years(!!!!!) post and still pee myself on a regular basis. Nice. Welcome to old age

anon.
Guest
anon.

Also going anonymous….My 9.5 lb daughter was born 41 hours after my water broke, and although I had no tearing (miracle!), when I got out of bed after sleeping a couple hours….whoosh! As Joy said, that was unexpected, although at the time I had no idea that I had peed myself because WTF?!…I couldn’t have possibly peed myself, right? I figred out pretty quickly that I had little bladder control if it got to full so peeing regularly whether I felt the urge to or not was part of my routine. I was also surprised ~4 weeks postpartum that I… Read more »

G
Guest
G

Thank you for posting about this! Why didn’t ANYONE tell me about this when I was pregnant? That was the largest surprise after having my 9lb daughter six months ago. I seriously thought something was wrong with me because I just couldn’t control it- and I had no problems with control the day before giving birth(when I was at 40+ weeks)! The doctor kind of just shrugged and said “It’ll go away eventually.” Um..Thanx?
It does/has gotten much better- but I’m still reminding myself to do Kegels.

Suzanne
Guest

I’m 6 months postpartum and finally stopped peeing a little every time I sneeze. I’ve never been very good at Kegals (is that the muscle? wait, am I doing it? did I stop yet?) but I do practice stopping and starting the flow when I pee. It really strengthened the muscles. Once I could stop it completely the, uh, leakage issues went away. I bet some doctor is going to get on here and tell me I’m causing bladder cancer/liver disease/brain tumors by doing that, but at least I don’t have to check my seat for a wet spot every… Read more »

Laura
Guest
Laura

KIMBERLY: So is this the appropriate place to talk about the, ahem, other type of incontinence? Or is that just a special hell reserved for those of us with third and fourth degree tears?
NOBODY TOLD ME ABOUT THAT.
No joke sister. The peeing thing was only an issue for about the first 6-8 months when I worked out but the other type still plagues me 2.25 years later. OMG it is a nightmare.

Trisha
Guest
Trisha

My mom has had both types of incontinence, and she only had me. It SUCKS. I am 31 weeks and talked to my OB about it today. She says it’s less related to baby’s or your size, and more about your skin itself. There’s no way to tell for sure until after giving birth. She also said that surgery can help but should only be performed after you’re dine with childbearing. I will look into it more and post whatever I find out.

Jessica
Guest

It’s so great to see women discussing this! Bladder weakness is more common in women than migraines and hay fever, but it is a taboo topic nonetheless. I work with a brand called TENA (www.tena.us), the worldwide leader in the management of bladder protection, and along with Harris Interactive we recently conducted “Bladder Talk,” a survey of 780 women over age 35 in North America and found that half of the women (51 percent) surveyed feel that bladder weakness has a strong impact on their daily life but forty three percent have never done anything about their symptoms! Some interesting… Read more »

Anonymous
Guest
Anonymous

OMG, reading this post and comments is the only thing that makes me want to go outside tomorrow! I had my son ALMOST A YEAR AGO, and haven’t had a ton of regular leaking issues. Of course until today, when I FREAKIN’ PEED MYSELF walking down the street pushing the stroller! WTF, I didn’t really even have to pee that badly, and suddenly here I am 5 minutes from my house, crouching. So I do what any normal mom would do, push the stroller between the street and moi and pretend to tie my shoe, then mess with the little… Read more »

Daisy
Guest
Daisy

Gyahhh. I can’t even… My heart goes out to you guys. I’ve been doing kegels, no lie, since I was a preteen. I saw a show on TV about it and ever since, every day pretty much. I was so diligent during pregnancy and after. I had NO problems during my pregnancy, even with a giant, head down baby who constantly pressed my bladder. I had a crazy birth where his head was stuck on my hip, and I had to push 3 hours, wasn’t allowed to be upright so I ended up sorta half up half lying… anyway, lots… Read more »

Isabel Kallman
Admin

you should see a doctor and there is improvement after you stop breastfeeding. In the meantime, you may want to look into Dear Kate Underwear. They are seriously awesome and hold over a tablespoon of liquid without leaking and stylish to boot: https://alphamom.com/pregnancy/leak-free-stylish-undies-by-dear-kate/

Latisha
Guest
Latisha

ok well my daughter is 3 years old and i had a vaginal birth she was 6 pounds and 9 ounces but i still pee myself when she is running from me and im trying to chase her i pee myself even if i dont have to pee and sometimes when i have to pee if i dont get to the bathroom fast and sit down fast enough i pee my pants its frustrating i do kegals every single day and i also did them like crazy during my pregnancy and i did pee alot when i was pregnet mostly… Read more »

Mimo
Guest
Mimo

The one very important suggestion left out of the “Things You Can Do” section is that there are physical therapists who specialize in pelvic floor rehabilitation. Someone like that can work on muscles using a variety of techniques, including biofeedback, and while it may eventually get better on its own, why wait and suffer when you can get help strengthening and retraining your muscles?!