Bladder Leakage Post-Pregnancy

(By Amy Tinetti, Women’s Health Physiotherapist)

So, you have just had a baby and may have noticed that you are having some bladder leaking and/or bowel problems. Firstly just know – you are not alone!

Did you know that more than one-third of women develop temporary bladder leakage during their first pregnancy?

This number increases again to more than three-quarters of women during subsequent pregnancies! Here is a list of some common issues post-delivery:

1. Stress Urinary Incontinence (bladder leakage): this is the leaking of urine during activities that increase the pressure inside your abdomen and push down on your bladder. Activities such as coughing, sneezing, laughing, walking and lifting.
2. Urinary Urgency: Increased urgency of needing to empty your bladder
3. Urge Urinary Incontinence: Leaking urine when feeling an urgent need to empty your bladder
4. Increased bladder or bowel frequency: Going to the toilet multiple times a day for bladder or bowel
5. Fecal or Flatus Incontinence (bowel or wind leakage): accidental leakage from the bowel
6. Haemorrhoids: Lumps that can occur inside or around the anus/back passage, they are swollen and enlarged blood vessels, they can be painful when emptying your bowels
7. Constipation

How do post-partum problems occur?

There are many factors that can contribute to urinary and bowel problems. These factors can include:

• Hormonal and mechanical pressures during pregnancy placing pressure on the pelvic floor, fascia, ligaments, nerves, bladder, and urethra
• Pelvic floor muscle dysfunction (this could be caused by weak pelvic floors, stretching/trauma of the pelvic floor during labour or nerve compression during delivery)
• Having a large baby
• Difficult vaginal delivery that can cause tearing or requiring the use of forceps
• Length of the pushing stage of labour
• Breastfeeding can cause mothers to become dehydrated causing issues with constipation and irritating haemorrhoids

What are the signs of bladder or bowel problems?

• Leakage of urine, poo or wind
• Increased urgency +/- leakage getting to the toilet for bladder or bowel
• Difficulty controlling bowel motions
• Inability to empty bladder completely
• Emptying your bladder or bowel multiple times a day (Note; people ask what normal is, this will depend on how much fluid you drink and your diet. If you have noticed your bladder or bowel frequency postpartum is different to pre-pregnancy then get it assessed)
• Signs of constipation include: feeling of incomplete emptying, hard stools, painful bowel emptying, straining, requiring assistance to empty and fewer than 3 defaecations a week.

How can a Women’s Health Physio help?

A Women’s Health Physiotherapist will go through a thorough subjective and objective assessment (current and past history) including discussing your past and present deliveries and your bladder/bowel problems.

At Wisdom Physiotherapy, will use real-time ultrasound to see your pelvic floor lift and check your technique. If required an internal examination can also be completed.

Your Physiotherapist will discuss strategies specific to your diagnosis, educate you on what specific pelvic floor exercises you may require and incorporate these into your current exercise and daily activities.

If you have any questions in regards to the above issues or would like to make an appointment, please call us on (08) 6389 2947 or book online for a Women’s Health Assessment.