Pregnancy, Childbirth & Bladder Control

Do pregnancy and childbirth affect bladder control?

Yes. But don't panic. If you lose bladder control after childbirth, the problem often goes away by itself. Your muscles may just need time to recover.

When do you need medical help?

If you still have a problem after 6 weeks, talk to your doctor. Without treatment, lost bladder control can become a long-term problem. Accidental leaking can also signal that something else is wrong in your body.

Bladder control problems do not always show up right after childbirth. Some women do not begin to have problems until later, often in their 40's.

You and your health care team must first find out why you have lost bladder control. Then you can discuss treatment.

After treatment, most women regain or improve their bladder control. Regaining control helps you enjoy a healthier and happier life.

Can you prevent bladder problems?

Yes. Women who exercise certain pelvic muscles have fewer bladder problems later on. These muscles are called pelvic floor muscles. If you plan to have a baby, talk to your doctor. Ask if you should do pelvic floor exercises. Exercises after childbirth also help prevent bladder problems in middle age.

Ask your health care team how to do pelvic exercises.

How does bladder control work?

Your bladder is a muscle shaped like a balloon. While the bladder stores urine, the bladder muscle relaxes. When you go to the bathroom, the bladder muscle tightens to squeeze urine out of the bladder.

More muscles help with bladder control. Two sphincter (SFINK-tur) muscles surround the tube that carries urine from your bladder down to an opening in front of the vagina. The tube is called the urethra (yoo-REE-thrah). Urine leaves your body through this tube. The sphincters keep the urethra closed by squeezing like rubber bands.

Pelvic floor muscles under the bladder also help keep the urethra closed.

When the bladder is full, nerves in your bladder signal the brain. That's when you get the urge to go to the bathroom. Once you reach the toilet, your brain sends a message down to the sphincter and pelvic floor muscles. The brain tells them to relax. The brain signal also tells the bladder muscles to tighten up. That squeezes urine out of the bladder.

Strong sphincter (bladder control) muscles prevent urine leakage in pregnancy and after childbirth. You can exercise these muscles to make them strong. Talk to your doctor about learning how to do pelvic floor exercises.

What do pregnancy and childbirth have to do with bladder control?

The added weight and pressure of pregnancy can weaken pelvic floor muscles. Other aspects of pregnancy and childbirth can also cause problems:

• changed position of bladder and urethra
• vaginal delivery
• episiotomy (the cut in the muscle that makes it easier for the baby to come out)
• Damage to bladder control nerves.

Which professionals can help you with bladder control?

Professionals who can help you with bladder control include

• your primary care doctor
• a gynecologist (guy-nuh-CALL-uh-jist): a women's doctor
• a urogynecologist (YOOR-oh-guy-nuh-CALL-uh-jist): an expert in women's bladder problems
• a urologist (yoor-ALL-uh-jist): an expert in bladder problems
• a nurse or nurse practitioner
• a physical therapist.

Points to Remember