How long does postpartum incontinence last?
If you're newly postpartum, you're not alone in wondering how long your postpartum incontinence will last. It's one of those symptoms that is often brushed off and said to be the price of admission for the "mom's club".
But here's the thing... Postpartum incontinence is not something you need to live with. Many of our patients come to pelvic therapy specifically for postpartum incontinence and are super successful when it comes to symptom resolution.
The time it takes to improve postpartum incontinence can differ for each person. However, most patients notice improvements quickly and will often find full relief after 6 to 8 sessions.
Let's talk about what's going on, why it may be happening, and what to do about it.
What is postpartum incontinence?
Postpartum incontinence refers to the leaking of urine that many women have after they've had a baby, whether it was vaginal delivery or a cesarean section.
Urine leakage happens most often while a new mom is sneezing, coughing, laughing, walking, running, lifting her baby out of the crib, putting heavy objects (like baby and baby's stroller!) into a car, etc.
It's described as an involuntary loss of bladder control and oftentimes leads women to wear black clothing or pads around the clock to avoid any chance of leaking being visible in public.
While leaking is talked about much more nowadays, it's still pretty taboo and can be frustrating if you're someone who is dealing with it and we understand and would love to help you.
Why does postpartum incontinence happen?
As mentioned above, postpartum incontinence can affect those who have had a vaginal delivery or C-section delivery.
Two types of incontinence that women experience are stress incontinence and urge incontinence.
Stress incontinence, the type of leaking that occurs secondary to the pelvic floor muscles' inability to accommodate for situations of increased pressure (think sneezing, laughing, running), results in leaking when that increased pressure occurs.
Urge incontinence can be described as when you see a bathroom, you feel an urge to have to go to the bathroom.
When it comes to postpartum incontinence, we often see stress urinary incontinence rather than urge incontinence.
This is most often because of the many physical changes that happen during pregnancy and birth. Here are some of the ways that this can contribute to leaking:
For nine months, your pelvic floor muscles are under constant pressure from a growing baby. This prolonged stress can challenge their strength and endurance. If the muscles aren’t able to keep up with the added load, you may notice leaking. This can carry on into the postpartum period as well.
After birth, those same muscles may be stretched, weakened, or fatigued. If they aren’t able to fully recover and adapt during the postpartum period, leaking can occur. Notice, this isn't just about the birth canal as the mechanism for delivering baby. It's about mom's body accommodating to the growing baby and the resulting factors of that.
Pregnancy hormones like relaxin and progesterone naturally loosen connective tissues to prepare your body for birth. While these hormones are necessary, this means that the pelvic floor may have less support as well as a need for controlling the muscles over an added range, as the pelvic expands to accommodate baby and the birth of baby. Combine that with nine months of pressure from a growing baby, and in the postpartum period, when hormone levels shift again, this is when leaking may show up.
Once baby is born, the pelvic floor muscles have to, yet again, accommodate for the body changes that are present. Without baby, the pelvic and abdominal region needs to regain coordination for the area.
During pregnancy and postpartum, your core and pressure mangament system (the diaphragm, deep abdominal muscles, and the pelvic floor) is affected. The growing baby pushes the diaphragm upward and stretches the abdominal wall, which can throw off how pressure is distributed inside the core "canister". If pressure isn’t well-controlled (think bearing down when lifting, coughing, or sneezing), that extra force gets pushed downward onto the pelvic floor. The result is too much downward pressure can overwhelm weakened pelvic floor muscles and instead of supporting the bladder and urethra, the pelvic floor gives way and leads to leaking.
What to do if you have postpartum incontinence
If you're experiencing postpartum incontinence, one of the best things is simply to know that you're not alone and that this is fairly common.
It's also important to note that you don't have to just live with this forever, you can get help.
The first thing that can be helpful if you're experiencing incontinence is to note exactly when you are having symptoms. Think about:
Time of day
Activities that you're doing
Is it constant and always or is it only after a hard day
That can make it easier to determine best treatment interventions in pelvic therapy to address your leaking.
One tip that can be helpful if you're leaking while coughing or sneezing can be what we call the "knack". All this is is a pelvic floor contraction before you sneeze or cough. Think about drawing your pelvic floor up and in just before you cough or sneeze. This is NOT a solution, but can be something that helps you get some relief from leaking before you get started in pelvic therapy.
Our suggestion is to have a full evaluation with one of our pelvic floor therapists (see what a pelvic floor internal exam looks like here) to determine exactly what your needs are for rehab and treatment. Not everyone's pelvic floor therapy looks the same after birth, so it's important to figure out your unique needs. Our physical therapists and occupational therapists specialize in treating the pelvic floor and will provide you with the most effective treatment option.
What you can expect in pelvic floor therapy for postpartum incontinence
If you do choose to reach out for help resolving your symptoms, you can expect a fully personalized plan.
Some of the this that may be included in your pelvic therapy:
Pelvic floor relaxation exercises to ensure that the muscles are able to fully lengthen
Kegel exercises and (most importantly!) Kegel education and feedback to make sure that you are doing these exercises correctly to help not only strengthen your pelvic floor but also to help with the coordination of these muscles.
Pelvic floor exercises and core stability exercises to get you back to being able to tolerate real life demands
Urinary incontinence after childbirth isn't something that has a protocol for treatment. It's always about what your specific body needs and how you respond to treatment and the exercises given.
Where to get pelvic floor therapy for postpartum incontinence in the St. Pete and Tampa, FL areas
If you are located in St. Pete, Lutz, or the Tampa area and want to get started with pelvic health therapy or treatment for postpartum incontinence, we have three clinics for your convenience. We offer pelvic floor physical therapy and pelvic floor occupational therapy for women and all three of our clinics are taking new patients and would love to help you. To get started, contact us! We offer free consult calls and have an easy booking experience.