Postpartum incontinence is the involuntary leakage of urine (or, less commonly, stool) that occurs after childbirth. It happens due to the strain that pregnancy and delivery place on the pelvic floor muscles, nerves, and connective tissues that support the bladder and bowel. After giving birth, these muscles may be stretched, weakened, or temporarily damaged, making it harder to fully control bladder or bowel function. As a result, some people experience loss of bladder control when coughing, laughing, sneezing, exercising, or feeling a sudden urge to go to the bathroom. Here, we'll explain in more detail why this happens and how to incorporate incontinence care to manage symptoms.
In this article, you’ll learn:
- What postpartum incontinence is and why it commonly occurs after childbirth
- How common postpartum urinary and fecal incontinence is among new mothers
- The different types of postpartum incontinence, including stress, urge, mixed, and fecal incontinence
- Key causes of incontinence after pregnancy, such as pelvic floor weakness, vaginal birth trauma, hormonal changes, and C-section considerations
- Common signs and symptoms to watch for, from mild leakage to bowel control issues
- How long postpartum incontinence typically lasts, and when to seek medical support
- Effective treatment options, including pelvic floor exercises, physical therapy, bladder training, and medical interventions
- Whether postpartum incontinence can be prevented, and steps to reduce the long-term risk
- How incontinence products can support daily comfort and quality of life during recovery
How Common is Postpartum Incontinence?
Postpartum incontinence is very common, especially in the weeks and months after delivery. As many as four in every 10 women experience it (although one study found that it affected 85% of surveyed mothers), and those who delivered vaginally have a 50% greater chance of developing it. For many, symptoms improve as the body heals and pelvic floor strength returns. However, without treatment, it may persist for longer.
Different Types of Postpartum Urinary Incontinence
Several different types of urinary incontinence can occur throughout the year after childbirth, which include:
- Stress Incontinence: Stress incontinence is the most common type after pregnancy and childbirth. It occurs when extra pressure is put on the abdominal wall or bladder, causing the muscular valve at the bottom of the bladder to open involuntarily.
- Urge Incontinence: Urge incontinence occurs when a sudden, intense need to urinate is followed by involuntary leakage, often due to an overactive bladder or disrupted nerve signals after pregnancy.
- Mixed Incontinence: Mixed incontinence is a combination of stress and urge incontinence, meaning individuals experience leakage both during physical activity and in response to sudden urinary urgency.
- Fecal Incontinence: Fecal incontinence involves the inability to control bowel movements or gas and may occur after childbirth due to pelvic floor muscle damage, nerve injury, or severe perineal tears.
What Causes Incontinence After Pregnancy?
Pregnancy and childbirth are tough on the body and can impact more than your uterus. The excess weight from your growing baby can put pressure on your bladder and other surrounding organs, often weakening the muscles that control urine flow, the pelvic floor muscles. Several additional factors can also make postpartum women more likely to experience urinary leakage, some of which include the following.
Pelvic Floor Muscle Weakness
Pelvic floor muscle weakness is the most common cause of postpartum incontinence. During pregnancy, pelvic floor muscles must support the growing weight of the baby, uterus, and placenta. This can strain the muscles around the bladder and make bladder incontinence more likely to occur. Other ways that the pelvic floor is affected include:
- Vaginal pushing during labor stretches these muscles beyond their normal range
- Overstretching can reduce muscle strength and coordination.
- Weakened muscles struggle to fully support the bladder and urethra, leading to leakage
Prolonged pregnancy pressure can also affect the pelvic floor throughout all trimesters, and multiple pregnancies or larger babies can increase this strain.
Vaginal Birth and Perineal Trauma
Certain aspects of vaginal delivery can further increase the risk of postpartum incontinence. For example:
- Perineal tearing or episiotomy can damage pelvic floor muscles
- Instrument-assisted deliveries (forceps or vacuum) place added strain on pelvic tissues
- Muscle and connective tissue injuries may affect bladder support
- Nerve involvement can interfere with the brain’s ability to control urine flow
There may also be complications with the pudendal nerve, which is responsible for controlling the pelvic floor. If this is what causes postpartum incontinence, your doctor will help you find the best methods to regain nerve function to control your bladder.
Hormonal Changes After Birth
Hormonal shifts after delivery play a role in bladder control. For example:
- Estrogen levels drop significantly after childbirth
- Low estrogen can thin and weaken tissues in the bladder and urethra
- Breastfeeding often prolongs low estrogen levels
- Reduced tissue elasticity can make leakage more likely
C-Section Birth Considerations
While cesarean births reduce some risks, they do not fully protect against postpartum incontinence. Pregnancy itself weakens the pelvic floor before delivery, and the weight of the baby still places prolonged pressure on the pelvic area.
Therefore, some people will still experience bladder leakage despite not having a vaginal delivery. It's important to listen to your doctor regarding post-op care, as you may still need to engage in core or pelvic muscle recovery to avoid leakage.
Symptoms of Postpartum Incontinence
Postpartum incontinence can present in different ways, depending on how the pelvic floor, bladder, and surrounding nerves were affected during pregnancy and childbirth. Symptoms may range from mild and occasional to more frequent or disruptive, especially in the early postpartum period.
Common symptoms of postpartum incontinence include:
- Leaking urine when coughing, sneezing, laughing, or exercising
- Urine leakage during activities such as lifting, running, or jumping
- A sudden, intense urge to urinate followed by leakage
- Difficulty holding urine long enough to reach the bathroom
- Frequent urination, including the need to wake up at night to urinate
- Feeling like the bladder does not fully empty
Some people may also experience bowel-related symptoms, particularly if there was significant pelvic floor or perineal trauma during delivery. These may include:
- Accidental leakage of stool
- Difficulty controlling gas
- Bowel urgency or decreased bowel control
In addition to bladder and bowel symptoms, postpartum incontinence may be accompanied by other pelvic floor–related sensations, such as:
- Pelvic pressure or heaviness
- A feeling of weakness or instability in the pelvic area
- Discomfort during physical activity
Symptoms often improve gradually as the body heals, but persistent or worsening leakage may indicate ongoing pelvic floor dysfunction. Recognizing these signs early can help guide appropriate treatment and support recovery.
How Long Does Postpartum Incontinence Last?
The length of time you experience incontinence after birth depends on the exact cause and your treatment. Therefore, it's important to seek medical advice if you notice bladder leaks or other incontinence symptoms. Many women experience postpartum incontinence, and it's nothing to be ashamed of. In fact, many new moms find that, with proper treatment and strengthening exercises, they can regain complete continence within 12 months, with symptoms often improving within three to six months. However, the key is to treat incontinence early and work with a pelvic floor physical therapist if necessary.
How to Treat Postpartum Incontinence
Before treatment, it's important that you talk to your doctor about postpartum incontinence to better understand exactly what's causing it. Once identified, your doctor will start creating a treatment plan that includes one or more of the following.
Pelvic Floor Exercises (Kegels)
One of the first treatment options is to strengthen the pelvic floor muscles. This is often one of the most effective treatments and can help you gain control of your bladder without more intensive requirements. Your doctor will likely have you start doing Kegel exercises, but there are also other exercises available to help strengthen your pelvic floor. If you have any questions or concerns about these, talk to your doctor.
Pelvic Floor Physical Therapy
Pelvic floor physical therapy is a specialized, evidence-based treatment that goes beyond basic exercises and is highly effective for postpartum incontinence.
Pelvic floor physical therapy may include:
- A comprehensive pelvic floor muscle assessment
- Guided exercises tailored to your specific weaknesses or imbalances
- Manual therapy to address muscle tightness or scar tissue
- Biofeedback or electrical stimulation to improve muscle awareness
Bladder Training Techniques
Bladder training helps retrain the bladder to hold urine for extended periods and reduce urgency. Common techniques include:
- Timed voiding, which involves urinating on a set schedule rather than waiting for urgency
- Delayed urination, which involves gradually increasing the time between bathroom visits
- Urge suppression methods, such as deep breathing, pelvic floor contractions, or distraction techniques
These strategies are often used alongside pelvic floor exercises for better results.
Medical Treatments
Medical treatment options can help when lifestyle modifications or exercises aren't effective, but they're often only recommended after trying other options. Some of the most common ones include:
- Pessaries, which provide support to the bladder and pelvic organs
- Biofeedback is used to improve pelvic floor muscle coordination
- Medications, particularly for urge incontinence or overactive bladder
- Minimally invasive procedures, such as sling surgery or injectable bulking agents, for persistent cases
Your healthcare provider can help determine whether these treatments are appropriate based on your symptoms and goals.
Will Everyone Who Gives Birth Experience Urinary Incontinence?
No, not everyone who has a child will experience incontinence. However, it is a common medical condition and has several treatment options. If you notice any symptoms, talk to your doctor early to determine the best approach to management and care.
Can Any Types of Urinary Incontinence After Childbirth Be Prevented?
Urinary incontinence after childbirth can’t always be prevented, but the risk can be reduced by strengthening the pelvic floor during and after pregnancy, maintaining a healthy weight gain, and practicing proper pushing techniques during delivery. Early postpartum pelvic floor exercises and physical therapy can also help support recovery and minimize long-term bladder control issues.
While there are many treatment options, they can take time to reduce symptoms. To help make sure that the involuntary leakage of urine isn't affecting your life too seriously, bladder control products and incontinence products are a great option. Byram Healthcare has a wide range of incontinence products to help. Browse our product catalog today.
