Pre & Postnatal Urinary Incontinence: Why It Happens and How to Treat It at PhysioMatters?
- PhysioMatters
- Sep 19
- 3 min read
Let’s talk about something many women experience, but few openly discuss urinary incontinence (UI) during and after pregnancy.
Bladder leakage can be frustrating, embarrassing, and isolating. But here’s the truth: you’re not alone, and you don’t have to live with it. There are natural, safe, and proven ways to manage and treat incontinence, and physiotherapy is one of the most effective.
Understanding Pre & Postnatal Urinary Incontinence
During pregnancy, your body undergoes incredible changes, hormonal shifts, increased intra-abdominal pressure, and a growing uterus stretching and weakening the pelvic floor muscles. After childbirth, these muscles may be further affected, especially following vaginal deliveries or births with assisted interventions such as forceps or vacuum.
Is it normal?
Leaking urine when you laugh, cough, or sneeze is common, but not normal in the medical sense. It’s called stress urinary incontinence (SUI) and is a sign your pelvic floor needs attention.
A large prospective cohort study published in BJOG found that about 1 in 3 women experience urinary incontinence during pregnancy, with up to 38% reporting symptoms postpartum.
Types of Urinary Incontinence
Stress incontinence: Leakage during increased pressure on the bladder.
Urge incontinence: Strong, sudden urge followed by leakage.
Mixed incontinence: A combination of both.
Risk Factors & Causes
While any woman can experience incontinence during or after pregnancy, certain factors increase the risk:
Vaginal delivery vs. C-section: A study in Obstetrics & Gynaecology found vaginal delivery carries a higher risk of postpartum incontinence, especially when combined with perineal trauma or a prolonged second stage of labour.
Multiple pregnancies: Multiple or additional pregnancy compounds strain on the pelvic floor.
Carrying multiples: Twin or triplet pregnancies increase intra-abdominal pressure.
Hormonal changes: Oestrogen drops postpartum, especially with breastfeeding, which can impact tissue tone and pelvic floor recovery.
What Are Prevention & Early Management Action You Can Take?
Here’s the good news: there’s a lot you can do to prevent or minimise symptoms—even before the baby arrives.
Start Pelvic Floor Exercises Early: Pelvic floor muscle training (PFMT) has strong evidence supporting its role in preventing and reducing incontinence during and after pregnancy. A 2020 Cochrane Review found that women who do PFMT are significantly less likely to report incontinence both late in pregnancy and postpartum.
Come into PhysioMatters to assess your PFM action on screen using Real Time Ultrasound Imagery. This ensures you’re doing the exercises correctly—many women unknowingly perform them incorrectly.
Maintain a Healthy Weight: Gaining weight within recommended guidelines helps reduce pressure on the bladder. Excessive weight gain is a known risk factor for both pregnancy-related and long-term incontinence.
Go slow and steady with the correct nutritional advice and exercise program. It takes time to lose pregnancy weight – I often say if you're 9 months pregnant be patient - it will take 9 more months to regain your body shape.
Stay Hydrated Smartly: Drinking enough water prevents bladder irritation caused by concentrated urine. Limit bladder irritants like caffeine, carbonated drinks, and artificial sweeteners.
Postpartum Recovery & Treatment
How long does it last?
For many, mild leakage resolves within 6–12 weeks postpartum. But if symptoms persist beyond that, early treatment can significantly improve recovery.
Can physiotherapy help?
Yes. In fact, pelvic floor physiotherapy is the gold standard for treating mild to moderate postpartum incontinence.And it doesn't involve being upside down and crossed legged!!
According to the NICE guidelines, PFMT should be the first-line treatment for women with postpartum incontinence.
Treatment may include:
Tailored pelvic floor muscle exercises
Bladder retraining
Core and breath coordination
Manual therapy or electrical stimulation (if appropriate)
Is surgery necessary?
Usually not. Conservative physiotherapy treatment is highly effective, and surgery is rarely recommended as a first approach, especially in the first year postpartum.
When to Seek Help from our Team – any time!
See a pelvic health physiotherapist if:
Urine leakage occurs in your pregnancy
Leakage persists beyond 6–8 weeks
You avoid exercise or intimacy due to symptoms
You feel heaviness or pressure in the vagina
You want to return to running or sport safely
Urinary incontinence during or after pregnancy is common, but very treatable. With evidence-based physiotherapy, most women can regain bladder control, pelvic strength, and confidence, naturally and without surgery.
Our team of physiotherapists (Danielle, Xan and Claire) specialise in pelvic health physiotherapy care. We are here to guide you with a customised plan that supports your body, your birth story, and your goals.
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