Break like water: Pregnancy and incontinence

break like water

During pregnancy, the fetus presses down on the bladder, urethra, and pelvic floor muscles, potentially weakening the pelvic floor and causing leakage problems. As a result, many pregnant women experience stress incontinence: the involuntary loss of urine provoked by increased pressure on the bladder. In this type of incontinence the bladder does not hold urine properly, and leaks occur when coughing, sneezing, laughing, exercising, or performing any activity that puts undue pressure on the abdomen. Additionally, pregnant women may also suffer from an overactive bladder which prompts them to urinate urgently more frequently and at inappropriate times, to the point that they may not be able to make it to the bathroom in time.

Pregnancy and urinary health timeline

First trimester

Second trimester

Third trimester

At 12 weeks of pregnancy the uterus has grown to the size of a grapefruit, which puts additional pressure on the bladder.

Some of the fluid retained in the legs and feet during the day returns to the blood stream and to the bladder while the pregnant woman lies down at night, increasing the nightly trips to the bathroom.

The fetus is at its largest putting even more pressure on the bladder. At the same time, during this period the body produces high quantities of a muscle relaxant called progesterone.


Urinary incontinence (UI) can be treated during pregnancy with timed voiding, bladder training, and Kegel exercises. UI can continue up to and after childbirth, seeing as labor and vaginal birth can weaken the pelvic floor and damage the nerves that control the bladder. The majority of bladder control problems resolve about six weeks after delivery once the muscles have had time to heal. However, new mothers have a 20% chance of developing post-pregnancy stress incontinence – 36% if there was forceps delivery. Furthermore, some women only experience incontinence problems years after the fact.

Urinary incontinence is perfectly normal during pregnancy but it could be a serious problem if the symptoms persist long after childbirth. Women should openly talk to their doctors about UI in order to find an effective long-term treatment for this condition, as well as rule out other possible causes such as constipation, medications, infection, nerve damage, or excess weight. In the meantime, there are pads that can be worn discreetly as a means of containing unexpected incontinent episodes. UI can worsen postnatal depression, so in addition to talking to a doctor, new mothers may wish to speak to others who have gone through a similar situation.