Incontinence During and After Pregnancy
Leaking urine during pregnancy or after having a baby is common, but it is not something you have to accept as normal or permanent. Many women experience incontinence at some point during pregnancy or in the months following birth, yet are unsure why it happens or whether it will improve.
The good news is that incontinence is treatable, and early assessment and guidance can significantly improve outcomes. Understanding why leakage occurs — and what can be done about it — is the first step toward regaining confidence and control.
What Is Incontinence?
Incontinence refers to the involuntary leakage of urine. It can occur during pregnancy, after birth, or both, and ranges from occasional leaks to more frequent or bothersome symptoms.
Incontinence is often associated with changes to the pelvic floor muscles, but it is not always caused by weakness alone. Muscle coordination, timing, relaxation and load management all play an important role in bladder control.
Is Leaking During Pregnancy Normal?
Leaking during pregnancy is very common, particularly with coughing, sneezing, laughing or exercise. Increased pressure on the bladder and pelvic floor means many women notice leakage for the first time while pregnant.
While common, leakage should not be ignored. Experiencing incontinence during pregnancy is one of the strongest predictors of postnatal incontinence. Addressing symptoms early can reduce the likelihood that leakage will continue after birth.
Why Does Incontinence Happen in Pregnancy?
Several factors contribute to incontinence during pregnancy, including:
Increased pressure on the pelvic floor as the uterus grows
Hormonal changes that affect tissue support and elasticity
Pelvic floor muscle fatigue or weakness
Poor muscle coordination, including difficulty switching between contraction and relaxation
Importantly, not all leakage is due to weak muscles. In some cases, pelvic floor muscles may be overactive or tense, which can interfere with normal bladder control.
Why Can Incontinence Continue After Birth?
For some women, leakage improves naturally in the weeks following birth. For others, symptoms persist or worsen.
Factors that can contribute to postnatal incontinence include:
Stretching or trauma to the pelvic floor muscles during vaginal birth
Nerve stretch or compression
Instrumental delivery
Prolonged pushing
Abdominal and pelvic floor coordination changes
Returning to high-impact exercise too quickly
It’s also important to note that incontinence can occur after caesarean birth. Pregnancy itself places strain on the pelvic floor, regardless of delivery method.
Types of Incontinence in Pregnancy and Postpartum
Stress Incontinence
Leakage that occurs with physical effort such as coughing, sneezing, lifting or exercise.
Urge Incontinence
A sudden, strong urge to urinate followed by leakage before reaching the toilet.
Mixed Incontinence
A combination of both stress and urge symptoms.
Identifying the type of incontinence helps guide appropriate treatment.
When Is Incontinence Not “Just Part of Motherhood”?
Incontinence is not something you should simply tolerate, especially if you experience:
Persistent leakage beyond the early postpartum period
Worsening symptoms over time
Pelvic heaviness or bulging
Difficulty emptying the bladder
Leakage that limits exercise or daily activities
These signs indicate that assessment and targeted treatment may be beneficial.
How Is Incontinence Treated?
Treatment for incontinence is individualised and based on how your pelvic floor is functioning, rather than a one-size-fits-all approach.
Management may include:
Pelvic floor muscle retraining (not just strengthening)
Relaxation strategies if muscles are overactive or tense
Bladder training and urge suppression techniques
Education around pressure management and daily habits
Graduated return-to-exercise guidance
Addressing contributing factors such as pelvic girdle pain or abdominal separation
Many women are surprised to learn that doing “more Kegels” is not always the answer. Correct technique, appropriate progression and muscle coordination are key.
Can You Prevent Postpartum Incontinence?
While not all cases can be prevented, the risk of ongoing incontinence can be reduced by:
Pelvic floor assessment during pregnancy
Learning correct pelvic floor activation and relaxation
Addressing symptoms early rather than waiting until after birth
Attending a postnatal pelvic floor assessment
Gradually returning to exercise with appropriate guidance
Early support often leads to faster recovery and better long-term outcomes.
When to See a Women’s Health Physiotherapist
A women’s health physiotherapist can assess pelvic floor function, including strength, coordination and relaxation, and provide a tailored plan based on your body and birth history.
You may benefit from assessment if you:
are leaking during pregnancy
have ongoing leakage after birth
feel unsure about pelvic floor exercises
want guidance on returning to exercise safely
Individualised care can help you regain confidence, comfort and control.
Frequently Asked Questions About Incontinence
How long does postnatal incontinence last?
For some women, leakage improves within weeks. For others, symptoms persist without targeted treatment.
Can incontinence improve on its own?
It can, but improvement is more likely and often faster with appropriate physiotherapy support.
Do pelvic floor exercises fix leaking?
Pelvic floor exercises can help, but only when done correctly and when they match the underlying issue.
Can I exercise or run if I’m leaking?
Leakage during exercise is a sign that your body may not yet be ready for that load. Assessment can help guide safe progression.
Takeaway
Leaking urine during or after pregnancy is common — but it is not something you have to live with. With the right assessment and support, most women can significantly improve or resolve symptoms and return to activity with confidence.
If you’re experiencing incontinence, seeking guidance early can make a meaningful difference to your recovery and long-term pelvic health. If you’d like personalised assessment you can book a women’s health physiotherapy consultation here.