Pelvic health
Postpartum incontinence: why you leak after baby, and what to do next
By Natura Integrative Care Clinic · Updated · 3 min read
The short answer
Postpartum incontinence, leaking urine after having a baby, affects about one in three women in the first months after birth, most often when you sneeze, cough, laugh or exercise. NHS guidance recommends pelvic floor exercises after birth, and any leaking is worth raising with your doctor, nurse practitioner or a pelvic floor therapist.
Postpartum incontinence is one of the most common things new parents don’t talk about. A 2020 Cochrane review reports that about a third of women leak urine in the first three months after giving birth, and up to one in ten have trouble controlling stool after childbirth. If you’re reaching for a pad every time you sneeze, you’re far from alone.
The Canadian Continence Foundation describes urinary incontinence as a symptom rather than a disease, pointing to an underlying issue, and notes that stress incontinence is more common after childbirth. This guide explains the common types of leaks, why they happen, how pelvic floor exercises are done, and when to see a doctor.
What kind of incontinence do I have?
| Type | What it feels like | Typical triggers |
|---|---|---|
| Stress incontinence | A leak when pressure suddenly pushes on the bladder | Coughing, sneezing, laughing, lifting, running or jumping |
| Urgency (overactive bladder) | A sudden, strong need to go that’s hard to put off, sometimes with a leak | Can be worsened by caffeine, bladder irritation or stress |
| Mixed incontinence | A combination of both | Any of the above |
Stress incontinence is the classic pattern after birth. Knowing which type you have shapes the conversation with your provider: with urgency, options often discussed include bladder training and cutting back on bladder irritants such as caffeine; with stress leaks, the focus is usually pelvic floor muscle exercises and timing.
Bladder leakage when sneezing: why it happens
A sneeze, cough or laugh sharply raises the pressure inside your abdomen. Normally your pelvic floor muscles tighten in response and keep the bladder outlet closed. After pregnancy and birth, those muscles may be weaker or slower to respond, so a little urine escapes.
One technique often taught for this is called “the knack”: getting in the habit of tightening your pelvic floor just before you cough, sneeze or lift something, then letting go afterwards.
Why can’t I just do kegels at home?
Kegel exercises, or pelvic floor muscle exercises, are strongly recommended after childbirth for urinary incontinence. However, it is important that the right muscles are activated. Not everyone benefits from kegels, which is why it is important to see a pelvic floor therapist.
Keeping a bladder diary before your appointment
A few days of simple notes give your provider a much clearer picture than memory alone. Use your phone or a sheet of paper, and write down:
- What you drink, roughly how much, and when.
- Each time you pass urine.
- Each leak: roughly how much, and what you were doing at the time (sneezing, lifting the car seat, running for the bus).
- Any sudden, strong urges to go, and whether you made it in time.
- Any trouble with bowel control or passing wind.
Bring it to your postpartum check-up or pelvic floor visit, along with a list of questions. Useful ones include: What type of leaking do I have? Am I doing my pelvic floor exercises correctly? When can I return to running or jumping? What should I do if things don’t change?
Everyday bladder habits from the Canadian Continence Foundation
- Don’t cut your fluids right back. The foundation suggests about 5 to 6 cups a day of non-caffeinated, non-carbonated drinks. Too little fluid can lead to constipation, which can make bladder problems worse.
- Go easy on caffeine. Caffeine can irritate the bladder. The foundation suggests no more than 2 cups a day and avoiding caffeinated drinks in the evening.
- Keep your bowels regular, and raise constipation with your provider early rather than straining.
- Use proper incontinence pads rather than menstrual pads if you need protection for now; they’re designed for urine.
- Ease back into heavy lifting and high-impact exercise in the months after birth, and ask your provider about timing a return to running or jumping.
What other options are there for bladder leaks?
If leaking continues, your family doctor can talk through other options, such as medications for urgency, procedures or surgery, and can refer you to a specialist such as a urologist or urogynecologist. Pelvic floor therapy and medical care can run side by side, so keep your family doctor informed about any therapy you’re doing.
Seeing Taryn at Natura for postpartum incontinence
Our pelvic floor therapist, Taryn Bloodworth, RNBN, is more than happy to help you in your postpartum journey, especially when it comes to urinary incontinence after baby. If your belly also feels different since birth, read about diastasis recti, another common reason people book with Taryn.
Common questions
Is it normal to leak urine after giving birth?
It’s common: about one in three women leak urine in the first three months after birth. The Canadian Continence Foundation describes leaking as a symptom rather than a disease, pointing to an underlying issue, so it’s worth raising rather than accepting as part of motherhood. Bring it up at your postpartum check-up or with a pelvic floor therapist.
How long does postpartum incontinence last?
There’s no fixed timeline, and it differs from person to person. An NHS pelvic health leaflet suggests doing pelvic floor exercises regularly for at least four to six months, and the NHS advises asking a doctor about any physical problem after birth at any time. You don’t need to wait to see whether leaking stops on its own before raising it.
Should I start Kegels during pregnancy?
Many people do, and it’s a good question to raise at a prenatal visit. Ask your prenatal care provider whether pelvic floor exercises suit your pregnancy, and if you have pelvic pain or aren’t sure of your technique, ask for an assessment first. Pregnancy preparation is also a common reason people book pelvic floor therapy.
What if I’m still leaking after doing Kegels?
First, check the technique: it’s easy to squeeze the wrong muscles or hold your breath without noticing, and a pelvic floor assessment includes checking this directly. If you’ve done the exercises consistently for several months and still leak, talk to your family doctor about other options and whether a specialist referral makes sense.
Sources
- Public information on urinary incontinence — Canadian Continence Foundation
- Tips for bladder control — Canadian Continence Foundation
- Pelvic floor muscle training for preventing and treating incontinence in antenatal and postnatal women (Cochrane review, 2020) — PMC
- Pelvic floor exercises for women — North Bristol NHS Trust
- Your post-pregnancy body — NHS
This article is general information, not medical advice for your situation. If you're unwell or worried, talk to your doctor or call Health Links – Info Santé, Manitoba’s free 24-hour nurse line, at 1-888-315-9257. In an emergency, call 911.
