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Not long ago, I was bouncing with my 3-year-old twin boys in one
of those street fair blow-up castles when—oops!—I felt a bit of urine spurt
out. It happens a few times a year, typically during a forceful sneeze, and
it’s a reminder that all is not the same, bladder-wise, as before I got
Doctors call it urinary incontinence. I prefer “the spritz,” the
term used in the TV commercials for Poise pads. Whatever you call it, leakage
is incredibly prevalent among moms. “Even a seemingly uneventful pregnancy and
delivery can change urinary control for up to 50 percent of women,” says Roger
Goldberg, M.D., director of urogynecology research at the University of Chicago
NorthShore University HealthSystem and author of Ever Since I Had My Baby (Random House).
Most cases resolve in the first year postpartum. However, five
years after delivery, one-third to one-half of women report some degree of
spritzing; 10 percent to 20 percent of women report having leakage that they
consider “socially bothersome.” Fortunately, a variety of methods, ranging from
do-it-yourself pelvic-floor exercises (Kegels) to a simple
surgical procedure, can help you stay dry.
Incontinence comes in two varieties: stress and urge. If you
leak when you forcefully laugh, sneeze, cough, run, jump or lift weights, you
have stress incontinence. “It’s really common in the third trimester because of
the pressure of the uterus on the bladder,” says Sangeeta Mahajan, M.D.,
division chief of female pelvic medicine and reconstructive surgery at
University Hospital’s Case Medical Center Department of OB-GYN in Cleveland.
Compounding the problem are the hormones that make your tissues and joints more
elastic for delivery: They also reduce bladder support, allowing urine to leak.
About two-thirds of women with stress incontinence also
experience urge incontinence, which is caused by an overactive bladder. You get
the sudden urge to go, even though your bladder may be nearly empty, and leak
before you can get to the bathroom.
older than 35 and obese women are at greater risk for prenatal leakage of both
varieties. After childbirth, the biggest risk factor for stress incontinence is
having had a vaginal delivery, especially one involving forceps or other
interventions that can injure pelvic nerves and muscles. A Norwegian study of
12,000 women found that among women who did not leak during pregnancy, 20
percent did so six months after a vaginal delivery, compared with 8 percent who
had elective Cesarean sections. Among prenatal leakers, half who delivered
vaginally were spritzing six months later, compared with 23 percent of those
who had a C-section.