Dealing with postpartum incontinence: what you need to know

I can’t remember whether bladder weakness was a problem for me before the birth of my now almost twelve-year-old son.

Research shows that up to 25% of young women experience involuntary urine leakage, as does 44% to 57% of middle-aged women and a whopping 75% of older women. Stress incontinence, which is caused by stress or pressure on the bladder, is far more common in women than in men and can be made worse by childbirth.

My son went into labor for about 30 hours. Later, when I raised myself to a sitting position in the hospital bed with the IV hooked up to my arm, the surge came and didn’t stop until my bladder was empty. This wasn’t a “cough and pee a little” situation. We’re talking zero bladder control.

I told one of the doctors and he assured me that sometimes this happens after childbirth. When I told a nurse about my problem, she asked about the pad I was wearing. It was soaked. She was a bit worried and told me to let the nurse know at my follow-up visit if the bladder leak was still happening.

The leaks continued, but became less severe in the days that followed. I’m sure I mentioned it in my follow-up appointments, but my focus was on my all-consuming little bundle of joy.

After giving birth, new moms don these attractive paper mesh panties and a giant pad. In the days that follow, the pads and fishnet panties are replaced with equally sexy oversized cotton panties from the back lingerie drawer. With all the bleeding and peeing, the pad becomes a part of our existence in the early haze of motherhood.

My son’s childhood was followed by the blurry toddler years, and when I became pregnant with my daughter I still wore a pad every day. The simple act of walking was difficult as I most likely leaked small amounts of pee along the way. A sneeze or a jump? I might as well just jump into the pool with my pants on.

The lack of control created a slight anxiety that I accepted along with the other inconveniences of being a mother, like less sleep and constant tidying up.

During my second pregnancy, I was afraid that the lack of bladder control after birth would be as bad as it was with my son. So I would try to “fix” the problem after she was born, I reasoned, because what was the point of dealing with it before then?

When my daughter was born, I was relieved to realize that I was dealing with the same leaky faucet and not the bubbling rivers of my first child. And with a baby and a preschooler, I was busy again. The years passed. My bladder kept leaking. The pad stayed in my underwear.

I knew what I was experiencing wasn’t normal, but it wasn’t unusual either. There are so many jokes about moms accidentally peeing their pants a little. When I spoke to mother friends and colleagues about urinary incontinence, they understood.

But what I experienced seemed different from the occasional drizzle of many others. Even a walk around the block during your work lunch break can result in wet pants and a damp desk chair. And that while wearing a pad. It was humiliating. Carrying an extra pair of underwear and pants to change in the trunk of your car is not a lifestyle.

I couldn’t fully relax and enjoy sex for fear of getting my husband in a surprise squirt gun fight. Still, I continued to try to ignore the problem. I did a few Kegel pelvic floor contractions when I remembered, but that was sporadic.

On a recent visit to my gynecologist, nearly 12 years after my son was born and the leakage started, I finally listened when the doctor suggested pelvic floor physical therapy.

A sign at a physical therapy practice visited by the author.
A sign at a physical therapy practice visited by the author.

Photo courtesy of Samantha Scroggin

At my first appointment, the physical therapist – who was about my age and would have been a potential mother friend had she not been soon elbowed into my abdomen – asked about my urinary leakage problems and whatever was making it worse. She showed me a model of a woman’s pelvic floor and explained why incontinence occurs before having me stripped from the waist down so she could use a gloved hand to feel if I was doing kegel exercises properly and where my bladder was. She was so talkative and relaxed that it wasn’t nearly as awkward as it sounds.

At the next session, she told me I would play “video games” with my pelvic floor muscles. The little skittles video games were pretty awesome. I prided myself on being able to control the game with my contractions. And it was helpful to see that the efforts I made were still effective after all these years of incontinence. I also committed to doing the kegel exercises she gave me, knowing full well that I would report back to her on my homework.

The best thing about pelvic floor physiotherapy was the results I saw in a short amount of time. With the encouragement of my physical therapist, I’ve dropped the security blanket of wearing pads at night and only wear panty liners in my underwear during the day. I’ve learned that it’s important to stay hydrated and wait at least two hours between trips to the bathroom, rather than constantly letting go of each bit “just to be safe.” For the past few weeks, I’ve even been able to go for a walk without my pad and underwear getting soaked.

It feels great not having to constantly think about my bladder. I’m not healed but I’m on my way.

I now believe it was shame at my incontinence that made me refuse to do anything about it. For many women, however, this is a major concern and it’s about time we gave it the spotlight it deserves. Resources on pelvic floor incontinence should be made available to all new mothers.

The success I’ve had with pelvic floor physical therapy has motivated me to get things done in other areas of my life as well. I have a mammogram scheduled for later this month and will soon have LASIK to correct my vision.

As mothers, we are used to putting our needs on the back burner. We can do it tomorrow, right? Until the mornings turn into weeks, months and years. But we are worth the time and effort to work on ourselves and seek treatment when treatment is needed. It is not too late.

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