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Now that you’re pregnant, you may notice you leak a little urine sometimes when you laugh or sneeze. Or maybe you find yourself peeing frequently while pregnant, with much greater urgency.

You may wonder, “Is incontinence normal during pregnancy?” Indeed, recent studies show that 40% to more than 50% of women have bladder control problems in pregnancy. Add it to the list of things no one told you about pregnancy.

While it’s common, that doesn’t mean you should live with urine leakage in pregnancy. These leaks are annoying, after all, and can be embarrassing. Your health provider can help with exercises and lifestyle changes that can help you take back your bladder control.

Why Does Incontinence Happen During Pregnancy?

Many factors increase the risk of poor bladder control in pregnancy, including your changing hormones. The hormones progesterone and relaxin help to loosen muscles and ligaments to make way for the baby.

But high levels of these hormones may also relax muscles in and around your bladder and urethra. This can make you more prone to release urine under pressure.

Meanwhile, your growing uterus puts pressure on your bladder and reduces how much urine it can hold. You’re also making more urine in general, because your kidneys are processing blood for you and your baby.

Added pressure combined with more relaxed muscles is what leads to bladder control problems in pregnancy.

What Are the Types of Incontinence During Pregnancy?

Bladder control problems are especially common toward the end of your pregnancy. That’s because your growing baby is putting extra pressure on your bladder and pelvic floor muscles. But incontinence can start in the first trimester too.

You may experience stress incontinence, urge incontinence, or both.

Stress incontinence

More than three-quarters of women who have bladder control issues in pregnancy experience stress incontinence. This is when you leak a little urine with added pressure on your pelvic floor. For example, you may notice urine leaks when you sneeze, jump, laugh, or cough. If you have very bothersome stress incontinence during pregnancy, your provider can also insert a pessary.

Urge incontinence

This is when you have a sudden urge to pee, with little warning. People with urge incontinence often leak some urine before they can get to the bathroom.

Incontinence or something else?

In rare cases, women may leak amniotic fluid in pregnancy. Some women may mistake this for incontinence.

Amniotic fluid is clear and doesn’t have an odor. If you think you may be leaking amniotic fluid, you should go to the hospital right away. This could mean you’re in labor or there’s a problem with the pregnancy that needs medical attention.

Pregnancy and Bladder Control Problems: Risk Factors

You’re more likely to have bladder control problems in pregnancy if:

•  You have had one or more vaginal births in the past.
• You have had one or more urinary tract infections in the past.
• You struggled with urinary incontinence before pregnancy.
• You were overweight before pregnancy, or you gained more weight than recommended in pregnancy.

If you have one or more pregnancy and bladder control risk factors, exercises to strengthen your pelvic floor are especially important to prevent incontinence.

Managing Urinary Incontinence in Pregnancy

While there are medications to help with incontinence, they’re not safe during pregnancy.

You can lower your risk of urine leakage with exercise and lifestyle changes.

Pelvic floor exercises (Kegels)

The best way to prevent incontinence in pregnancy is to strengthen your pelvic floor. You can do this by doing Kegels.

To do these exercises, it’s best to start with an empty bladder. You then tighten your muscles as if you are holding in urine. Hold this for a few seconds and release.

Start with a few Kegels at a time, and gradually increase. Try to work up to doing ten Kegels in a row, two or three times a day.

Your pregnancy provider can teach you how to do Kegels properly. They can also refer you to a physical therapist who can teach you pelvic floor exercises and other techniques to prevent leakage.

Bladder training and timed voiding

If you feel like you’re going to the bathroom all the time during pregnancy, your provider may suggest bladder training. With this method, you slowly increase the length of time between bathroom visits.

Your provider may also suggest you keep a diary of when leaks occur over many days and look for patterns. Your provider can help you with timing urination before leaks are most likely to occur.

Lifestyle changes

On top of exercises and bladder training, you can prevent incontinence by making the following lifestyle changes.

• Avoid caffeinated beverages, like coffee and tea. They can irritate the bladder and increase the risk of leaks.
• Increase the amount of fiber in your diet by eating more whole grains, fruits, and vegetables. Constipation can add pressure to the pelvic muscles.
• Make sure you’re not reducing your water intake. Your bladder needs enough water to work properly. You may find you need extra water due to the demands of pregnancy on your body.

Avoiding Urinary Incontinence After Pregnancy

Bladder control issues often get better in the postpartum period, without the pressure of the fetus and hormone changes. However, for some, urine leakage can continue in the postpartum period. A 2022 study found 16% of people had urinary incontinence three months after giving birth.

Many people may not mention urine leakage to their doctor out of embarrassment. However, women’s health providers often respond to urine leakage problems. They know why it happens, and they know what methods work.

Your health provider can help you avoid urine leaks during pregnancy and reduce the risk of this continuing after pregnancy. Plus, strengthening your pelvic floor can make for an easier birth.