As amazing and miraculous as child birth is, it does, without question, come with a slew of embarrassing aftermaths. Today, Dr. Rebecca Nelken, a board-certified OB/GYN with fellowship training in urogynecology and female pelvic surgery, answers this question about one common problem known as stress incontinence:

 

Q: Is Incontinence after child birth "normal?"  I just had my second baby and I'm finding that I pee everytime I cough or sneeze (or even laugh too hard). Is this normal? What can I do? I want to have more children but am scared that it's only going to get worse.



A: Leakage of urine with straining such as coughing, sneezing, laughing,  lifting, or exercising is called stress urinary incontinence, or simply stress incontinence, and it is very common.  In the postpartum period, stress incontinence can affect up to 35% of women.



The biggest contributing factor is genetic predisposition, i.e., did your mom or sister have this problem?  In addition, pregnancy and childbirth, especially vaginal delivery, can put a lot of stress on your pelvic floor, damaging nerves and muscles which can lead to stress incontinence. 



The good news is that as your body recovers from delivery, your pelvic floor muscles will regain strength and your urinary symptoms will most likely improve on their own.  It is important for you to help your body along with this recovery.  Kegel exercises will strengthen your pelvic floor muscles which can improve your symptoms of urinary leakage and even help your vagina feel tighter during intercourse. 



To perform Kegel exercises, squeeze the vaginal muscles as if to stop your stream of urine.  Do not contract your abdomen, buttocks or thighs.  Hold this contraction for 10 seconds, then relax for 10 seconds.  Do 10 repetitions, 3 times per day.



If time and exercise do not improve your urinary leakage, there is a surgery that can treat the problem.  It is generally best, however, to wait until you have completed childbearing before undergoing this surgery. 



Remember to discuss all of your symptoms with your OBGYN.  He or she may want to send you to a urogynecologist for further evaluation.