Postpregnancy incontinence isn't a subject that new mothers are exactly dying to talk about, but it's quite common. Around 40 percent of women experience stress urinary incontinence—the involuntary loss of urine when coughing, sneezing, laughing, or doing physical activity—after giving birth.
During pregnancy, the uterine and vaginal muscle and tissue that help support the bladder are stretched and weakened due to the added weight of the baby and hormonal changes, and some pelvic nerves may be damaged from labor and delivery. Luckily, the condition, which is more common in women who've had more than one pregnancy, usually rights itself with the help of regular Kegel exercises (squeezing the vaginal muscles that help strengthen the pelvic-floor muscles). The National Association for Continence recommends working up to three sets of 20 short and 20 long contractions daily. Some women report less leakage in as little as three weeks after starting the exercises, although it can take up to six months to regain total control.
Until the condition is resolved, talk to your doctor about using a urethral insert (a tampon-like disposable plug) or trying special foam pads or silicone caps that fit over your urethral opening to prevent leakage.
If the problem persists beyond six months, even after you’ve tried doing Kegel exercises, see your ob-gyn, who may suggest collagen injections near the urethra to help keep the area taut; these help controls leakage. Because collagen breaks down, the injections need to be repeated every three to five years.
In rare cases, surgery may be necessary.