Yes, Pregnancy Leaks Are Common (But No, You Don't Have to Live With Them!)

If you've ever laughed, sneezed, or simply stood up while pregnant and felt that unmistakable "whoops" moment—you're in good company. Leaking pee during pregnancy or after birth is so common that it is often treated like a fact of life.

But just because something is common doesn't mean it should be your new normal. Your body is doing incredible things, and with the right support, those surprise leaks don't have to be part of your pregnancy story.

What Causes Pregnancy Incontinence?

During pregnancy, your body undergoes transformations that can put your pelvic floor—the hammock of muscles at the base of your pelvis—through quite the workout. This can contribute to leakage, which is called “urinary incontinence.” Three main factors contribute to those unexpected leaks:

• Your growing baby puts increasing pressure on your bladder (hello, third-trimester bathroom trips!)
• Pregnancy hormones naturally relax your tissues to prepare for birth
• Your pelvic floor muscles can become stretched and sometimes overwhelmed by these changes

These factors can lead to two different types of leakage during pregnancy–stress incontinence and urge incontinence:

1. Stress Incontinence: The Sneeze-and-Leak Situation

Stress incontinence is leakage that happens when you cough, sneeze, or jump. During a cough or sneeze, there is a strong involuntary downward pressure on the pelvis, and if the pelvic floor muscles are not braced for impact then this can cause pee to come out. To prevent this, it’s important to train your pelvic floor muscles to contract, or Kegel, to brace against the pressure of these movements. 

Pelvic Floor Strengthening Exercises (Kegels) for Bladder Leaks

To contract your pelvic floor, imagine you are trying to stop the flow of urine, or trying to prevent a tampon from coming out. If you aren’t sure if you are doing it,  place a finger into your vagina and squeeze tightly. It should feel like an even squeeze from all sides, with an upward lift. If you can do this, try making a few quick “shh” sounds while holding the squeeze, then letting go. This simulates a cough or sneeze. You can also practice holding while bouncing on a yoga ball. Just like any other exercise, you don’t want to overdo it at first– just perform a few in row, then rest. Make sure to relax your pelvic floor when you finish– if your muscles are clenching too much, they may be too fatigued to do a stronger contraction when it is needed. If you have difficulty performing this movement, or aren’t sure if you are doing it right, a pelvic physical therapist can help.

2. Urge Incontinence: The "I Can't Wait" Rush

The other type of leakage is called “urge incontinence”, which is when you suddenly get a strong urge to go to the bathroom and leak on the way to the toilet. This happens when the pelvic floor muscles are squeezing too tightly and pushing on the bladder, causing it to contract prematurely. Urge incontinence tends to happen with specific triggers. These can be behavioral triggers, such as when you first get home from work or right after you lay down in bed at night, or dietary triggers like after drinking caffeine or carbonated beverages which can irritate the bladder, causing it to contract. Peeing more frequently is totally normal during pregnancy, but the leaking part is preventable. The trick here is to help your pelvic floor muscles relax, and to train your bladder not to jump the gun. 

Pelvic Floor Relaxation and Stretches to help with urge incontinence

If you are experiencing urge incontinence, start by taking a few deep breaths focusing on expanding and relaxing the pelvic floor. If you are fearful of leaking, many folks react by trying to squeeze these muscles constantly, which is counterproductive since they will just fatigue. Performing stretches that open up the base of the pelvis, such as happy baby or child’s pose with the knees apart, can help to decrease pelvic floor tension. While in these positions, try inhaling deeply into the belly, and see if you can feel expansion all the way down to the bottom of the pelvis. If there is significant tension down there, you may benefit from rolling on a tennis ball in the tight areas between the sit bones and anus, and around the lower glutes. 

Other Strategies to Reduce Urinary Urgency

Another thing to keep in mind is that unless your bladder is extremely full, the urge to go pee will usually lessen after a few minutes, especially if you can distract yourself. You have probably experienced this before– maybe you noticed you needed to pee but then got caught up in a task or a conversation and forgot to go for a while, and then realized you didn’t think about it for a while. So if you suddenly feel the urge to go when you first get home, try to distract yourself for a few minutes – maybe unload the dishwasher, or work on a task that takes more focus, like a crossword puzzle– and then calmly walk to the bathroom when the urgency has reduced. Running to the toilet while at the peak of your urgency is much more likely to lead to a leak. 

On top of caffeinated or carbonated beverages, some folks find that foods and drinks with artificial colors/flavors, or particularly spicy or sour foods can cause their symptoms to worsen. Try to notice if your symptoms are worse at a particular time of day. A common example is that symptoms are bad after morning coffee. If you do identify a trigger, try to either find a substitute for that item, or consider drinking more water when you have that food or drink. This can help to dilute your urine so that it is less irritating to the lining of the bladder. Many people restrict liquids to avoid leaking pee, but this can be counterproductive, since it makes urine more concentrated and therefore more irritating to the bladder. During pregnancy, drinking enough fluids is particularly important, for the health of both you and your baby!

Does Leaking Pee Resolve After Giving Birth?

Childbirth relieves urinary incontinence for some folks, while worsening it (or starting it) for others. How it changes depends on many factors, such as if you give birth vaginally, and if you experience any complications such as tearing or bladder damage. It is also common for incontinence to worsen for a few weeks following labor but then resolve itself as the tissues heal and swelling goes down. However, if you are several weeks (or several months/years) postpartum and are still experiencing urine leaks, you are definitely not alone! Don’t worry, there are still treatment options available.

What if I Need More Help?

If you are not having any luck resolving your leakage with the tips above, or if you are further postpartum and still are experiencing incontinence, reaching out to a pelvic physical therapist is a great option for a more individualized approach. There are also medications and other medical interventions that your gynecologist can explore with you. And in the meantime, you may want to consider purchasing some pads designed specifically for holding urine, because they will work much better than a menstrual pad to help keep you dry and comfortable. The most important thing is that you are still able to participate in the activities in your life that are important to you!