As all mothers know, pregnancy and childbirth brings a lot of changes. There is no part of your mind, body or life that is left unchanged after you have a child! Unfortunately, alongside the joy and love that your baby brings, there can be a lot of less pleasant side effects. One of those, urinary incontinence, can be a particularly unpleasant experience. It is also an extremely normal and common one - 33% of people experience urinary incontinence after giving birth.
It is no wonder that birth causes urinary incontinence. Carrying and delivering a child puts an unbelievable amount of stress on your pelvic floor as well as your bladder. Starting from about the eighth week of pregnancy, the uterus appears to interfere with pelvic floor muscle activity, and pregnancy itself is associated with bladder issues such as decreased urethral resistance, bladder neck lowering, increased bladder mobility and decreased pelvic floor muscle strength. Childbirth with a vaginal delivery also can cause denervation of the pelvic floor muscle, and connective tissues supports of the bladder and urethra can be affected.
Given all this information, it’s not surprising that many new mothers find themselves experiencing one form or another of urinary incontinence. In Inceptive's class, ‘Managing Urinary Incontinence After Childbirth,’ led by Annemarie Everett, PT, DPT, WCS, new mothers can learn what they can do to reduce urinary incontinence and what treatments are available to new mothers with urinary incontinence. Dr. Everett is a board certified Women’s Health Specialist with a doctorate in physical therapy, and has several years of experience helping women through pelvic and pre/postpartum physical therapy.
According to Dr. Everett, there are five types of urinary incontinence: stress, urge, mixed, post-void dribble, and overflow. Only one of these types may be experienced, or a new mother might find herself experiencing a mixture of them, depending on different factors. The treatment for urinary incontinence depends on the type that you have, and in some cases a mixture of treatments might be recommended.
The two best known treatments for urinary incontinence are pelvic floor muscle training (also known as Kegels) and bladder training. Pelvic floor muscle training is often prescribed for stress incontinence, which is when the downward pressure on the bladder exceeds the body’s ability to match it and keep urine in, such as when coughing, sneezing or jumping. Bladder training is often prescribed for urge incontinence, which is when the bladder is triggered to contract and the mechanisms providing continence are unable to prevent urine from leaking out, such as when you put your key in the front door when you desperately need to pee.
However, there is a third treatment that may help new mothers reduce their urinary incontinence. According to Dr. Everett, your diet can have a direct effect on your bladder, and many types of food can irritate your bladder lining, increasing feelings of urinary frequency or urgency. If a new mother is experiencing urinary incontinence, making some dietary adjustments can reduce the likelihood of leaking.
Which foods are bladder irritants? Well, some are not very surprising - spicy foods and caffeinated drinks can irritate a bladder, which you might have guessed, but even decaf coffee and herbal tea can be irritants. Anything with a lot of citric acid, like lemon, can be an issue, as well as carbonated drinks and many fruit and vegetable juices. You may also want to avoid tomatoes, apples, cranberries, dairy, vinegar and artificial sweeteners.
Consider avoiding these probable bladder irritant foods for about a week to see if your symptoms improve. Then slowly every one to two days, add one back into your diet and note any changes in urinary urgency, frequency or incontinence. Even if you decide that you don’t want to completely cut out some of these irritants (and who would blame you for not wanting to cut caffeine out again!), reducing their intake or simply knowing what they are and the effect that they have can help you regain a sense of control.
This type of dietary adjustment can help new mothers with both urge and stress incontinence, and is often prescribed in conjunction with one of the other treatments previously mentioned. Most mothers find that their pelvic floor muscle returns to normal function within a year of delivery, so don’t worry, these changes are not usually permanent! They just require a little effort and understanding, not to mention some treatment, to resolve.
In tackling urinary incontinence after childbirth, there are a lot of options out there for new mothers, as well as plenty of specialists that can help create a treatment plan that is personalized for your needs. For more information about the other treatments available for urinary incontinence, enroll in Dr. Everett’s class ‘Managing Urinary Incontinence After Childbirth.’
 Thom, David & Rortveit, Guri. (2010). Prevalence of postpartum urinary incontinence: A systematic review. Acta obstetricia et gynecologica Scandinavica. 89. 1511-22. 10.3109/00016349.2010.526188.