Urinary incontinence

^{Tell your midwife or maternity service if you have concerns urinating or are experiencing urinary incontinence such as the symptoms below:}

What is urinary incontinence?

Urinary incontinence is the unintentional passing of urine.(uncontrolled leakage of pee)

^{Symptoms of urinary incontinence}

pain or blood when you pee - it maybe a urine infection
unable to empty your bladder
leakage or urine despite measures mentioned above
leakage of stools

Contact information for your local maternity service

East and North Hertfordshire (The Lister Hospital): 01438 284 124

West Essex (The Princess Alexandra Hospital): 01279 827 286

South and West Hertfordshire (Watford General Hospital): 01923 217 343

^{Urinary incontinence in pregnancy}

What to expect in pregnancy

1 in 3 women experience urinary incontinence during pregnancy and/or after birth. During pregnancy, hormones make your muscles relax and your pelvic floor stretches in preparation for birth. These hormonal changes are also responsible for your frequent night trips to the toilet. As your pregnancy progresses, the pressure of your baby (or babies) over your bladder can make you leak urine when coughing, sneezing, laughing, running, jumping and lifting weights, such as shopping bags or your own children. Top tip: tighten your pelvic muscles before doing any of these activities.

Just because it's a common problem doesn't mean it's normal, and you can't do anything about it.

Here are some tips for a healthy bladder:

- Do pelvic floor exercises regularly during pregnancy. Click here for information on how to do them

- Drink plenty of fluid to keep you hydrated. Top tip: look at the colour of your pee. The ideal wee should have a good amount with little or no smell, a dribble is not enough.

- Limit the amount of caffeine, fizzy drinks, alcohol, fruit juices and anything that contains caffeine, as they all irritate your bladder and make you need the toilet more often. Smoking also irritates the bladder.

- Constipation is related to urinary incontinence. Pressure from a full bowel and too much strain can weaken your pelvic floor muscles and make it harder to control your urine. Excessive weight gain can also increase the pressure over your bladder. Top tip: Eat a healthy balanced diet with plenty of fibre and exercise regularly.

- When passing urine, pay attention to the flow (weak or slow), feeling of emptiness (do you think you still need to go but you can't?) and hesitancy (trouble starting to pee or maintaining the flow). Top tip: Later in pregnancy, some women find it helps to rock backwards and forwards while they're on the toilet. This lessens the pressure of the womb on the bladder so you can empty it properly.

How Much Caffiene should you take?

You can have caffeine, but no more than 200mg per day. Regularly drinking more than this amount can increase your risk of pregnancy complications, such as low birthweight, and even miscarriage.

There is:

100mg in a mug of instant coffee
140mg in a mug of filter coffee
75mg in a mug of tea (green tea can have the same amount of caffeine as regular tea)
40mg in a can of cola
80mg in a 250ml can of energy drink
less than 25mg in a 50g bar of plain dark chocolate
less than 10mg in a 50g bar of plain milk chocolate

It is normal to have a weak sensation in your pelvic floor after birth, particularly if you had:

a long labour
an epidural
a big baby
an instrumental delivery (forceps or suction cup)
a cut or a 3rd/4th degree tear

Current research estimates that it can take up to a year to fully recover from childbirth.

Some women are scared of peeing after labour. Top tip: you can pour some water when you pee or pee in the shower.

The first few times you pee after giving birth you might find some blood, which usually comes from your vagina (lochia) rather than your bladder. Keep an eye on the colour of your urine, flow, hesitancy and bladder emptiness.

Start your pelvic floor exercises as soon as possible and keep exercising throughout your life, like any other muscle. You might not have much feeling at the beginning, but the earlier you start, the better.

Drink plenty of fluids, keep caffeine to a minimum, and avoid constipation and smoking. Remember to tighten your pelvic floor muscles before lifting your baby or babies, or any other weight. Make sure you go to the toilet regularly. This might be hard when looking after a newborn baby, but you need to look after yourself too.

Some women experience abdominal muscle separation (diastasis recti), which has been linked with urinary incontinence and back pain. Talk to your midwife or GP if you are worried about this.