Leaking urine after childbirth: when it’s normal and when to worry

Most women have heard that it’s normal to leak a little urine after you’ve given birth to your baby. While that is definitely true, it doesn’t mean that all urine leakage is created equal. Some types of urine leakage, or urinary incontinence, are abnormal and should be discussed with your doctor.

There are three main kinds of urinary incontinence after delivery:

• Stress incontinence
• Urge incontinence
• Mixed (which is when you have both)

Stress incontinence is the kind most women think about after giving birth: this is when you leak urine with activities like jumping or sneezing. Urge incontinence is the feeling of having to go to the bathroom immediately and without warning, and then you leak on the way to the bathroom.

Any type of incontinence can cause stress for a woman, and usually the worse the leakage, the worse the quality of life. With about 25 percent of women being affected by urinary incontinence, and only about 45 percent of women seeing their doctors about it, this leaves a lot of women who are not being treated and who are suffering in silence.

Urinary incontinence can lead to embarrassment, avoidance of sex, social isolation, rashes, or urinary tract infections. This is why getting a diagnosis and treatment plan is so important.

Leaking urine after childbirth can be considered normal if it is small in amount and does not interfere with a woman’s daily activities. It also usually gets better as more time passes from giving birth.

However, a woman should tell her doctor or midwife if she is leaking large amounts of urine, if she can’t make it to the bathroom in time, if she is having trouble emptying her bladder, has any concerns for infection, or if she has continuous urine leakage. The last symptom is especially important as this may represent a fistula, or an abnormal connection that has developed from the bladder to the vagina. This sometimes happens after especially prolonged or traumatic deliveries, and if missed can cause serious problems.

Certain situations can put a woman at risk for urinary incontinence: giving birth vaginally, pushing for a long time, having a larger baby, and being a smoker are just a few.

Your doctor can do a variety of things to figure out what is going on. She may check your urine for an infection and do a pelvic exam, and this may be all that is needed. Sometimes a test is done where you urinate with or without a catheter in your bladder see how your bladder is working and if it is emptying properly. Some women may be referred to specialists who have expertise in this field, known as urogynecologists.

Treatment depends on how severe the incontinence and what type it is. It may include pelvic floor physical therapy to strengthen your muscles and help them work effectively, decreasing the amount you drink, medication, or surgery.

The good news is that urinary leakage is often very treatable for women who experience it related to childbirth. All women should be screened at their postpartum visit for this complication, but don’t be afraid to bring it if your doctor or midwife doesn’t. Tell your doctor or midwife if you have concerns so you can get on to the road to recovery.