What is postpartum stress incontinence?

While it sounds like something caused by the mental and emotional stress of having a new baby, stress urinary incontinence is the term for the involuntary loss of urine caused by physical movement or activity. That can include coughing, sneezing, exercising, laughing, sex, or even just a brisk walk. It has nothing to do with psychological stress, although it can cause plenty of it. Stress incontinence is different from urge incontinence, which is the unintentional loss of urine caused by the bladder muscle contracting. When that happens, you usually feel like you really need to pee. Stress incontinence comes out of nowhere, without an urge.

Following pregnancy, changes to the tissue in the pelvis and the pelvic floor muscles can cause the urethra and the base of the bladder to be improperly supported. “The junction doesn’t hold tight, so if someone jumps, laughs, coughs, or sneezes, whatever is in the bladder comes out,” Dr. Lauren F. Streicher, MD told me. She’s a clinical professor of obstetrics and gynecology at Northwestern University and oversees the Northwestern Medicine Center for Sexual Medicine and Menopause.

There are multiple risk factors that can lead to this type of postpartum bladder leakage. Streicher outlined some of them, which include a genetic predisposition, long labor, a big baby, or forceps delivery. Streicher noted that there are some women who request C-Sections in order to avoid the pelvic floor becoming incontinent, although stress incontinence can still occur, even if you opt out of traditional delivery. “Having a C-Section and avoiding labor can be protective, but it is certainly no guarantee,” Streicher explained. And of course, long labor or large baby is also not a guarantee that you’ll end up with stress incontinence since, as Streicher told me, there are plenty of women who push out nine-pound babies and don’t have problems with incontinence.