Leaking After Having a Baby? You Don't Have to Put Up With It

"It's just what happens after kids." I hear this all the time - and while leaking after having a baby is really common, it's not something you have to accept for the rest of your life.

Around 1 in 3 women experience some bladder leakage after having a baby. Pregnancy and birth put a lot of strain on the pelvic floor, the group of muscles that support your bladder, bowel and uterus. Whether you had a vaginal birth or a C-section, those muscles have been through a lot.

What kind of leaking is it?

There are two main types of bladder leakage:

• Stress urinary incontinence - leaking when there's pressure on your bladder, such as when you cough, sneeze, laugh, jump, run or lift.
• Urge incontinence - a sudden, strong need to wee that's hard to put off, sometimes with leaking before you reach the toilet.

Many women have a mix of both. Understanding which type you have is important, because the right treatment is different for each.

The good news: it often gets better with the right help

NICE (the National Institute for Health and Care Excellence) recommends a programme of supervised pelvic floor muscle training, for at least three months, as the first treatment for stress urinary incontinence.

The key word is supervised. Lots of women are told to "do your pelvic floor exercises" but never shown how. Without feedback, it's easy to squeeze the wrong muscles, hold your breath, or push down instead of lifting up - which can make things worse.

Things you can start doing today

• Keep drinking. It's tempting to cut down on fluids, but concentrated urine can irritate your bladder. Aim for around 6-8 glasses a day, spread through the day.
• Avoid "just in case" wees. Going to the toilet too often can train your bladder to hold less.
• Look after your bowels. Constipation and straining put extra pressure on your pelvic floor.
• Try the NHS Squeezy app. It's a helpful reminder to do your pelvic floor exercises regularly.
• Squeeze before you sneeze. Tightening your pelvic floor just before a cough, sneeze or lift can help reduce leaks.

When to see a pelvic health physiotherapist

Honestly? Whenever leaking bothers you. There's no need to wait until it's "bad enough". You might want to book if:

• You leak when you cough, sneeze, laugh or exercise
• You've stopped doing activities you love because of leaking
• You feel a heaviness or dragging sensation in your vagina (this can be a sign of prolapse)
• You want to return to running or high-impact exercise
• You're not sure whether you're doing pelvic floor exercises correctly

A Mummy MOT is a great place to start if you've had a baby - whether that was 6 weeks or 16 years ago. Once postnatal always postnatal. If leaking is your main concern, a gynaecology assessment is also a good fit.

When to speak to your GP

Please contact your GP if you notice blood in your urine, pain or burning when you wee, or a fever, as these can be signs of infection.

Go to A&E immediately if you develop new numbness around your genitals, bottom or inner thighs, difficulty passing urine, loss of bladder or bowel sensation, or sudden unexplained loss of bladder or bowel control, especially with new back or leg pain. These can be signs of a serious spinal nerve problem. Do not wait for a routine appointment. Read the NHS advice on these warning signs.

You don't have to live with leaking. If you'd like help, book an appointment at our Bramhall or Northenden clinic.

– Bex Rotheram, HCPC registered specialist pelvic health physiotherapist