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Is stress incontinence a serious condition?
Q: I’ve read about a condition called stress incontinence, where you seem to leak a little bit of urine throughout the day. Is this a major condition that I need to talk to my doctor about right away, or can this wait until my next appointment? I am seven months along. I’ve been under some stress lately, and my daughter is kicking.
Jolene Springfield
A: Incontinence refers to loss of urine, which can be from extra pressure on the bladder, loss of pelvic muscle support and problems within the bladder itself, such as a bladder infection. Stress incontinence means that physical stress on the bladder causes the bladder to release urine. The bladder is a balloon-shaped muscle that expands as it fills with urine. Urine is released when your bladder muscle contracts. Extra pressure on the bladder (for example, from coughing, sneezing or, in your case, a baby’s kick) can stimulate your bladder muscle to contract, resulting in a loss of urine. Up to 50% of pregnant women experience some loss of bladder control during pregnancy.

You can minimize this problem by strengthening the muscles that support the pelvis—ask your health care provider about Kegel exercises or refer to my article on this topic on this web site. While loss of urine is unpleasant, it’s not considered an emergency, and you can wait to talk to your doctor about it at your next visit. Most women find that stress incontinence continues for several weeks, or months, following delivery. This is especially likely if your labor is prolonged, your baby is large and delivers vaginally and if you have a large episiotomy. With consistent exercise and time, most women find that bladder control eventually returns to normal. If it doesn’t, you should seek further medical evaluation.
Laura E. Stachel M.D. Obstetrician & Gynecologist