Pregnancy and childbirth

Understanding more about the impact of pregnancy and childbirth on pelvic floor health can help women* to take positive steps to improve function and reduce the risk of long-term continence issues later in life.

These steps may include regular pelvic floor exercises, healthy eating, seeking a medical clearance before returning to activities and sport, and seeking early support at the first sign of incontinence to promote recovery.

It’s important to seek personalised advice from a qualified health professional to ensure these actions are right for you.

* References to ‘women’ or ‘men’ include anyone with similar health needs, regardless of sex at birth or gender identity. Read our Gender inclusivity statement.

How common is loss of bladder control?

Pregnancy is a time of many changes and it’s natural to receive lots of advice. Few people talk about how pregnancy and childbirth can cause changes to bladder and bowel control.

One in 3 women who have had a baby experience some loss of bladder control, leading to leaking of urine (wee), particularly when they cough, sneeze, laugh, lift or exercise.

Knowing this is common but not normal and that help is available can help you feel more confident and prepared.

Caring for your pelvic floor health is an important part of feeling strong, confident and supported during pregnancy.

Regular pelvic floor exercises before, during and after pregnancy can help with bladder and bowel control and support the organs in your pelvis.

Strong pelvic floor muscles can reduce the risk of incontinence – leaking urine (wee) or faeces (poo) – improve sexual function and help with a smoother recovery after childbirth so you can return to activities with confidence.

Changes you might notice after pregnancy and birth

Carrying a baby through pregnancy can result in weakening of the pelvic floor muscles. In addition, a long labour or difficult delivery may stretch or injure the pelvic floor muscles. As a new mum you might notice:

• leaking urine (wee) when you cough, sneeze, laugh, lift or exercise
• it’s hard to control passing wind
• a strong, sudden need to go to the toilet
• it’s hard to pass faeces (poo) – this may be due to constipation
• it’s hard to clean yourself after passing faeces (poo)
• feeling uncertain about returning to sport because of a fear of leaking urine (wee), or wearing a pad ‘just in case’
• pelvic pain
• unusual or differently shaped faeces (poo)
• stains (poo) on underwear
• passing wind in the vagina, often noticeable as you kneel then stand up
• a feeling of heaviness or a lump in your vagina – this could be a sign of pelvic organ prolapse.

Frequently asked questions

Who is more likely to experience these changes?

Some women may be more likely to have bladder or bowel symptoms, even after an easy birth. This can include those with existing conditions such as irritable bowel syndrome or overactive bladder, or those who have had:

• a large baby
• a long labour, especially during the pushing stage
• a vaginal birth with tears or stitches
• births that resulted in the use of instruments, such as forceps or vacuum.

What is the risk with caesarean births?

While a caesarean birth may lower the chance of severe bladder issues for a first baby, it doesn’t remove the risk entirely, especially after multiple caesareans.

What can I do to prevent incontinence?

Doing pelvic floor exercises before and during pregnancy can help prevent incontinence from starting. Even so, the pelvic floor muscles may stretch during birth. You can protect and strengthen them by:

• squeezing and lifting before coughing, sneezing or lifting
• crossing your legs before coughing or sneezing
• avoid pushing or forcing your urine (wee) out – allow it to empty out without pressure
• being careful not to lift things that are too heavy
• doing regular pelvic floor exercises
• getting a medical clearance from your doctor before returning to activities and sport
• avoiding bouncing exercises.

Will things get better?

Most women see improvement in the first 6 months after birth. The right support from a health professional and regular pelvic floor exercises performed correctly can help recovery.

It’s good to make pelvic floor exercises part of your daily life, because the pelvic floor muscles also weaken with age. This will set you up for good health through the different stages of life. Regular times for pelvic floor exercises may include:

• after you finish on the toilet
• while washing your hands
• while waiting for the kettle to boil or when having a drink
• during a shower
• while waiting at traffic lights.

If you’re not satisfied with the advice from your health professional, you have the option to seek a second opinion from another qualified health professional.

What you can do next

• Learn about pelvic floor exercises and visit the Pelvic Floor First website
• Understand signs of pelvic floor prolapse
• Visit Pregnancy, birth and baby, operated by Healthdirect Australia.

This content has been reviewed by sub­ject mat­ter experts in line with Continence Health Australia’s established process. Read about our clinical content review protocol.