Perinatal depression and anxiety awareness week

One in seven new mothers experiences postnatal depression in Australia. This amounts to around 100,000 cases of women diagnosed each year.

On the surface, bladder leakage may seem a trivial matter, but there is considerable research linking it to depression, including postnatal depression.

Recent research in Canada revealed that women who experience incontinence after childbirth are nearly twice as likely to experience post natal depression as other new mothers (Sword et al 2011).

Recent research from the University of Adelaide (Avery et al. 2013) found that younger women's mental health was often hit hardest by urinary incontinence, while older women tended to be more resilient and accepting of the condition. These results supported the findings of a Norwegian study (Felde, 2012), which showed that urinary incontinence was associated with high levels of depression and anxiety in women aged 40–44 years.

This finding that younger women struggled more than older women might be due to the (mistaken) assumption that incontinence was an older woman’s condition, according to Jodie Avery, author of the University of Adelaide study.

Despite common beliefs, more than half the women in Australia living with incontinence are under 50 years of age. Dr Avery found that the key issues for younger women affected by incontinence were family, sexual relationships, sport and leisure activities.

According to Ms Avery’s s study, 20 per cent of the incontinent population had depression, much higher than the rest of the population (estimated at between 0.8 and 9.6 per cent by the World Health Organisation).

Like depression, there is still a stigma attached to incontinence, with only about 70 per cent of people affected seeking professional help, despite the fact that incontinence is preventable and easily treated in most cases.

Health promotion officer with the Continence Foundation of Australia Danyel Walker said there was much that could be done to prevent and manage incontinence.

“When you consider it can impact a person psychologically as well as physically, it’s even more important people acquire good bladder and bowel health practices,” she said.

In the majority of cases, preventing incontinence was simply a case of protecting the pelvic floor.

“Avoid activities that stretch your pelvic floor or force you to push down on it – like heavy lifting, high impact sports, straining on the toilet due to constipation, chronic coughing or gaining excessive weight.

“And of course, doing your pelvic floor exercises every day will strengthen the pelvic floor muscles, which, like any other muscles, can be made stronger with regular exercise,” Ms Walker said. 

She also acknowledged the important role exercise played in general health and wellbeing, and directed readers to, which provides information on pelvic floor-safe exercises. 

Incontinence is one of Australia’s biggest health issues, more prevalent than asthma (2 million), anxiety disorders (2.3 million) and arthritis (3.1 million), with 4.8 million, or one in four Australians over the age of 15, affected.  (Deloitte, 2011)

Sometimes conservative measures aren’t enough to manage more severe cases of incontinence, and help is available through the Continence Foundation’s National Continence Helpline (1800 33 00 66), which is staffed by continence health nurses who provide advice, information and referrals to the public and health professionals. 


Post and Antenatal Depression Association (PANDA)

Sword, W., C. K. Landy, et al. (2011). "Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study." BJOG 118(8): 966.

Avery et al. BMC Urology 2013, 13:11

Felde G, Bjelland I, Hunskaar S. Anxiety and depression associated with  incontinence in middle-aged women: a large Norwegian cross-sectional study. Int Urogynecol J 2012; 23 (3): 299-306.

The economic impact of incontinence in Australia, Deloitte Access Economics 2011