Urinary incontinence and involuntary urination in a woman during pregnancy: why does leakage occur and what to do? Urine leakage during pregnancy.

Urinary incontinence refers to a pathology that does not allow a person to control this process. In such a situation, full urination occurs involuntarily, without human control. However, incontinence during pregnancy has its own characteristics and causes.

Can urine leak periodically during pregnancy?

Basically, this phenomenon is absolutely physiological, determined by the state of the body, and goes away on its own after the baby is born. However, sometimes it indicates the presence of pathologies that need treatment.

How to distinguish between urinary incontinence and water leakage, which occurs during pregnancy? What to do in this case and is it possible to cure this deviation?

Symptoms of urine leakage in women during pregnancy

Research results indicate that about a third of all women suffer from this disorder during pregnancy, and in the last trimester - about half.

Moreover, this phenomenon can occur at any time.

1. Some ladies don't even notice this, because the portions of urine are negligible and mix with natural vaginal secretions. But sometimes women notice wet spots on their underwear, and it happens that they become completely wet. As a result, you have to constantly change clothes and wear pads;
2. Often, incontinence occurs when the muscles of the abdominal wall are tense: when coughing, sneezing, blowing your nose, physical activity, etc. Underwear can get wet when rising from a chair or bed, squatting and bending over;
3. Symptoms of leakage include the sensation of not emptying the bladder completely during normal visits to the toilet, including at night. In the last trimester, especially before childbirth, the urge becomes more frequent, the volume of urine increases significantly, but the portions released at a time are reduced. In the last weeks of gestation, the passage of urine becomes significantly more difficult due to strong compression of the bladder.

Why does urine leak periodically during pregnancy?

This phenomenon can be explained quite easily. The first reason is relaxation of the muscles, including the vagina and bladder. This occurs under the influence of progesterone, which begins to be more actively produced before childbirth. As a result, it becomes more difficult to restrain yourself. If the perineal muscles are already weak, then leakage increases noticeably.

As gestation progresses, bladder tension increases. The uterus growing along with the fetus puts pressure on it, which leads to compression of the walls of the organ and relaxation of its sphincter.

On the other hand, the amount of fluid released increases, and accordingly, the number of urges to go to the toilet increases, and the bladder regularly overflows. Often the urge to go to the toilet occurs very suddenly, the woman does not even have time to get to it.

Incontinence can occur even in early pregnancy and is sometimes regarded as one of the first signs of successful conception. In the second trimester, this phenomenon occurs less frequently, but is still sometimes diagnosed. In most cases, women suffer in the last months, when the bladder experiences the greatest stress. In addition, urine may leak when the baby moves.

The problem is aggravated when the fetus is presented incorrectly, for example, oblique or transverse, as well as when it is large. The risk group includes women who are not distinguished by physical endurance, that is, inactive, as well as those who have already given birth and those who have recently had childbirth. In the latter case, the muscles simply do not have time to recover from the previous pregnancy.

How to eliminate urine leakage that occurs during pregnancy?

Since this phenomenon is temporary and has a physiological etiology, specific therapy is not expected. The only exceptions are infectious and inflammatory processes, which include this condition in their symptoms. If you want to sneeze or cough, you need to cover your mouth. This will reduce the pressure on the diaphragm and bladder. In a standing position, you need to lean forward slightly, bending your knees slightly.

Many pregnant women practice limiting the amount of fluid they consume, fearing
worsening the problem. However, this can negatively affect the condition of the woman and her child. Every day you need to drink up to one and a half liters of ordinary water, unless, of course, there are contraindications, for example, edema.

However, in the evening you can try to restrain yourself a little, but do not give up drinks completely. Your doctor may recommend the use of a prenatal bandage.

This product will reduce the load on the spine, lower back, internal organs, including the urinary system. You should not lift weights during this period, even if there are no urine leaks.

If you feel incomplete emptying, you can try one effective technique: at the end of the procedure, lean forward a little. This will allow you to empty yourself to the maximum. Ah, you shouldn’t endure and restrain yourself.

As for traditional medicine recipes, during the gestation period they are used only as prescribed by a doctor, since herbs that are harmless in normal times can now pose a danger. It is worth noting that there are many plants that help cope with this problem, but you should first consult with a gynecologist about the advisability of their use.

Why you need to do exercises for urinary incontinence

The world-famous Kegel exercises will help restore tone to the muscles of the perineum and, accordingly, get rid of the problem. Gymnastics involves several exercises that are approved for use during pregnancy. For example, during this period the following training is acceptable: having started to empty the stream, hold the stream for a while, and then continue until the end, but with pressure. But before you start doing gymnastics, you need to make sure that this is allowed during pregnancy. It is better to consult with your pregnancy doctor.

Otherwise, when urine leaks, you only need to maintain hygiene and change your underwear or pads in a timely manner. It is worth noting that panties should be made only from natural fabrics. It is better to use gaskets in extreme cases, for example, when going out into the city. This is due to the fact that such hygiene products contribute to the development of thrush, colpitis and other gynecological diseases, which is extremely undesirable in this situation.

Pregnancy is not only a wonderful time of waiting, but also a time of serious stress on internal organs, especially the pelvic region. During this period, changes in urination are observed; it may become more frequent and not always completely controlled.

Urinary incontinence in various forms is detected in more than 60% of expectant mothers, in most cases it is considered normal if it does not indicate the development of pathology or leakage of amniotic fluid.

Types of urinary incontinence

Involuntary urination has a certain classification, in relation to which the following types of urinary incontinence during pregnancy can be distinguished:

The classification is conditional and when making a diagnosis, if problems with the bladder are pathological in nature, the syndrome is called a special medical term.

Causes of incontinence during pregnancy

Conceiving and carrying a child is accompanied by hormonal changes that affect the functioning of all organs, including the bladder. It is for this reason that uncontrolled urine output may occur, muscle elasticity may change, the rate of metabolic processes, the functioning of the kidneys and other systems may change.

In addition to hormonal imbalance, provoke urine leakage during pregnancy The following factors may:

The causes of incontinence can be natural processes occurring in a woman’s body and not being dangerous, but there are provoking factors that require elimination and subsequent monitoring.

What are the manifestations of the disease?

A woman may exhibit both obvious signs of incontinence and moderate ones, when urine leaks are scanty and almost unnoticeable against the background of discharge accompanying pregnancy. Typical symptoms of incontinence include:

• , it is difficult to hold back urination;
• a feeling of urine leaking when coughing, laughing, or minor exertion;
• uncontrolled leakage of urine, including at night.

If incontinence is critical, a lot of urine is released or there is no urge, and urine flows out spontaneously, you should additionally consult a doctor.

How to distinguish urine from water leakage?

Any questionable or copious discharge in a pregnant woman should cause some concern, as these may be signs of a violation of the integrity of the amniotic sac. There are several differences between urine and amniotic fluid.

The main ones are smell and color; more often the waters are colorless, odorless, unless pathology is present and they are dark or green. In such cases, you should immediately call an ambulance. Continuous leakage may also indicate water.

To accurately determine water leakage, there are devices that are used even in medical institutions and can be freely purchased in pharmacies.

Diagnostic measures

If incontinence occurs frequently and the symptoms are intense, then a special diagnosis is carried out for the woman. It differs slightly from the standard list of activities, especially if the pregnancy is short. Typically, the patient is referred for the following diagnostic procedures:

In late pregnancy and serious problems of urinary incontinence, other hardware tests may be used. Manipulations pose a risk to the baby and are used in exceptional cases. It is possible to study the dynamics of urination when carried out by measuring the speed and overall dynamics of urine excretion.

After determining the cause of incontinence, a treatment regimen for the woman or measures are selected to prevent and develop such problems.

Treatment while expecting a baby

If, after diagnosis, pathological processes are identified, then a treatment regimen is selected aimed at eliminating the provoking factor. For example, if there is an infection in the body, the spread of which has led to inflammation of the bladder and its dysfunction, then antibiotics are selected.

It is important to cure the disease in a timely manner, otherwise there will be consequences not only for the woman, but also for the unborn child.

For incontinence caused by natural changes in the expectant mother, the following treatment is primarily prescribed:

1. , helping to train the muscles of the perineum. Such gymnastics will be useful not only for controlling urination, but also in the future for the birth process. The principle of their implementation is to periodically tense and relax the muscles, vagina and urinary tract.
2. Using a bandage. The doctor may recommend the use of a bandage already in the second trimester, thereby reducing compression of the bladder and making it easier to bear the load.
3. Bowel control. Evacuations should be daily. If there are problems with this, you should reconsider your diet and, if necessary, use special means.
4. Bladder training. It consists of determining the intervals for going to the toilet, for example, not every 15-20 minutes, but only after 40 or an hour, and then sticking to this schedule. Sometimes incontinence is associated with an emotional aspect, when a woman is simply afraid of getting into an unpleasant situation and plays it safe with frequent visits to the restroom.

The given treatment will be effective only in the absence of serious diseases of the urinary system. If organ hyperactivity associated with tissue dysfunction and inflammation is detected, then conservative therapy includes.

It has a separate category, but even herbal remedies should be used with caution and in consultation with your doctor. Some herbal preparations have a wide spectrum of action and can provoke negative consequences during pregnancy.

It is important not to self-medicate, as there is a risk of not only aggravating the situation, but also a critical situation for pregnancy. There is a possibility of leakage of amniotic fluid, rather than signs of incontinence.

Prevention of pathology

It is impossible to completely eliminate incontinence during pregnancy if no measures were taken to prevent gynecological diseases and disorders of the genitourinary system before conception.

As practice shows, women who led an active lifestyle and took timely measures to eliminate pathological processes in the pelvic area are less susceptible to problems with urination during pregnancy.

During pregnancy, to reduce the risk of incontinence symptoms or minimize their manifestations, it is recommended:

1. Choose your diet wisely. Smoked foods, coffee, and a lot of citrus fruits can further irritate the bladder.
2. Moderate physical activity, if there are no special contraindications. Organize, for example, outdoor exercise, walking, Kegel exercises and other activities that help maintain muscle elasticity.
3. Regulating fluid intake, there should be enough of it, but not an excess. You should aim for 2-2.5 liters.
4. Wearing a bandage on the recommendation of a doctor. There is no need to wear it on your own, since during some stages of pregnancy this product may interfere with the free movement of the baby, including taking a head-down position before childbirth.

Although urinary incontinence is a problem that is not convenient to talk about, it is imperative to report it to the supervising specialist. This will help to adjust the method of introducing pregnancy, eliminating the possibility of leakage of amniotic fluid, which is critical for the unborn child.

Pregnancy is a unique period, full of pleasant expectations and minor worries. In addition to joyful impressions, the expectant mother will have to experience a number of unpleasant emotions from dizziness and nausea, loss of appetite.

One of the unpleasant conditions isurinary incontinence during pregnancy, which can begin already in the first trimester, from about 14 weeks. Usually incontinence during pregnancyis not considered a pathology, but there are exceptions, so if symptoms appear, you should consult a doctor.

It is important to understand that incontinence urine in women and leakage are different pathologies. First – no urge to urinatein pregnant womensome amount of urine is released. The second is that a couple of drops of urine are released a short period after urination.

Both conditions make life difficult for pregnant women girls , impose restrictions on the duration and frequency of walks, and social activity. Women have to use sanitary pads, change their underwear frequently and find themselves in embarrassing situations, which spoils the beauty of this magical period. To try to eliminateurinary incontinence during pregnancyyou need to determine what type of pathology it is:

• enuresis against a background of stress. It is observed with a slight increase in pressure in the peritoneum. Even minor physical activity leads to tension in the peritoneum, which provokes involuntary release of urine. Incontinence may occur when coughing and laughing, when sneezing and temperature changes (when a woman leaves a warm room to go outside in winter);
• Urge incontinence. The condition is caused by an overactive bladder. Provoke spasms in the m obviously a bladder and the desire to empty it can be the sounds of pouring water or the sound of raindrops hitting the glass;
• leakage - the release of a very small volume of liquid, just a couple of drops of urine. If the tone of the bladder is increased, this leakage becomes chronic, and the volume of urine produced gradually increases.

Why does incontinence occur in pregnant women?

Many women have to deal with incontinence alreadyin early pregnancy, this condition for some even serves as a signal about the conception of a child (usually during the second and subsequent pregnancies).

The reason for this condition is if earlier no leakage was observed, there may be hormonal changes - the ovaries of a pregnant woman produce a lot of progesterone, which is responsible for the elasticity of the organs in the pelvis.

At the same time, the muscles stretch, the tone of the bladder increases.

In the second period andin later stages(35 weeks or more) urinary incontinence in pregnant womencaused by the following factors:

• the child grows in the womb, the volume of the uterus increases, which puts pressure on the bladder. Due to this pressure, the functions of the bladder are limited, not all urine flows out during urination, so a few drops may be released after visiting the toilet;
• the changed hormonal background stimulates an increase in the volume of fluid in the pregnant woman’s body, the kidneys do not have time to remove it;
• enlarged uterus to last period puts pressure on the urethra, which leads to the release of small portions of urine very often. If we add to this the high tone of the bladder walls, this is fraught with voluntary urination;
• incontinence during The last trimester is provoked by the active movements of the baby, who is already quite large and can put a lot of pressure on the mother’s bladder. This leads to urine leakage.

In addition to the listed factors that provokepregnancy urinary incontinencemay be caused by the presence of certain diseases:

• syphilis, gonorrhea;
• exacerbation of chronic ailments (pyelonephritis, renal failure);
• cystitis and other inflammatory processes in the organs of the urinary system.

Other causes of incontinence include:

• anomalies in the structure of organs in the pelvis;
• physical condition and health of the pregnant woman;
• child's size;
• if little time has passed since the previous pregnancy;
• excessive increase in body weight of the expectant mother during pregnancy.

Does incontinence go away after childbirth?

If a woman suffered from incontinence during pregnancy, constantly bought pads and infringed on her interests, it is logical that she expects to get rid of the pathology after delivery.

It also happens that childbirth provokes urinary incontinence in the future. A child, passing through the birth canal, disrupts the anatomy of the muscles of the pelvis, bladder, and urethra:

• the muscles responsible for the release of urine are compressed;
• blood circulation in organs in the pelvis is disrupted;
• the transmission of impulses from the bladder to the brain decreases.
  

Difficult labor with multiple ruptures also causes temporary loss of sensation and involuntary urination.

Do I need to see a doctor?

To be calm about your own and your child’s health, a woman must consult a doctor about any changes in the body. The gynecologist will conduct a standard examination, listen to complaints, and based on the condition of the mucous membranes, may suspect the presence of pathologies.

If necessary, a general analysis of urine and blood is prescribed. If the results reveal an increased level of white blood cells, this may indicate diseases of the genitourinary system. If an infection is suspected, a smear is taken to identify pathogens; other diagnostic measures may be prescribed:

• Ultrasound of organs in the pelvis without contrast agent;
• CT scan of the urinary tract;
• MRI in the 2nd and 3rd trimester.

Careful diagnosis is necessary to exclude relapses of chronic pathologies.

How to eliminate urinary incontinence in a pregnant woman

Treatment of pathology is carried out after identifying the cause. If viruses or bacteria are present in urine tests, gentle antimicrobial drugs are prescribed, since not all medications are approved for pregnant women.

If a doctor identifies a weakened immune system in a pregnant woman, he prescribes her a complex of vitamins specially designed for pregnant women. Incontinence caused by natural causes does not require medication, and to help a pregnant woman, a doctor may recommend:

• wear a support bandage and special underwear to prevent the skin from stretching and the bladder from being compressed;
• At night you need to limit the amount of liquid you drink. It is better to eat an apple shortly before bed or drink half a glass of kefir;
• eat less fatty and smoked foods, so as not to provoke thirst;
• drink a weak rosehip decoction and dill infusion. It is better not to try other herbal decoctions, since during pregnancy, herbs can negatively affect the fetus. All procedures and medications can only be tried after the approval of the attending physician.

If a pregnant woman experiences leakage in the later stages, she should urgently consult a gynecologist to determine whether the leakage is urine or amniotic fluid. Pregnant women shouldn’t worry too much, so you shouldn’t invent non-existent diseases.

Questions should be addressed in the doctor's office. The specialist will provide comprehensive support - explain the cause of the pathology, give recommendations on how to reduce its manifestations, and answer your questions in full.

The most wonderful period in a woman’s life is pregnancy, the time of waiting to meet her baby. During the period of bearing a child, the expectant mother, in addition to joyful emotions, experiences all the symptoms of toxicosis: nausea, dizziness, lack of appetite. Urinary incontinence during pregnancy also causes a lot of inconvenience, often appearing already in the first trimester. This condition occurs in many women and is usually not considered a pathology, but there are exceptions. Therefore, if you leak urine during pregnancy, you should immediately consult your gynecologist.

Types of urinary incontinence

Sometimes incontinence and leakage are interpreted in the same way, meaning involuntary urination. But these are completely different urinary disorders:

• Incontinence is the release of an arbitrary volume of urine without the urge to urinate.
• Leakage is the release of a few drops of urine a short time after urination.

Both processes significantly complicate the life of a pregnant woman and even limit long walks: for a comfortable state of mind, a toilet stall should always be nearby. Urinary incontinence during pregnancy forces girls to use urological pads and often change underwear, and this also causes inconvenience. To reduce the frequency of unwanted urination and leakage, you should determine the type of unpleasant phenomenon:

• Stress incontinence. Occurs with a slight increase in pressure in the peritoneal cavity. Minor physical activity provokes tension in the anterior wall of the peritoneum, causing involuntary urination. Incontinence can occur when you sneeze, laugh or cough heavily, and sometimes when there is a sudden change in temperature. For example, when a pregnant woman leaves the house during the cold season.
• Urge incontinence. The cause of this condition is bladder overactivity of various etiologies. A pregnant woman may feel a strong urge to urinate when she hears the sound of water dripping from a faucet or the sound of rain hitting a window pane. Sometimes experts classify enuresis as this type. Enuresis is usually diagnosed in childhood, but also occurs in some adults.
• Leakage. Small leakage is more common when the volume of urine produced does not exceed a few drops. With increased tone of the bladder, leakage becomes chronic with large volumes of urine discharge.

Doctors also identify full bladder syndrome. When visiting the toilet, a pregnant woman cannot empty her bladder completely. And after a short time, urine is released in small portions.

Causes of incontinence and urine leakage in pregnant women

Many women begin to experience urinary incontinence in the first trimester of pregnancy. And if the pregnancy is not the first, it can serve as a sign of conception of the baby. In the early stages they occur due to changing hormonal levels. The ovaries produce an increased amount of progesterone, which is responsible for the elasticity of the pelvic muscles. The muscles begin to stretch, the tone of the bladder increases.

The baby's increasing weight causes incontinence and urine leakage

In the second and third trimester, urine may leak during pregnancy for several reasons:

• As the baby grows, the size of the uterus increases. It begins to put pressure on neighboring organs, including the bladder. This limits its functional activity, it is reduced in volume, and urine does not completely flow out when urinating.
• The constantly enlarging uterus puts pressure on the urethra, causing frequent discharge of small portions of urine. In combination with the increased tone of the bladder, urination begins to be voluntary.
• Under the influence of hormones, the volume of fluid in a pregnant woman’s body increases, and the kidneys cannot cope with their excretory function.
• In the third trimester, the baby is fully formed and begins to move actively. If during the movement the baby hits the bladder with his hand or foot, then the woman experiences involuntary urination or a slight leakage of urine.

In addition to the physiological causes of incontinence, there are diseases that cause it. If a woman experiences involuntary urine leakage, she should consult a doctor to rule out:

• Sexually transmitted diseases (syphilis, gonorrhea).
• Exacerbations of chronic diseases, even if they were treated before conception (chronic renal failure, pyelonephritis).
• Formation of foci of inflammation in the urinary system caused by pathogenic microorganisms (cystitis, including hemorrhagic).

Do not limit yourself to clean water if you have urinary incontinence.

Urine in pregnant women may involuntarily be released and leak due to the abnormal structure of the pelvic organs (mobile bladder). Secondary causes of urinary incontinence include:

• Position of the baby in the uterine cavity in the later stages.
• Baby sizes.
• Physical condition of a pregnant woman.
• Rapid onset of pregnancy after a previous birth.
• Second and subsequent pregnancies.

If the expectant mother has gained 15 kg or more during the period of bearing the baby, then the likelihood of her developing incontinence increases significantly.

Urinary incontinence after childbirth

Throughout pregnancy, a woman’s body prepares for the upcoming birth of a baby. The birth canal is formed, the load on the pelvic organs increases. The passage of a child through the birth canal causes a violation of the anatomical relationship between the pelvic muscles and the bladder, and sometimes the urethra. During the birth of the baby:

• Blood circulation in the pelvic organs is impaired.
• The muscles responsible for urination are compressed.
• The ability of impulses regenerated by the bladder to pass into the central nervous system decreases.

After pregnancy, incontinence or urinary leakage is diagnosed in women who have had a difficult birth. A large number of tears and stitches are directly dependent on the duration of involuntary urination.

Why go to the doctor

For your own peace of mind for the health of your unborn child. Nine months of bearing a child is a long time, and there is a possibility of developing a disease. When visiting a gynecologist, the patient will be examined.

The doctor will assess the girl's general health and perform a gynecological examination. Based on the condition of the mucous membranes of the vagina and cervix, one can preliminarily judge the presence of signs of pathologies.

If necessary, the woman will need to submit urine and blood samples to the laboratory.

To diagnose urinary incontinence, a pregnant woman is examined

An increased content of white blood cells and protein breakdown products indirectly indicates diseases of the genitourinary system. If the doctor suspects an infectious inflammation, a sample will be cultured to identify pathogenic pathogens. Sometimes pregnant women are given:

• Ultrasound examination of the pelvic organs without the use of contrast agent.
• MRI in the 2nd or 3rd trimester of pregnancy.
• Computed tomography of the urinary system.

A thorough examination of urinary incontinence or leakage is necessary to differentiate the natural state of the pregnant woman from a relapse of a chronic disease.

Should incontinence and urinary leakage be treated during pregnancy?

If harmful viruses or bacteria are detected in urine samples, the woman will be treated with gentle antimicrobial drugs. Antibiotics are contraindicated during pregnancy, but correctly selected doses of drugs cannot harm the child or the expectant mother. If a woman’s health is weakened by an ever-increasing load, the doctor will select a special complex of vitamins for pregnant women.

Urinary incontinence during pregnancy usually does not require medication

Incontinence caused by natural causes does not require drug therapy. Your doctor will help you correct involuntary urination in the following ways:

• Wearing special underwear and a support bandage. The bandage will help avoid stretch marks on the skin and squeezing the bladder.
• There is no need to limit the amount of liquid, but it is better to drink a little water before going to bed. You can replace it with a glass of kefir or a juicy apple.
• A pregnant woman should take walks in the fresh air more often.
• Try to avoid eating smoked or fatty foods that cause thirst.

In late pregnancy, if you have incontinence, you should definitely visit a gynecologist - he will determine what is causing the leakage: drops of urine or amniotic fluid. The emotional and psychological state of a woman is very important when carrying a baby. Therefore, in order not to worry unnecessarily, you need to visit a doctor and ask him your questions.

A truly beautiful woman is a pregnant mother-to-be. After all, what could be more beautiful when a little life grows inside, and happiness in the eyes. There comes a time in every woman's life when she wonders whether she is ready to take responsibility for another life of an innocent little person. There can be no unwanted children. Since heaven has decreed that a new person wants to appear in this world, then we must provide him with such an opportunity.

One of the most important callings of a woman is to be a good mother. Give life and thereby prolong yourself. Pregnancy is a very memorable period in the life of every woman. For some it proceeds painlessly and smoothly, for others it is quite the opposite. I really want to say that being a mother is God’s gift and blessing. Therefore, we must appreciate every day, every minute. After all, not everyone in life is as lucky as you, future mothers. And even if it’s difficult, bad and difficult, let everything go and relax, because you are allowed to be tired much more than others, because you are an expectant mother.

Urinary incontinence during pregnancy: causes

Today I would like to talk about a problem that upsets many young mothers at all stages of pregnancy. This issue is quite sensitive, so it should be given special attention. What we are embarrassed to talk about and even consult with doctors is urinary incontinence in women during pregnancy. I would like to explain in more detail and explain to mothers what’s what and why.

1. During pregnancy, almost all of a woman’s internal organs undergo changes. And when involuntary urine discharge occurs, almost all women get scared and begin to think that something is wrong with them. I would like to reassure expectant mothers that everything is normal and as it should be.
2. The reason for this not entirely pleasant process is the weakening of the muscles of the pelvic area. The hormonal background of a woman carrying a child under her heart changes dramatically. What was quite familiar and normal may already seem almost abnormal and vice versa.
3. It is necessary to name the main reasons why involuntary urination occurs:

• the pelvic muscles weaken, which leads to loss of bladder muscle tone;
• hormonal changes and global changes in a woman’s body;
• compression of the bladder under the pressure of the fetus, which increases every day;
• the child’s activity in the uterus, during which the bladder is often touched and this allegedly provokes a desire to go to the toilet.

1. Expectant mothers should not be afraid of this under any circumstances. This is a completely natural and physiologically correct process.
2. Of course, you need to notify your obstetrician about this. In any case, all women undergo a urine test during pregnancy, which can be used to determine the developing anomaly.
3. Several factors have a big influence on how urinary incontinence is expressed:

• previous pregnancies;
• mother's physical training;
• fetal activity in the womb;
• fruit size;
• position of the baby in the womb;
• weight of the expectant mother.

1. If a woman is pregnant for the first time and notices involuntary urination, it is possible that the thigh muscles are simply not trained enough.
2. If the expected child is not the first and there was a short period of time between pregnancies, then we can assume that the muscles simply did not have time to recover and regain their previous tone.
3. Excess weight is also one of the causes of urinary incontinence during pregnancy.

Urinary incontinence: what to do?

1. After undergoing an examination and consulting with a doctor, most often involuntary urination does not require special treatment. But a gynecologist may advise you to adhere to the following simple rules:

• change underwear more often;
• It is recommended to wear special underwear, which is made from natural material for pregnant women;
• use panty liners;
• take a warm shower daily;
• do not overload the bladder with too much fluid;
• periodic release of urine can be completed by slightly bending forward, this will allow the urethra to open sufficiently to completely cleanse the body;
• make additional muscle movements at the end of urination;
• Minimize, if not completely prohibit, physical activity and heavy lifting.

1. Urinary incontinence during pregnancy can be especially pronounced when sneezing. Experts recommend opening your mouth in this case. Thanks to such actions, the pressure on the diaphragm is reduced. Therefore, when you have the urge to sneeze or cough, you need to slightly bend your knees and lean forward a little.
2. Urinary incontinence due to coughing during pregnancy is as common as urinary incontinence due to sneezing.

Types of urinary incontinence

The following categories of urinary incontinence can be distinguished.

1. Urgency to urinate.

• Such attacks are characterized by their sudden appearance;
• some clumsiness of expectant mothers simply does not give them the opportunity to quickly get to the toilet;
• Urgent urinary incontinence most often occurs at the end of pregnancy, when overstretching of the pelvic muscles occurs, or after childbirth, when the muscles are still quite relaxed and have not regained their previous tone.

1. The urge to urinate due to stress.
2. Incontinence in the early stages.
   Urinary incontinence is most common in early pregnancy; involuntary release of urine can occur both when coughing, sneezing, and when laughing too harshly.

1. Full bladder.

• after a bowel movement, a woman may often feel as if she did not go to the toilet “all the way”;
• it feels like urine remains in the bladder;
• the inability to completely empty can be explained by the fact that the walls of the bladder become sluggish and stretched during pregnancy, which leads to its not functioning correctly.

Urinary incontinence problem: treatment

1. As a rule, involuntary urination does not require drug treatment. Of course, it is necessary to visit a gynecologist and inform him of the changes taking place.
2. The doctor will first do a general examination and prescribe the necessary tests. Based on the results of the examination, the gynecologist can tell you whether an inflammatory process is detected in your body, a virus, or whether involuntary urination is purely mechanical in nature, associated with a delicate position.
3. In order to protect yourself from the risk of such problems during pregnancy, doctors recommend doing special training for the femoral and pelvic muscles. This is the best prevention of urinary incontinence while in position.
4. However, if you are already pregnant, then doctors do not recommend doing this kind of training. Otherwise, this can lead to muscle overstrain, and subsequently to an increase in the tone of the uterus, which, in turn, is dangerous for the fetus. Such activities will have to be postponed and you will have to start actively doing them after giving birth.

1. Strict control over the amount of fluid consumed is necessary. Liquid meals in the diet also need to be taken into account. In addition to the fact that this can lead to unwanted swelling of the limbs, uncontrolled fluid intake may well provoke urinary incontinence. It is recommended to consume no more than 2 liters of liquid per day.
2. When urinating, try to empty your bladder as much as possible. If urine remains in it, then there is a risk of various kinds of infections getting there. Most often, this is fraught with a disease such as cystitis - inflammation of the bladder, which must be treated, otherwise it can end in kidney damage. If the doctor, after taking tests, finds signs of inflammation, he is obliged to prescribe a treatment that will give a good result and is harmless to the child.
3. Make it a rule to go to the toilet before bed, before and after meals, even if you don’t feel an urgent need for it.
4. Sugary and carbonated drinks, coffee and alcohol can also cause involuntary urination. Try to replace them with freshly squeezed juices and purified water.
5. Every 6 months it is necessary to undergo a medical examination in order to prevent such a sensitive problem during pregnancy in advance. Most women, especially during their first pregnancy, are ashamed to tell the doctor that they have encountered such inconveniences. In no case should urinary incontinence cause complexes or shame in the expectant mother. This problem can be effectively resolved with the help of various gymnastics and training, which can be prescribed by the obstetrician-gynecologist observing you.
6. If your urinary incontinence occurs when you cough, sneeze or laugh, then try to cross your legs before sneezing and seem to clench. Often this simple action produces tangible results.
7. Try to carefully monitor your weight. Often, extra pounds can also cause urinary incontinence in early pregnancy.
8. Try to move more time - go for walks, do simple gymnastics.
9. Try to keep all your muscles toned. Controlling your body gives good results.
10. During pregnancy, a bandage is of particular importance. It somewhat reduces the pressure on the bladder, and, accordingly, the risk of voluntary urine leakage.

Prevention: exercises to train the pelvic muscles

1. Before performing any exercises, be sure to consult your doctor. Some movements can be harmful to the baby and you.
2. First you need to master the so-called Kegel exercises. These are very simple movements that can help expectant mothers strengthen the muscles of the pelvic diaphragm. They consist in the fact that the woman must imagine that she is interrupting the act of defecation. To do this, forcefully squeeze the opening of the anus, and then smoothly relax. Do this exercise several times in a row. Adjust the frequency of execution yourself. After some time after regularly performing this action, the woman will be able to keep her pelvic muscles under control.
3. When urinating, try to squeeze the perineum and force it to stop. After a few seconds, push out the remaining urine with force and pressure. Do this action every time you urinate. This exercise trains the muscles of the internal pelvic area and vagina well. Such simple exercises make it possible to pinch yourself when sneezing or coughing, thereby preventing involuntary urination.
4. Alternate tension in the anus and vagina. While squeezing, count to five, and then slowly relax your muscles and also count to five. Do these internal movements up to 5 – 6 times in a row.
5. Kegel exercises are very effective and completely uncomplicated. The exercises do not require special skills and take very little time. A pregnant woman can do them at any convenient time and place. Results can be observed within a week after systematic exercise.
6. There is also a whole range of therapeutic exercises. Each doctor individually selects one or another type of exercise for a woman. This also depends on the essence of the problem and the physiological characteristics of the expectant mother’s body. In each individual case, the obstetrician-gynecologist takes into account all the factors that may influence the problems of the urination process.
7. The following exercise is easy and harmless: hold a small ball between your legs and move around the apartment. Make sure that the ball does not fall below your knees. In the process, you will feel some tension in the inner muscles of the legs.
8. In addition, doctors sometimes recommend using tinctures of medicinal herbs. A decoction of rosehip berries is popular. To prepare it, 3 tbsp. Rose hips should be poured into 1 liter of boiling water, left for about 2 hours and taken 1 glass daily.
9. Lingonberry leaves, flowers and fruits also have a beneficial effect on muscles. The flowers and berries of this plant are taken in equal proportions: 4 tbsp. The mixture is poured with a liter of water and boiled for 15 - 20 minutes. After 2 hours, the decoction can be consumed. You need to drink 3 glasses of this drink a day.

To summarize, I would like to remind you once again that the problem of urinary incontinence during pregnancy or after childbirth should not be a reason for shame or the emergence of complexes. By immediately consulting with a doctor and choosing the optimal necessary treatment in the form of simple exercises, you can cope with this problem on your own in a short time. Take care of your health, because now you are responsible not only for yourself, but also for your future baby.