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Pregnancy & Postpartum

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Bladder control often improves in the first few months after birth as tissues heal. Regular pelvic floor exercises support recovery and reduce leakage. In the early weeks, try to protect your pelvic floor by tightening the muscles before coughing, sneezing or lifting, avoiding heavy loads, and choosing gentle exercise that does not cause a feeling of pelvic strain.

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Postpartum urinary incontinence can often be effectively managed independently — regularity, patience, and body awareness are key. It is worth introducing daily:

- __pelvic floor muscle exercises (Kegel exercises)__ – tightening and relaxing the muscles responsible for holding urine; do this several times a day;
- __strengthening deep abdominal muscles__ – supported by breathing exercises or postpartum physiotherapy;
- __maintaining proper posture__ – avoid slouching and excessive pressure on the pelvic floor;
- __avoiding lifting heavy objects__, which increase abdominal pressure and strain bladder-supporting muscles;
- __preventing constipation__ through adequate hydration, fibre intake, and regular bowel habits, as straining places additional pressure on bladder-supporting muscles;
- __maintaining a healthy body weight__
- __limiting caffeine, alcohol, and carbonated beverages__ that irritate the bladder.


How can I manage incontinence after pregnancy?

While only 1% to 5% of women develop excessive bleeding after birth, it is important to know what to look out for. If you bleed profusely, your organs will not receive enough blood. This is known as shock, and it can be fatal.

Call an ambulance immediately and head to A&E if you are experiencing symptoms of shock. These include:

- Bright red bleeding beyond the third day after birth

- Blood clots bigger than a plum

- Bleeding that soaks more than one sanitary pad an hour and doesn’t slow down or stop

- Blurred vision

- Chills

- Clammy skin

- Cramping-type pelvic pain

- Rapid heartbeat

- Dizziness

- Weakness

- Nausea

- Feeling faint

Once you are in the hands of trained medical professionals, it’s good to know what types of treatment might be offered. Treatment options for postpartum haemorrhage can include blood transfusion, an injection of antibiotics to stop the bleeding, hysterectomy or removal of the uterus, or surgery to identify the source of the bleeding and stop it, called a laparotomy.

What to Do About Excessive Bleeding After Birth

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After pregnancy, symptoms of urinary incontinence may include leaking urine when coughing, sneezing, laughing, lifting or exercising. Some women also experience urgency, needing to pass urine more often, waking at night to use the toilet, or occasional leakage during sleep.

incontinence after pregnancy

After childbirth, a woman enters a new stage of life that, while beautiful, can be filled with both emotional and physical challenges. The body needs time to recover, and new mothers learn to adjust to their new role. In the weeks following delivery, lochia (postpartum discharge), is unavoidable. At the same time, weakened pelvic floor muscles can lead to unexpected urinary incontinence, catching many new moms off guard. But the good news? Proper preparation and suitable products can make managing these challenges much easier. In this article, we’ll highlight the products worth having before childbirth to help you prepare for the postpartum period.

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Pregnancy and motherhood change your body in so, so, so many ways! We get that! Here’s one way your body may change that many new mums face but few talk about: bladder leaks. Find out why incontinence after childbirth happens and how you can manage it in healthy ways so your focus is exactly where it should be — on your little one.

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Urinary incontinence is the involuntary leakage of urine, which may be mild or more significant. Although many people suffer in silence it extremely common affecting approximately half to a third of women, particularly during pregnancy, after childbirth and around menopause.  It occurs when the coordination between the bladder, urethra and pelvic floor muscles is disrupted.

What is urinary incontinence?

What to Include in Hospital Bag?

You’ll go through three postpartum bleeding stages.

1. Lochia rubra – Days 2-4

Bleeding is heaviest the first few days after giving birth. Blood will be bright red and will be very heavy. It is normal to see clots in your lochia during this stage. As long as your clots are no larger than a small plum, this is part and parcel of normal postpartum bleeding. You may feel cramping and uterine contractions as your uterus returns to its usual size.

2. Lochia serosa - Day 4, lasts about 2 weeks

Your blood flow will lighten. Its colour will change from red to a watery pink. Your placental wound will likely still be bleeding, but it will be significantly lighter than the first few days after giving birth.

3. Lochia alba – 2 to 6 weeks postpartum

Lochia changes from pink to a yellowish-whitish colour. You may still experience occasional spotting of blood. This stage of postpartum bleeding is mostly white blood cells leaving the body after they helped to heal your uterus after birth.

__What to do__

All of this bleeding after giving birth can be worrying for a new mum. While changing nappies and caring for your little one, you may be wondering how to provide protection and comfort for yourself as well. Regular menstrual pads just don’t cut it. You may even find yourself soaking through one every three hours or so. Definitely do not use tampons. This can be very dangerous after giving birth. Instead, postpartum underpants are great for bleeding after giving birth, especially during the first stage when bleeding is heaviest.

__When to call a doctor__

Bleeding is heavy for the first few days after your give birth. However, if heavy bleeding persists after that, call your doctor.

In some cases, heavy bleeding after giving birth is a sign of postpartum haemorrhage. While it is most likely to happen in the first 24 hours after giving birth, postpartum haemorrhage can take place anytime during the first 12 weeks after birth. Postpartum is very serious and needs immediate attention. It can make your blood pressure drop so much that your organs don’t get enough blood. This can cause death. If you think you have postpartum haemorrhage, head to A&E. Here are some signs to look out for:

- Bright red bleeding beyond the third day after birth

- Blood clots bigger than a plum

- Bleeding that soaks more than one sanitary pad an hour and doesn’t slow down or stop

- Blurred vision

- Chills

- Clammy skin

- Cramping pains in the pelvis

- Rapid heartbeat

- Dizziness

- Weakness

- Nausea

- Feeling faint

What to expect

Experiencing bladder leaks during pregnancy? Learn about causes of urine leakage, effective solutions, and prevention tips to manage incontinence safely.

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Incontinence in pregnancy: causes, solutions and prevention

Giving birth can be an awe-inspiring experience. As you’re enjoying your new addition to your family, you may have noticed some less expected changes to your body, such as heavy vaginal bleeding after birth. All new mums experience heavy bleeding after birth. But when is it too much? When should you worry and when is it no big deal?

Here’s the deal. [Heavy bleeding after birth](/en-gb/discreet/incontinence-advice/pregnancy-and-postpartum/what-you-need-to-know-about-the-stages-of-postpartum-bleeding) is your body’s way of flushing out tissue and blood from your uterus that supported your pregnancy but is no longer needed. The blood and fluid shed after birth is called lochia. It is normal. Some of your lochia will also be comprised of fresh blood from the wound created when your placenta detached from your uterus during labour.

Lochia is made up of a number of things:

  - Placental tissue that got left behind
  - Thickened endometrium no longer needed post-pregnancy
  - Blood from the wound site where the placenta detached from the uterine wall
  - Cervical mucous

In the first 1 to 3 days after birth, your lochia will be bright red and heavy. This is not a sign of excessive postpartum bleeding and is nothing to worry about. After a few days, your lochia will lighten up, becoming watery and pinkish in color. Within a week or so, it will lessen into a yellowish-whitish discharge with occasional spotting. This can last up to 12 weeks postpartum but will likely go away within 3 to 6 weeks.

You may even soak through a normal menstrual pad every few hours. This is normal in the first few days after birth. It may be a good idea to use absorbent pants instead of a pad that needs to be changed so often.

However, soaking through a menstrual pad in an hour or less is a sign of excessive bleeding after birth and you should consult your doctor. Another sign of excessive postpartum bleeding is passing blood clots larger than a plum. Keep an eye out.

Excessive bleeding after birth can be a sign of postpartum haemorrhage, a very serious condition. The highest risk period for primary postpartum haemorrhage is within 24 hours of giving birth. This type of severe postnatal blood loss is known as primary postpartum haemorrhage, and it affects 5 out of every 100 women who give birth. However, although much more rare, postpartum haemorrhage can occur anywhere within 12 weeks of birth. This is called secondary postpartum haemorrhage.

The most common cause of postpartum haemorrhage is something called uterine atony. Typically, after labour, your uterus contracts to stop bleeding at the site where the placenta was attached during pregnancy. Uterine atony means your uterus doesn’t contract as strongly as it should. Although it is quite rare, there are a number of risk factors both before and during labour for primary postpartum haemorrhage.

Before labour, the risk factors include:

  - Previous postpartum haemorrhage
  - Obesity
  - Giving birth to multiples (twins, etc.)
  - Placenta previa (a low-sitting placenta)
  - Placental abruption (when the placenta pulls away too early)
  - Pre-eclampsia or high blood pressure
  - Anaemia

During labour, the risk factors include:

  - Intrapartum infection or sepsis
  - Caesarean section birth
  - Induced labour
  - Retained placenta
  - Episiotomy
  - Uterine rupture
  - Forceps or vacuum-assisted vaginal delivery birth
  - Labour that lasted for longer than 12 hours
  - Having a baby that weighs more than 4kg (9lbs)
  - Having your first baby when you’re over 40 years old

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Incontinence after childbirth will often improve in the first six months as your body heals. Until then, you may feel a bit baffled by this new reality. We’re here to help you make sense of it all.

First of all, here are some factors that may add to your risk of experiencing weakened bladder control after pregnancy:

- Having your first baby

- Delivering a large baby

- Experiencing a long labour or a difficult vaginal delivery

- Having a C-section

There are two main types of incontinence after birth that you may develop: stress incontinence and urge incontinence.

How Pregnancy Can Cause Incontinence

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Bleeding after giving birth is perfectly normal. In fact, there’s even a name for post-pregnancy bleeding. It’s called lochia. Lochia after birth is bloody fluid made up of blood, placental tissue, endometrial lining and mucous. 

New mums deserve every bit of comfort they can get. That’s why choosing the right postpartum underwear is so important. With the right postpartum underwear, focus your attention on what matters – bonding with and caring for your new little one.

Urinary incontinence is very common in new moms who have just given birth. Find out why and what to do about it!

Dr. Anne Henderson - Discreet

Dr. Anne Henderson

Article reviewed by

In addition to all the excitement, so many new experiences and challenges come with a new baby!. One challenge many mums face but rarely talk about is incontinence after pregnancy. Taking time for self-care and focusing on strengthening your pelvic floor can make a real difference. Find out why incontinence after childbirth happens and how you can manage it so you can focus on what matters most to you.

Postpartum disposable pants

The postpartum period is a phase in a woman’s life that begins after childbirth and lasts around 6 weeks. Find out what happens to the body after labour!

Pregnancy is a unique period during which a woman’s body undergoes numerous anatomical and hormonal changes, preparing for childbirth. These same changes can also increase the change of bladder leaks during pregnancy.

The most common causes of incontinence include:

- __increased urine production__ due to higher blood volume, which causes the kidneys to filter more of it, so the bladder therefore has to empty more often;
- __pressure from the growing uterus on the bladder__ - as pregnancy progresses, the growing uterus moves upwards and forwards, putting pressure on the bladder, which limits its capacity and promotes leakage, especially in the third trimester;
- __hormonal influence__ - progesterone and relaxin loosen muscles, ligaments and joints, preparing the body for childbirth. At the same time, they weaken the pelvic floor muscles, which have a role in controlling urination;
- __constipation increases abdominal pressure__ – frequent bowel problems during pregnancy further strain the pelvic floor muscles, increasing the risk of stress urinary incontinence;


What are the causes of incontinence in pregnancy?

You’ve welcomed a beautiful bundle of joy into the world – congrats! Having a baby comes along with a lot of physical changes to your body. Some of them can be quite surprising, like bleeding after giving birth.

[Bleeding after giving birth](/en-gb/discreet/incontinence-advice/pregnancy-and-postpartum/heavy-bleeding-after-giving-birth-whats-normal-and-whats-not) is perfectly normal. In fact, there’s even a name for post-pregnancy bleeding. It’s called lochia. Lochia after birth is bloody fluid made up of blood, placental tissue, endometrial lining and mucous. Normal postpartum bleeding continues for 3 to 6 weeks as your uterus heals and returns to its usual shape and size.

How to take care of yourself during recovery after a caesarean section?

During pregnancy and childbirth, the pelvic floor muscles, connective tissues and nerves are stretched to allow the baby to pass through the birth canal. This can weaken pelvic floor support and affect bladder control after birth. Pregnancy itself can also place strain on these muscles, meaning symptoms may occur even before delivery.

Factors that can increase the likelihood of postnatal urinary incontinence include delivering a larger baby, a prolonged or difficult vaginal birth, and assisted deliveries. Although caesarean birth may reduce the risk compared with vaginal delivery, carrying a baby during pregnancy can still weaken pelvic floor muscles, so incontinence can occur regardless of birth method.

What causes incontinence after pregnancy?

Heavy bleeding after birth is your body’s way of flushing out tissue and blood from your uterus that supported your pregnancy but is no longer needed.

How to take care of yourself during postpartum recovery?

There are a number of steps you can take to prompt your uterus to contract more rapidly, thereby reducing normal [heavy bleeding after birth.](/en-gb/discreet/incontinence-advice/pregnancy-and-postpartum/pregnancy-incontinence-and-new-mums) They include:

- Having another person massage your uterus

- Breastfeeding

- Urinating as often as you can

- Resting and letting your body heal

Your lochia will be heavier the more active you are. So try to take it easy as much as you can in order to let your body heal.

What to Do About Normal Postpartum Bleeding

Pregnancy is an exciting time that's full of anticipation, but it also involves some significant changes to your body. One change you may not be expecting, however, is little bladder leaks. You may have noticed that everyday activities like laughing, coughing, sneezing or exercising now result in some dampness in your underwear. Incontinence during pregnancy is common and something many expectant mothers experience. The fact that something is common doesn’t mean that it is normal, please don’t simply put up with it!.


If you have weak pelvic floor muscles that cause stress incontinence, you may leak urine when you:

- Cough

- Sneeze

- Lift

- Laugh

- Exercise

If you have weakened bladder control after pregnancy due to urge incontinence, you will:

- Urinate more than 8 times a day

- Wake up in the middle of the night 2 times or more to urinate

- Feel sudden, strong, and frequent urges to urinate

Symptoms of Post-pregnancy Incontinence

Incontinence After Pregnancy

Dr. Philippa Kaye - Discreet

Dr. Philippa Kaye

The postpartum period, which is the recovery phase following pregnancy and childbirth, is an extremely important yet often underestimated process during which a woman's body undergoes intensive regeneration. The duration and nature of the post birth recovery depend on many factors, such as the type of delivery—natural or caesarean section—the course of labour itself, as well as the individual's unique physical characteristics. For a new mother to fully regain her strength after childbirth, proper rest, support, and attention to her own needs are essential. What happens to the body after childbirth? What does healing after giving birth look like when you’ve had a planned caesarean section?


__Stress Incontinence Remedies:__

Treating stress incontinence is as simple as giving your pelvic floor some extra loving care so you can return to your pre-mummy bladder control. Here’s how regular Kegel exercises, or pelvic floor muscle training, will speed up the process of getting your strength and control back quickly after birth. Also, remember that any "pushing down" action in the first weeks after labour may stress or further stretch your pelvic floor. Protect those muscles by following these tips:

- Squeeze, lift and hold your pelvic floor muscles before you sneeze, cough, blow your nose or lift an object

- Cross your legs and squeeze tightly together before coughing or sneezing

- Do not lift heavy loads

- Avoid exercises that make your pelvic area feel strained

- Shed some extra pounds to take pressure off the pelvic floor

If your sensitive bladder doesn’t improve after four to six months, talk to your doctor. He or she can help try new ideas for treatment or explore other possible causes of the urinary incontinence you’re experiencing.

__Urge incontinence treatments and remedies:__

Staying on a bathroom schedule can serve to alleviate some of the urgency associated with having an overactive bladder. In addition, there are some straightforward lifestyle changes that can help you regain bladder control after pregnancy.

- Adopt a bladder-friendly diet

- Empty the bladder twice in one toilet visit – wait 30 seconds after you first urinate and then pass urine again to make sure your bladder is completely empty

- Stay hydrated

- Talk to your doctor about medication

What Can I do about Incontinence After Birth?

Heavy Bleeding After Giving Birth

Belly of a woman holding a baby in her arms

How to Choose Postpartum Underwear IMG 27

Just because pregnancy incontinence is common, doesn’t mean that you need to be uncomfortable. There are a number of tips and tricks that can help prevent or reduce the severity of your symptoms and assist postpartum recovery.

- __Pelvic floor exercises__ -
You may know them as Kegels. Performing Kegel exercises strengthen the pelvic floor muscles so they are stronger and more successful at holding in urine, preventing bladder leakage during pregnancy. Read how to perfect your pelvic floor routine here.  Depending on where you live you may be able to self refer to a women’s health physiotherapist or your GP may be able to refer you for support.

- __Toilet habits__ -
If you need to go, go, don’t routinely delay going but also don’t force urination or go just in case, only when you need to. Also avoid stopping passing your urine mid way, when you go, go!

- __Diet__ -
A high-fibre diet supports proper bowel function and prevents constipation, which is common during pregnancy , straining increases pressure on the pelvic floor.  Your local pharmacist, GP or midwife may be able to advise you on laxatives if needed. 
It is also important to limit artificially sweetened caffeinated beverages (soft drinks, energy drinks, sweetened juices), as sweeteners and caffeine irritate the bladder, increase urination, and may worsen dehydration, paradoxically intensifying incontinence.

- __Don’t forget protection!__ -
Wear a sensitive liner or pad to protect your underwear and to keep you feeling fresh, clean and comfortable. Incontinence products are specially formulated for urine loss, whereas the traditional feminine hygiene products you might use for your period are formulated for menstrual blood, which is more viscous than urine.  Incontinence liners and pads absorb leaks and odours within seconds, keeping you dry and protected, so that you can successfully manage your pregnancy incontinence for an enjoyable and comfortable pregnancy. Incontinence pads and liners are not treatments for bladder leaks, but can help keep you comfortable while you seek advice and treatment.

### This is generalised advice and isn't personalised nor to replace the advice of your doctor and other health care professionals.

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