There’s nothing like a baby on your bladder to make you feel like you need to PEE ALL THE TIME! While it might be okay to deal with for a short period of time, you do not want to have this feeling forever or even worse, deal with urinary incontinence (bladder leaking) for the rest of your life. During my first pregnancy, I was constantly peeing but my body didn’t return to normal once baby arrived.
Your bladder and all of those pelvic floor muscles might not bounce back after birth. You might even be making the problem worse. I had no idea how to help myself so I began a long journey which involved getting pelvic physical therapy (PT).
Here is all that I learned from PT and why it matters. Start using these lessons right now if you want to conceive, are pregnant, postpartum or even years after having a baby. If you are still having issues after trying the tips in this post, I highly recommend physical therapy. It was the best decision I made after the birth of my first baby. It can help with anything from bathroom issues, to the feeling of falling out, to pain during sex.
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How can bladder problems develop during pregnancy?
Let’s jump back to my first pregnancy. During my first trimester, I felt like I had to pee all the time. In the second trimester, I didn’t. Once the third trimester hit, I was back to feeling like I had to pee all the time. This is pretty typical. In fact, no one goes through pregnancy without experiencing this. In the first trimester, your growing uterus puts pressure on your bladder. You then get some relief because your uterus basically pops outward and allows for some relief off your bladder. However, by the third trimester, baby and your uterus are so big that baby literally sits on your bladder.
However, this feeling to pee all the time can change how you pee and that is the first reason you can develop pee problems. The bladder works like any muscle. It contracts so you can pee and stretches so it can fill. If you start to pee all the time, then the muscle (your bladder) will only be filling partially and will basically lose the ability to “stretch” completely. Similar to if you don’t stretch your leg muscles, you lose your ability to touch your toes. The result is needing to pee even more and makes the problem worse. During my pregnancy, I started to pee “just in case” which as I can see now made the problem worse.
Then in the third trimester, due to baby’s weight, your bladder is being compressed. Therefore, it can’t be used at maximum effectiveness and you will have to pee more often. However, due to the baby’s weight, it might be very hard to empty your bladder completely and trying to do so might change how you pee. For instance, you might start pushing your pee out. If you do this, you are using those muscles incorrectly and that can result in pee problems postpartum. All of the muscles in the pelvic floor must work correctly and together.
Tips to Prevent or Repair Pee Problems from Pregnancy
Don’t “push” your pee out
Everyone is in a hurry and it is so easy to try to pee faster by “pushing” when you pee, but don’t. This is not how those muscles were designed to work. Instead, just sit, breathe and wait. The muscles need to engage on their own.
You know who you are! Stop it immediately. If you don’t want to sit on a public toilet, use a liner. Just don’t hover because nothing is worse for those muscles than this. This alone could cause pee problems. You also are not likely to fully empty your bladder if you are hovering over the seat.
If you are constantly feeling the need to pee or only peeing a little at a time, you probably aren’t able to empty your bladder completely. To start, ensure that after you pee and before you get up, lean in all directions while still sitting.
This is especially important if you are pregnant because baby could be sitting directly on your bladder and not allowing it to empty. Chances are if you do this, you will pee more.
Get a stool
Toilets are actually poorly designed for peeing. You actually want to be more in a squatting position to pee due to the biology of those muscles. Therefore, someone invented a stool known as the squatty potty. It fits around the toilet seat. The stool will also come in handy when you have a little one who needs a stool to get up on the potty.
Check your diet for bladder irritants
We all know coffee makes you pee, making it actually a bladder irritant. There are actually a lot of bladder irritants so check your diet and cut them out. If you see a dramatic difference, add one back at a time. Likely, there is one that you are really sensitive to. Here is a list of common bladder irritants from the Mayo Clinic:
- Coffee, tea and carbonated drinks, even without caffeine
- Certain acidic fruits — oranges, grapefruits, lemons and limes — and fruit juices
- Spicy foods
- Tomato-based products
- Carbonated drinks
Breathe out when lifting
If you bend down to pick up something like a toddler, be sure to breathe out when you lift. Why does this have anything to do with peeing? Well when you hold your breath or breathe in while lifting, you are just creating more downward pressure on your bladder. This is especially important to remember while pregnant because that belly causes so much extra pressure, you really want to avoid increasing it.
Kegels might not be your best friend
No one goes through pregnancy without hearing about kegels. The idea behind kegels is to strengthen the pelvic floor but most people do them incorrectly.
You have to remember that a complete kegel involves tightening the pelvic floor muscles and then completely relaxing them. If you don’t relax the muscles, all you are doing is causing the muscle to cramp up. It won’t be able to relax and lengthen to its original resting length.
The second important thing to remember when doing kegels is to lift the muscles. Don’t just try to tighten, instead draw your muscles up and try to lift your pelvic floor to your nose. This will result in your lower abdominal muscles to engage.
How to do a proper kegel
Examine your kegel. Lay down and relax all of your muscles. Then try to do a kegel, remembering to lift and draw the muscles up. Hold it for a few seconds and then release ensuring you feel EVERY muscle relax. If it is hard to relax your muscles but easy to engage them, then you don’t have a weak pelvic floor but instead some of your muscles are too tight.
This is similar to when you run and a few days later it is painful to stretch. If you continue to just run and not stretch, your muscles will just keep tightening up and you will get worse and worse at stretching. If you keep doing kegels, you are doing the same thing.
The best thing to do if your pelvic floor muscles are too tight is to go to pelvic physical therapy. After one or two appointments you will feel like a new person. If that isn’t possible, then you should try to stretch those muscles similar to how you do a perineal massage. Press around or have your partner press around on the inside and if it hurts, hold the press so there is a little pressure and pain but not too much.
Start waiting to pee
If you have pee problems and the frequent urge to urinate, then you have to retrain your bladder. Once you start peeing “all the time”, your bladder isn’t being used properly and needs to be retrained. I needed to do this during the night. I got into a habit of peeing every few hours during the night during both pregnancy and being up with a newborn.
The result was that I felt like I always had to pee day and night because if you aren’t using your full bladder it will want to empty when it is half full. You need to retrain those muscles to wait until the bladder is actually full. Once full, then you should have the urge to pee.
To do this, start to wait every time you feel like you need to pee. Try distraction. Start small, try waiting 5-15 minutes. Then increase the time span once you can easily wait 15 minutes.
The worst part for me on retraining my bladder was trying to fall asleep when I felt like I needed to sleep. However, after a week of retraining, I could get through the whole night without any issues.
The amount of water you drink matters when it comes to getting rid of bladder issues. For example, if you aren’t drinking enough water, your urine becomes concentrated with body waste, which irritates the bladder.
Remember that if you are breastfeeding you need a lot of extra water so your pee problems could be directly related to not drinking enough water.
Wait on returning to exercise
The rule of thumb is to not return to exercise until you are at least 6 weeks. You might need to wait longer. By exercise, I mean running, hopping, bouncing or any type of exercise that relies on a strong pelvic floor. If you try working out and you are leaking, then your muscles aren’t ready to return to working out.
You need to stop or you will make the problem worse. Give yourself a few more weeks and then try again. Also consider a postpartum exercise program, as it will be designed specifically for women recovering from childbirth. And if you are still pregnant, try a workout class that is geared towards pregnant women like Knocked-up Fitness.
Seriously, start squatting
Your pelvic floor can’t work properly if it is too tight and if your butt muscles that are part of the pelvic floor aren’t being used. So you need to start squatting. The type of squat I’m talking about is a deep squat where you bring your butt as close to the floor as possible.
You can do this during or after pregnancy as a great way to keep your pelvic floor in shape.
Pelvic Physical Therapy
Like I said, getting pelvic physical therapy was the best decision I ever made after the birth of my first baby. A physical therapist can identify your exact issue, such as an injured muscle, and determine exactly which muscle needs help and how to help it heal and retrain it. Another big thing that a PT can help with is scar tissue and getting that muscle back in shape. If you tore, then that might be causing some issues.
The other big advantage to going to PT is that you can get back to 100% before trying to get pregnant again. It is very common for these issues to get worse with each pregnancy. I know they did for me and I can’t image what my second pregnancy would have been like if I hadn’t gone to PT.
Not sure how to find a physical therapist or get a referral? Call your OB or midwife. You should bring this up during your 6 week postpartum visit.
If Pelvic Physical Therapy isn’t an Option
I really recommend you go see a physical therapist because it is worth every dime. However, if you aren’t comfortable with the idea of pelvic PT or you don’t have insurance that can cover it, or the co-pay is too high, I would consider checking out the Postpartum Cure or finding another similar option online. The blogger who developed the course is a pre/postnatal exercise specialist. In addition to discussing healthy foods and recipes to get back in shape, she goes through exercises that can help you repair your pelvic floor. She had lots of scar tissue from tearing and needed to go to a PT for pelvic floor work and used that experience to help develop the course.
I don’t want you to have a lifetime of pain or incontinence. As the years continue, these problems don’t resolve themselves and instead get worse. You might even need surgery years later.
I share my story and all I learned from my physical therapist in hopes that this will help you throughout your pregnancy and beyond.
- Always sit while peeing, never hover.
- Don’t push but breathe and move about when you pee.
- Invest in a squatty potty.
- Take your time ramping up your workout routine.
- Work on kegels (with proper form) but more importantly start squatting.
- Check your diet for bladder irritants.
- Make sure to breathe out when lifting.
- Start retraining your bladder by waiting to pee.
- And in addition to prepping that postpartum care kit and getting ready for postpartum recovery, consider a pelvic physical therapist.
- Drink lots of water (especially those breastfeeding mamas!)
You got this mama
Don’t ignore the problem. Incontinence is something anyone can have even if they have never been pregnant or given birth. The best way to heal is to start using those muscles correctly and keep them in shape by exercising them properly. You can utilize every suggestion I give if you are pregnant or postpartum.
I would love to hear what has worked for you or if you have any other tips that I haven’t added here, please comment below.
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Dr. Trina Fitzpatrick is a wife, mom, blogger, and a breastfeeding advocate. She is the co-author of the Week-by-Week Bump Smart Course, the Nesting Planner and the Breastfeeding Handbook. She attributes her success at breastfeeding her own children into toddlerhood with working with lactation consultants in the hospital in the early stages and on a weekly basis afterwards. By writing at MomSmartNotHard, she educates mamas-to-be on all things pregnancy, birth and breastfeeding. Read more about Trina.