Urinary Incontinence

Delivery Woes for Your Bladder

After the strain of carrying a baby to term, your bladder, urethra, and pelvic floor are further battered during the labor and delivery of your baby. Even in a relatively easy, brief labor, a vaginal birth stretches the urethra and pelvic floor muscles. Muscles that were once taut and flexible can become more like an overstretched rubber band that has lost some of its elasticity and has more difficulty holding its original shape.

Other factors in your delivery—such as a long labor and forceps or vacuum deliveries—can further traumatize a weakened urethra and pelvic floor. Episiotomies can contribute to urinary problems later as well.

With so many risks to your bladder and pelvic muscles, some women are turning to planned Cesarean sections as an alternative. Women who deliver with C-sections have a much lower risk of incontinence, from 25 percent with vaginal births to five percent with Cesarean in the first pregnancy. While C-sections may create fewer urinary problems, the procedure is not without risk and certainly has its own aftereffects.

Dr. Roger Goldberg, a urogynecologist and author of Ever Since I Had My Baby: Understanding, Treating, and Preventing the Most Common Physical Aftereffects of Pregnancy and Childbirth, advises women "to discuss their concerns and their birth options with their doctor long before the delivery."

Dr. Goldberg and his wife decided on a passive labor technique for their first child. His wife had an epidural for the initial stages of labor, relaxing her body and allowing her to rest so that once the medicine wore off, she had energy for the delivery. "Everything went smoothly, but now that she's pregnant with twins, we're looking at our options again," says Dr. Goldberg.