Lots of us do it — leak pee, that is. According to Phoenix Physical Therapy, which treats pelvic floor dysfunction in South Burlington, Vermont, 1 in 4 women in the United States experiences involuntary urinary leakage. That’s a technical way of saying that 1 in 4 women pee when they sneeze, laugh, cough, barf, jump, or run. Isn’t being a woman great?
From ages 18 to 44 — prime childbearing years, people — a whopping 24% of women will experience urinary incontinence, says Phoenix. Pregnancy. Childbearing and menopause are the main reasons for this involuntary peeing. Many women also experience what Dr. Abby Kramer, chiropractor and holistic physician, calls it “urge incontinence.” That means, basically, you have to pee all the damn time, but even if you’re well-hydrated, she says, you should only have to go every 2–4 hours, not, um, every hour and certainly not when your bladder isn’t full.
All this peeing is a giant pain in the ass. I should know. I vaginally birthed three sons, all two years apart, and ended up with third-degree tears from each after pushing for a long time. In fact, that’s when it started: I was barfing my guts out with my second pregnancy, and I’d lose my bladder at the same time I lost my lunch. It’s only gotten worse since, to the point that a hard nose blow can, well, leak out a few drops. If I’m home, I change my drawers and go about my business. But if I’m out, there’s not much to be done about it. I’m not wearing freaking Depends for the few times it happens, and it’s not worth carting extra undies around. So I sit around worried that I smell like pee until I get home.
Real talk, ladies: Mommy bladder is a thing, and it’s actually curable. According to Laura Ardnt, National Strength and Conditioning Association — Certified Strength and Conditioning Specialist, certified fitness and pilates instructor, and owner of Matriac, which specializes in pregnancy and postpartum health, it happens when pregnancy puts pressure on the pelvic floor.
“The muscles and ligaments in your pelvic floor are weakened and damaged, making it more difficult to hold your bladder,” she says, and there can be additional complications during delivery, including “damage and strain to your pelvic floor.” Prudence Hall, MD, who practices at The Hall Center in Los Angeles, says that pelvic muscles relax to allow delivery, which makes the bladder drop and can cause urinary incontinence.
Emily Silver, a certified family nurse practitioner and certified lactation consultant, explains that during pregnancy, the uterus puts pressure on the bladder and the surrounding tissues and muscles can all be damaged. Birth itself can do “damage to our nerves that control the bladder, including someone who had an assisted vaginal delivery (episiotomy or forceps), a long push (maybe from a large baby), or if you have had previous children and vaginally deliveries.” Considering I’ve had two of the three, it’s no shock that I pee when I sneeze.
One mom told me about her experience with mommy bladder. She had gotten all high and mighty after having four boys, thinking she’d escaped with the pelvic floor of She-Hulk. Until she was bouncing at a trampoline park the other day, and on the fifth bounce, found herself dribbling pee. “My intact bladder pride has been shattered,” she said.
Another mom says that she pees five or six times in the hour before she goes to sleep because she’s so afraid she’ll wet the bed. She’ll run off to the bathroom, “let go 1–2 cc’s of pee,” and run back to bed. One mom experienced overactive bladder that was mistaken for UTIs; they medicated her, but when the meds didn’t work finally referred her to physical therapy, which fixed the problem.
Physical therapy does tend to be key for fixing mommy bladder. The first step, of course, is to talk to your gyno about it. Believe me: She’s heard it all before. She may offer some suggestions, like Kegels, which seem to be the most popular exercises for strengthening the pelvic floor. But as Dr. Kramer says, “SUI [stress urinary incontinence] happens due to pelvic floor muscles that are weak from underuse or weak from overuse. And here, just doing Kegels won’t cut it. There is so much more to pelvic floor strengthening. I typically recommend more functional exercises such as squats, hinges, lunges, and planks.”
In some cases, pelvic floor therapy might be necessary. This sounds far kinkier than it is. According to Janet Kimmel, who’s certified in several different kinds of fitness methods and reparative strategies specific to women and childbirth, “there are many breathing exercises, physical exercise and something called low pressure fitness (previously referred to as hypopressives) which are all good ways to retrain your deep core and get rid of mommy bladder.”
There are other noninvasive solutions too. You can wear a pessary, which you insert into your va-jay-jay to put pressure on the right places to hold stuff where it needs to be. Poise makes one called the Impressa. It’s not absorbent, and it’s sized to ensure proper fit.
If your case merits it, you can also go the surgical route. Maria Canter, board-certified physician in Female Pelvic Medicine and Reconstructive Surgery as well as obstetrics and gynecology, says, “The current gold standard surgery for treatment of urinary stress incontinence is a sling. The sling procedure is an approximately 20-minute procedure done in an operating room and consists of placing a 1 cm wide strip of synthetic graft in the vagina underneath the mid-urethra. Success rates with this treatment are high. There is usually a recovery time consisting of a few weeks of weight lifting restrictions and pelvic rest.” There are other types of surgery available if that one won’t work in your case.
As she notes, mommy bladder can seriously impact your quality of life. It can feel totally embarrassing and isolating. But you aren’t alone. And even better than having company in your peefulness, you’ve got solutions. There are ways to cure mommy bladder. You don’t have to pee when you sneeze or run or jump. Talk to your gyno, tell her what’s up, and see what she says. It’s the first step on the road to pee-free undies. Because the only family member with pee in their pants should be the toddler.