Pregnancy, childbirth, and bladder control.

Let's talk about blader control for women. There's treatment that works.

Let's Talk about Bladder Control for Women is a public health awareness campaign conducted by the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health.

Do pregnancy and childbirth affect bladder control?

Yes. But don't panic. If you lose bladder control after childbirth, the problem often goes away by itself. Your muscles may just need time to recover.

When do you need medical help?

If you still have a problem after 6 weeks, talk to your doctor. Without treatment, lost bladder control can become a longterm problem. Accidental leaking can also signal that somethine else is wrong in your body.

Bladder control problems do not always show up right after childbirth. Some women do not begin to have problems until later, often in their 40's.

You and your health care team must first find out why you have lost bladder control. Then you can discuss treatment.

After treatment, most women regain or improve their bladder control. Regaining control helps you enjoy a healthier and happier life.

Can you prevent bladder problems?

Yes. Women who exercise certain pelvic muscles have fewer bladder problems later on. These muscles are called pelvic floor muscles. If you plan to have a baby, talk to your doctor. Ask if you should do pelvic floor exercises. Exercises after childbirth also help prevent bladder problems in middle age.

Ask your health care team how to do pelvic exercises.

How does bladder control work?

Your bladder is a muscle shaped like a balloon. While the bladder stores urine, the bladder muscle relaxes. When you go to the bathroom, the bladder muscle tightens to squeeze urine out of the bladder.

More muscles help with bladder control. Two sphincter (SFINK-tur) muscles surround the tube that carries urine from your bladder down to an opening in front of the vagina. The tube is called the urethra (yoo-REE-thrah). Urine leaves your body through this tube. The sphincters keep the urethra dosed by squeezing like rubber bands.

Pelvic floor muscles under the bladder also help keep the urethra closed.

When the bladder is full, nerves in your bladder signal the brain. That's when you get the urge to go to the bathroom. Once you reach the toilet, your brain sends a message down to the sphincter and pelvic floor muscles. The brain tells them to relax. The brain signal also tells the bladder muscles to tighten up. That squeezes urine out of the bladder.

Strong sphincter (bladder control) muscles prevent urine leakage in pregnancy and after childbirth. You can exercise these muscles to make them strong. Talk to your doctor about learning how to do pelvic floor exercises.

What do pregnancy and childbirth have to do with bladder control?

The added weight and pressure of pregnancy can weaken pelvic floor muscles. Other aspects of pregnancy and childbirth can also cause problems:

* changed position of bladder and urethra

* vaginal delivery

* episiotomy (the cut in the muscle that makes it easier for the baby to come out)

* Damage to bladder control nerves.

Which professionals can help you with bladder control?

Professionals who can help you with bladder control include

* your primary care doctor

* a gynecologist (guy-nuh-CALL-uh-jist): a women's doctor

* a urogynecologist (YOOR-oh-guy-nuh-CALL-uh-jist): an expert in women's bladder problems

* a urologist (yoor-ALL-uh-jist): an expert in bladder problems

* a nurse or nurse practitioner 

* a physical therapist.

Points to Remember

* Temporary bladder control problems are common during pregnancy.

* Exercising pelvic floor muscles can help prevent bladder control problems.

* Bladder control problems may show up months to years after childbirth. Talk to your health care team if this happens to you.

National Kidney and Urologic Diseases Information Clearinghouse

3 Information Way Bethesda, MD 20892-3580 Phone: [phone] Fax: [phone] E-mail: [e-mail]

The National Kidney and Urologic Diseases Information Clearinghouse is a service of the National Institute of Diabetes and Digestive and Kidney Diseases, of the National Institutes of Health, under the U.S. Public Health Service. Established in 1987, the clearing-house provides information about diseases of the kidneys and urologic system to people with these disorders and to their families, health care professionals, and the public. The clearinghouse answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and government agencies to coordinate resources about kidney and urologic diseases.

Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability.

This publication is not copyrighted. The clearinghouse encourages users of this fact sheet to duplicate and distribute as many copies as desired.

This publication is also available at http://www.niddk.nih.gov