Incontinence in pregnancy 'not normal'

  • Deborah Condon

At least one-third of women in Ireland experience urinary incontinence during early pregnancy, while half of women suffer with this problem three months after giving birth, a major new study has found.

Incontinence is an uncontrollable and involuntary loss of bladder control. In other words, those affected leak urine when they do not mean to.

Researchers at Trinity College Dublin (TCD) are carrying out a study - the first of its kind - to track the health of first-time mothers in Ireland. It will follow over 2,600 women throughout their pregnancies and their first year as mothers. This represents almost 10% of all first-time mothers giving birth in this country in any given year.

The MAMMI (Maternal Health And Maternal Morbidity in Ireland) study will look at a range of health issues including mental health problems, sexual health, diet during and after pregnancy, and caesarean sections.

It has just released the first set of early findings on urinary incontinence in women before, during and after birth. These findings are based on the experiences of 860 women.

The study found that one in three women occasionally leak urine before becoming pregnant, with one in 12 experiencing this problem at least once a month.

During pregnancy, at least one in three women have this problem, with almost one in five leaking urine at least once a month.

Meanwhile, one in two women admitted to leaking some urine three months after giving birth, and even six months later, with one in five leaking at least once a month.

Before becoming pregnant, those most at risk of urinary incontinence include women with a high body mass index (BMI). In fact, obese and very obese women are four times more likely to experience this problem compared to women of a normal weight.

The risk is also increased in those who experience bed wetting as a child.

During pregnancy, the risk is increased in those over the age of 35 and those who are overweight before becoming pregnant.

Meanwhile women who have this problem during pregnancy are three times more likely to still have it three and six months after the birth.

According to Dr Deirdre Daly of TCD's School of Nursing and Midwifery, while leaking urine is common, ‘it is not normal and can be treated'.

"Far too many women put up with urinary leakage during and after pregnancy because they think it is ‘normal' or ‘to be expected'. Because of this the majority of the women in the MAMMI study had not really talked to anyone about leaking urine.

"The reality is that this can make some women miserable. While it affects them physically, it can also affect them emotionally and socially and affect the way women interact with their partner," she noted.

She pointed out that some women stop exercising or are more cautious about socialising because they are afraid they will leak urine and someone will notice.

"Unfortunately, and partly because we have no information on leaking urine in pregnant women or new mothers in Ireland, many women who leak urine think they are alone. This can make women feel isolated, embarrassed and reluctant to talk about it or to seek help," Dr Daly explained.

Meanwhile, speaking about the importance of the MAMMI study, its principal investigator, Prof Cecily Begley of TCD, emphasised that currently, there is a lack of information on the health of women after their baby is born. This means that subsequent problems ‘remain invisible, not talked about and very often untreated'.

For example, care of the woman focuses on the pregnancy and period straight after the birth. A woman's final check-up is six weeks after giving birth, ‘usually with their GP, when it is assumed that her body has returned to normal'.

"This information is not collected in our maternity services. There is also no connection between the woman's record held in the maternity hospital and any records kept on her if she has to attend a general hospital with a health problem resulting from pregnancy or childbirth.

"This means that clinicians in the maternity services never receive feedback on how women who have been in their care for pregnancy and childbirth return to normal health and wellbeing. We hope that this study will bridge that gap and make these issues visible," Prof Begley commented.

The MAMMI study is being funded by the Health Research Board (HRB). A number of videos on urinary incontinence and pelvic floor exercises are available on the MAMMI website here

For more information on pregnancy, see our Pregnancy Clinic here


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