Postpartum urinary incontinence: causes, treatments, and pelvic exercises for relief

Leaking urine when you laugh, cough, sneeze, or bend over to pick up your baby — or maybe just a continuous dribble when you least expect it. Postpartum urinary incontinence may not be a hot baby shower topic, but leaking urine after childbirth is a common experience that affects about one in three people postpartum. 

Body changes during pregnancy and childbirth can weaken the pelvic floor muscles around the bladder and pelvis, leading to accidental leaks.

Postpartum urinary incontinence is common, but it’s not something you just have to live with. Gentle pelvic floor stretches, targeted exercises, and lifestyle changes can help improve bladder control after birth.

Here, learn more about what causes postpartum urinary incontinence, plus practical strategies to help manage and treat it — including pelvic floor exercises from Hinge Health physical therapists.

What is postpartum urinary incontinence?

Postpartum urinary incontinence is involuntary or accidental loss of urine after pregnancy and childbirth. It can show up in different ways and may be triggered by different situations. 

The most common type is called stress urinary incontinence (SUI), which involves leaking urine when you do things that put extra pressure on your bladder — for example, coughing, sneezing, laughing, exercising, lifting, or bending over. Other activities like jumping or running can also cause stress urinary incontinence.

Some people may develop other types of urinary incontinence after childbirth, such as urge incontinence (when urine leaks after feeling a sudden, strong urge to pee) or mixed incontinence (experiencing more than one type of urinary leakage).

Causes of postpartum urinary incontinence

Leaking urine postpartum can occur due to a combination of factors, including weakened pelvic floor muscles, hormonal changes during pregnancy, the effects of vaginal or cesarean (C-section) delivery, injuries or interventions during childbirth, and pre-existing urinary problems. Here’s more on common causes of postpartum urinary incontinence:

• Weakened pelvic floor muscles. Your pelvic floor is made up of muscles and tissues that provide support for organs like your bladder and bowel. These play an important role in continence (controlling when you urinate or have a bowel movement). During pregnancy, these muscles are under more strain to support your growing baby and uterus. Labor and delivery can further stretch and temporarily weaken these muscles. When  pelvic floor muscles are weaker or uncoordinated, everyday movements — like sneezing, laughing, or bending over — can lead to urine leakage.

• Hormone changes during pregnancy. Pregnancy hormones help loosen muscles and supportive ligaments in the pelvis to prepare for birth. “These changes are normal, but they can lead to less support for pelvic organs and muscle weakness, which may contribute to postpartum incontinence,” says Karina Marquez, PT, DPT, a Hinge Health physical therapist.

• Vaginal or cesarean delivery. During labor and vaginal delivery, your pelvic floor muscles relax and stretch to allow your baby to pass through the vaginal canal. This process can sometimes affect the muscles and nerves that help with bladder control. Research shows that having more vaginal deliveries can increase your risk of postpartum stress urinary incontinence. Delivering by C-section can also play a role. Healing from an abdominal incision may affect how well the muscles involved in bladder control work together, which can lead to urine leakage after childbirth.

• Perineal issues. It’s common for the area between the vagina and rectum (the perineum) to stretch or sometimes tear as you push during childbirth. In some cases, your provider may make a small cut (episiotomy) to help your baby come out more easily. More severe tears can increase the risk of postpartum incontinence. Factors like a longer pushing stage, needing assistance with forceps or a vacuum, or delivering a larger baby can also put extra stress on the muscles and nerves that help with bladder control. This may include the pudendal nerve, which plays an important role in urinary and bowel control. When the pudendal nerve is affected, it may increase your chances of experiencing postpartum urinary or fecal incontinence, says Dr. Marquez.

• Changes in abdominal muscles (diastasis recti). During or after pregnancy, some people develop diastasis recti, a separation of the abdominal muscles. While diastasis recti doesn’t directly cause urine leakage, it can decrease core strength and stability. Reduced core support can make it harder for your pelvic floor muscles to function, which may contribute to postpartum incontinence symptoms.

• Pelvic organ prolapse. Pelvic organs (like the bladder, uterus, or rectum) can shift downward, a condition called pelvic organ prolapse. This shift may put extra pressure on the bladder and pelvic floor muscles, sometimes contributing to incontinence. Prolapse and postpartum incontinence don’t always occur together — many people have one without the other.

• Urinary incontinence before pregnancy. People who’ve had urinary incontinence before becoming pregnant, or notice leaks during pregnancy, are more likely to have incontinence after childbirth. 

• Other factors. Older maternal age, higher BMI during pregnancy, or long-term habits like smoking or chronic coughing, can further increase your risk of postpartum urinary incontinence.

Symptoms of postpartum urinary incontinence

Postpartum urinary incontinence symptoms can vary based on the type you have. Stress incontinence is the most common type of postpartum incontinence. With stress incontinence, you might leak small amounts of urine during activities that put extra pressure on your bladder. If your bladder is full, the leakage may be more noticeable. Common situations that can trigger urine leakage include:

• Coughing

• Sneezing

• Laughing

• Exercising

• Lifting something heavy

• Bending over

• Having sex 

• Sleeping

Other postpartum bladder control issues

Some people may also develop urge incontinence after having a baby. This type of incontinence is marked by a sudden, intense urge to urinate, followed by leakage — sometimes without much warning and regardless of how full your bladder is. 

Mixed incontinence can also occur postpartum. This includese symptoms of both stress and urge incontinence.

When to see a doctor

Postpartum urinary incontinence often improves as your body heals after having a baby and with simple, at-home treatments. However, you should contact your healthcare provider if you experience any of the following:

• Prolonged incontinence (lasts longer than 6 to 8 weeks postpartum)

• Any symptoms of a urinary tract infection (UTI), such as pain or burning with urination, foul-smelling urine, or cloudy urine

• A bulge in your vagina or heaviness in your pelvis (may indicate pelvic organ prolapse)

• Severe or sudden lower abdominal pain or bladder pain

• Fever and chills (may indicate an infection)

• Nausea and vomiting (along with urinary symptoms)

• Visible blood in your urine

• Weakness or numbness in your legs or saddle area — especially if combined with incontinence (may indicate a serious nerve issue) 

Treatments for postpartum urinary incontinence

Postpartum urinary incontinence can be managed with a combination of exercise therapy, pelvic trainers, bladder training, vaginal support devices, or surgery, depending on the severity of your symptoms and their impact on everyday life. Here’s a closer look at postpartum urinary incontinence treatments:

Pelvic floor physical therapy

Physical therapy and targeted exercises are a key treatment for postpartum urinary incontinence due to weak or uncoordinated pelvic floor muscles. Pelvic floor muscles need to be able to tighten and fully relax for bladder and bowel control. Weak or poorly coordinated muscles can interfere with bladder control, leading to leakage during daily activities. Pelvic floor physical therapy and targeted exercises can help strengthen, stretch, and coordinate muscles involved in bladder control, making it easier to prevent urine leaks after childbirth. 

Check with your healthcare provider before starting any new exercise routine or resuming activities after giving birth.

A physical therapist (PT) can assess your symptoms and movement patterns to customize a strengthening and stretching program that’s right for you. They may also suggest ways to adjust your daily activities, including childcare routines, to help minimize symptoms and improve bladder function. PTs can also provide practical tools and tips — like healthy bladder habits, strategies to reduce pain, and, for some, recommendations for trying a pelvic trainer (see below for more).

You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. (See examples of pelvic floor exercises for postpartum urinary incontinence below.)

Pelvic trainer devices

Pelvic trainers are vaginal devices designed to help you strengthen and coordinate your pelvic floor muscles by providing real-time biofeedback. Using a pelvic trainer during pelvic floor muscle training gives you instant feedback so you can see and feel the strength and quality of your muscle contraction. This guidance can help guide your pelvic exercises and improve symptoms of urinary incontinence.

Pelvic trainers can be a helpful part of a wider pelvic health routine, which includes physical therapy and targeted exercises, education, supportive lifestyle changes, or other treatments. 

Pelvic trainers aren’t recommended for everyone. If you’re pregnant or have given birth within the last six weeks, recently had pelvic surgery, are experiencing unusual vaginal symptoms, or have significant pelvic pain or prolapse, talk with your healthcare provider before trying one.

Hinge Health offers a pelvic trainer for those who qualify as part of a holistic pelvic health program.

Bladder training

This involves techniques to help train the muscles that control your bladder. While bladder training is most often used for people who urinate more frequently than “normal” (which is about seven times per day with two to four hours in between), it can also help manage postpartum urinary incontinence. Here’s how to do bladder training:

1. Set an interval goal. Decide on a target amount of time you want to wait between bathroom visits (say, two hours between trips to the bathroom).

2. Make a schedule. Plan out and write down the actual times you’ll go to the bathroom based on your interval goal. For example, if you wake up at 7 and choose a two-hour interval, you’d set bathroom times at 7, 9, 11, and so on. Having a schedule helps keep you accountable and makes it easier to track your progress over time.

3. Practice urge suppression if you feel the urge to urinate before your scheduled time. Delaying even five minutes can help your bladder learn to wait to empty.

4. Gradually adjust the interval between bathroom breaks until you reach two to four hours between trips.

Vaginal devices

Urethral support devices are small, disposable inserts placed in the vagina — often with an applicator similar to a tampon — that help support the urethra and help prevent leaks. Many can be purchased over the counter. Pessaries are another type of device: these are soft, flexible silicone support devices fitted by your doctor and worn inside the vagina to support the bladder or other pelvic organs. Pessaries are reusable and can be especially helpful if you experience leaks during physical activities. Talk to your healthcare provider to determine if these options are appropriate for you and when it’s safe to try them.

Surgery

If your symptoms don’t improve with other treatments, you and your doctor might consider surgery. There are several types of procedures that lift and support the urethra or bladder neck, making it easier to prevent leaks during activities that put pressure on your bladder. Your healthcare provider can talk with you about the potential benefits and risks, and help you decide what approach is best for your needs and preferences.

These pelvic floor exercises target specific muscles and functions involved in bladder control to help manage postpartum urinary incontinence and prevent leaking urine and bladder issues after childbirth. Diaphragmatic breathing promotes flexibility and endurance in the pelvic floor, while quick holdhooklying Kegels train the fast-twitch muscle fibers you need to react quickly to sudden pressure from coughing, sneezing, or running. Happy baby exercise helps release tightness in the hips and inner thighs, which are areas closely connected to bladder support. Abdominal bracing, bridge and clamshell exercises build strength and stability in the pelvic floor, core, and lower body, so these muscles can better support your bladder and prevent leakage during sudden physical activities or movements that increase pressure in your abdomen. 

Check with your healthcare provider before starting any new exercise routine or resuming activities after giving birth.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tips to manage postpartum urinary incontinence

There are several simple lifestyle and self-care strategies — such as using healthy toilet habits, avoiding bladder irritants, staying hydrated, managing constipation, and modifying childcare activities — that can help manage postpartum urinary incontinence and reduce urine leakage. Here’s more about each option:

Consider absorbent pads or liners

If you’re leaking urine postpartum, using absorbent pads or liners can help you feel more comfortable and confident as you heal. Many options are thin, flexible, and specifically made for bladder leaks. Using pads or liners is a helpful short-term strategy while you implement other treatments and lifestyle changes to improve bladder control.

Practice healthy toilet habits 

Making a few simple changes to your bathroom routine can reduce strain on your bladder and pelvic floor. Consider the following tips:

• Aim to urinate every two to four hours. Avoid going “just in case” too early or waiting too long when you really need to go — both can be hard on your bladder. Try to listen to your body’s natural cues and avoid either extreme.

• Try not to push or strain to empty your bladder. Straining can put stress on your pelvic floor muscles and contribute to hesitancy symptoms.

• Choose a relaxed position when you urinate. Make sure you’re fully supported when sitting to urinate — this helps your pelvic floor muscles relax, supports a steady urine stream, and allows your bladder to empty completely. Avoid hovering over the toilet seat, as it can make it harder for your bladder to empty completely.

Limit bladder irritants

Certain foods and drinks can irritate the lining of your bladder, leading to increased urgency, frequency, or leakage. Common bladder irritants include caffeine (found in coffee, tea, chocolate, and some sodas), carbonated beverages, alcohol, spicy foods, artificial sweeteners, and acidic foods like citrus fruits and tomatoes.

While these bladder irritants don’t affect everyone the same way, you may notice more leaks or discomfort after consuming them. If you suspect something in your diet is making symptoms worse, try tracking what you eat and drink and noticing how your bladder feels afterward. Gradually reducing or eliminating suspected triggers can help you figure out what works best for your body and support better postpartum bladder control.

Stay active before and after delivery

Regular physical activity helps support your overall health and can play a key role in preventing and managing postpartum urinary incontinence. Staying active before delivery keeps your muscles — especially your core, hips, and pelvic floor — strong and coordinated, better preparing your body for birth and recovery. After delivery, gentle movement such as walking, stretching, or targeted pelvic floor exercises can help your body heal, support bladder control, and boost your energy. 

Check with your healthcare provider before starting any new exercise routine or resuming activities after giving birth.

Stay hydrated

It’s a common misconception that drinking less will help prevent leaks. Not getting enough fluids can actually make urinary symptoms worse. When you limit water intake, your urine becomes more concentrated, which can irritate the bladder and increase the urge to go. Staying well-hydrated helps keep your bladder lining healthy and may make it easier to manage leaks. Aim to drink enough water so your urine is a pale yellow color. If you consume known bladder irritants, drinking extra water can help dilute their effects. 

Manage constipation

Postpartum constipation can strain pelvic floor muscles, which may lead to bladder control problems or make stress incontinence worse. To help prevent constipation, eat more fiber, stay hydrated, and avoid straining on the toilet, suggests Dr. Marquez. Instead, place a small stool or box underneath your feet so your knees sit higher than your hips. This can help relax your pelvic floor and make it easier to pass stool. Taking time for undisturbed bathroom visits and practicing diaphragmatic breathing during bowel movements can also help you avoid straining.

Engage your core when lifting your baby

Lifting your baby and other heavy objects (car seats, laundry baskets, etc.) is a regular part of life after childbirth, but these movements can put extra pressure on your pelvic floor and may contribute to back pain and postpartum urinary incontinence. 

Practicing good lifting habits can help protect your bladder and pelvic floor muscles during recovery. There’s no single right or wrong way to lift, but this guidance is generally helpful: As you get ready to lift, take a deep breath in. Gently engage your core muscles (think about hugging your belly toward your spine). Then, exhale as you lift, keeping your baby close to your body and using your legs to power the movement. “This technique helps reduce strain on your pelvic floor and supports better bladder control, making everyday activities feel more manageable as you heal,” says Dr. Marquez.

How long does postpartum incontinence last?

Postpartum urinary incontinence often improves as your pelvic floor muscles and tissues recover after pregnancy and childbirth. This process can take a few weeks to a few months. Gentle stretches, targeted exercises, and simple lifestyle changes can help speed up your recovery and reduce urine leaks. 

For some people, postpartum incontinence may last for months or longer. “If your symptoms aren’t starting to improve after six to eight weeks postpartum or are affecting your daily life, see your healthcare provider and consider pelvic floor physical therapy,” says Dr. Marquez. “There are a lot of effective options to help you feel your best again.”

PT tip: Think beyond Kegels

Kegels can strengthen your pelvic floor muscles to help support your bladder and prevent leakage. “But managing postpartum incontinence isn’t just about Kegels,” says Dr. Marquez. “Your breath, core, hips, and everyday movement patterns all work together with your pelvic floor to support bladder control.” Improving how you breathe and move during daily activities can be just as important as exercise, Dr. Marquez explains. “And remember: Recovery takes time, but your body is adaptable and strong.”

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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