A sneeze and you feel a few drops escape. A fit of laughter with your partner and you have to run to the bathroom. Lift your shopping bag and... another little leak. Welcome to a reality no one really talks about before getting pregnant. Between 30% and 67% of pregnant women experience urinary leakage during their pregnancy, according to studies. That's almost 1 in 2 women. Yet the subject remains taboo, as if it were an embarrassing detail to be handled in silence. It's neither normal nor inevitable, and above all, several solutions exist to drastically reduce these leaksThis article tells you the truth about urinary leaks during pregnancy, why they happen, and what you can actually do to prevent or limit them.
The main thing to remember
- 30 to 67% of pregnant women have urinary leaks, especially from the 2nd trimester
- Kegel exercises DURING pregnancy prevent leaks in 1 in 6 women during pregnancy and 1 in 8 after childbirth
- Start from 20 weeks of pregnancy gives the best results
- 12% of women still have leaks in the days following delivery
- Urinary leakage ≠ amniotic fluid : Urine is spotty and yellowish, amniotic fluid is clear, odorless and continuous
- Leaks often disappear after delivery, especially if you are doing perineal rehabilitation
- It's not inevitable : Preventive measures can be a game changer
Why Your Body Is Letting Go (Literally)
Bladder leakage during pregnancy isn't a bodily malfunction. It's the result of a perfect storm where several factors combine to put maximum pressure on your perineum.
Cause #1: The Uterus That Crushes Everything
Imagine a balloon gradually inflating over your bladder. That's exactly what's happening. As the months go by, your uterus grows to accommodate your baby. In the second trimester, it begins to exert significant pressure on your bladder. By the third trimester, it's completely squashed.
Direct consequences
- Your bladder capacity decreases (it can no longer hold as much urine)
- You feel like you have to urinate every hour, even if you just went
- The slightest additional pressure (coughing, sneezing) is enough to break the camel's back
- The night becomes hell: you get up several times to urinate because when lying down, the fluids retained in your legs return to the bloodstream and end up in your bladder.
Cause #2: Relaxin, That Treacherous Hormone
Relaxin is a hormone secreted during pregnancy to prepare your body for childbirth. Its role? To soften ligaments and relax pelvic muscles so the baby can pass through. Except it doesn't get bogged down in details. It relaxes EVERYTHING, including the muscles of your pelvic floor and urinary sphincter.
As a result, your pelvic floor—the hammock of muscles that normally supports your bladder, uterus, and rectum—loses its tone. It becomes less effective at holding pressure when you cough, laugh, or exert yourself.
Cause #3: Weight (Yours + Baby's)
Between the weight of the baby, the placenta, the amniotic fluid, and your own pregnancy weight, you're carrying an average of 10 to 15 extra kg. This load puts constant and increasing pressure on your pelvic floor.
Aggravating factors
- Excessive weight gain The more kilos you gain beyond the recommended weight (12 kg on average), the more pressure on your bladder increases.
- Overweight before pregnancy : A high BMI at the start further weakens the perineum
- Chronic constipation : Repeated thrusts further weaken the pelvic floor
- Age > 35 years : Pelvic tissues naturally lose tone and elasticity with age.
- Multiple pregnancies : Each pregnancy/childbirth weakens the perineum a little more if there is no rehabilitation between the two.
Cause #4: Your Bladder Is Producing More Urine
From the very beginning of pregnancy, your kidneys are working overtime. They filter more blood (yours and the baby's) and therefore produce more urine. As a result, your bladder fills faster and you feel the need to urinate more often, starting in the first trimester.
Quarter by Quarter: When Leaks Appear
Urinary leaks do not all occur at the same time during pregnancy. Each trimester has its own specificities.
The most common type of leakage: stress incontinence
During pregnancy, you mainly suffer from stress incontinence. This means that leaks occur during exertion that increases abdominal pressure:
- Coughing, sneezing, laughing
- Lifting an object (even a light one like your oldest child)
- Physical activity (brisk walking, stair climbing)
- Change of position (getting up from a chair, getting out of the car)
- Sometimes even just walking or standing in late pregnancy
Urinary Leakage or Amniotic Fluid Loss? The Panic-Stricken Question
Especially in late pregnancy, many women ask themselves this anxiety-inducing question: "What if it's not urine but a ruptured water bag?" The confusion is understandable, but there are simple ways to tell the difference.
Simple test to do at home
After urinating, place a panty liner or toilet paper inside your underwear. Wait 15-30 minutes. If the panty liner stays dry, it was probably just urine. If the panty liner continues to be wet with a clear, odorless liquid, call your maternity ward.
If in doubt, ALWAYS call your maternity ward. A ruptured water bag requires medical attention, even if the flow is minimal.
Kegel Exercises During Pregnancy: Your Best Weapon
The good news is that you are not doomed to passively suffer. Scientific studies are clear: doing Kegel exercises DURING pregnancy prevents leaks in 1 in 6 women during pregnancy and 1 in 8 women after childbirth.The earlier you start, the better the results.
What the scientific studies say
- A Cochrane review (worldwide reference) shows that Kegel exercises during pregnancy reduce the risk of incontinence by 30% in late pregnancy.
- Women who do supervised exercise during pregnancy are 32% less likely to have leaks at 36 weeks
- The protective effect is maintained after delivery: 20% leaks in the "exercise" group vs. 32% in the control group at 3 months postpartum
- The more intensive the program (3 supervised sessions per week), the better the results
When to Start Exercises
The ideal time: from 20 weeks of pregnancy (beginning of the 5th month)At this stage, the perineum is beginning to be stressed but is not yet too weakened. You have time to strengthen it before the third trimester when the pressure becomes maximum.
However, it's never too late. Even if you're in your eighth month, starting now is better than doing nothing at all. The benefits will be less for your current pregnancy, but you'll be better prepared for delivery and postpartum recovery.
Exercises Suitable for Pregnancy
Kegel exercises remain the same as during pregnancy, but with some adaptations. During pregnancy, favor comfortable positions and avoid lying completely on your back after 20 weeks (a position that compresses the vena cava).
Daily program during pregnancy
Exercise 1: Fast Contractions
- Sitting or semi-reclining position (back supported by cushions)
- Contract the perineum for 2 seconds
- Release for 2 seconds
- Repeat 10 times, 3 times a day
Exercise 2: Long contractions
- Same position
- Contract the perineum for 5 to 10 seconds
- Release for 10 seconds
- Repeat 10 times, 2 times a day
Exercise 3: Preventive contraction (the most important!)
- BEFORE you cough, sneeze, laugh or stand up, contract your perineum
- Maintain the contraction during the effort
- This technique prevents leaks in real time. Over time, it becomes a reflex.
Have Your Exercises Supervised (Really Important)
About 50% of women don't properly contract their pelvic floor muscles without guidance. They push instead of contracting, or contract the wrong muscles (abdominals, glutes). As a result, the exercises are ineffective or even counterproductive.
Ideally, consult a physiotherapist specializing in perinatal care or a midwife from the second trimesterOne or two sessions are enough to learn the correct technique. Then, you continue on your own at home. The sessions can be covered by Social Security upon prescription.
Other Preventive Actions That Work
Beyond Kegel exercises, several daily habits can limit leaks during pregnancy.
Control Your Weight Gain
Gaining the weight recommended by your doctor (around 12 kg for a single pregnancy) without excess limits the pressure on your perineum. Every extra kilo beyond the recommendations increases the load on your pelvic floor.
Avoid Constipation
Constipation is common during pregnancy (hormones + pressure of the uterus on the intestines). Repeated pushing on the toilet weakens the perineum. To avoid it:
- Drink 1,5 to 2L of water per day
- Eat fiber (fruits, vegetables, whole grains)
- Walk 30 minutes a day
- Never hold it in: go to the bathroom whenever you feel like it.
Adapt Your Physical Activity
Some high-impact sports (running, tennis, trampolining) increase pressure on the perineum. Focus on gentle activities:
Recommended sports during pregnancy
- Swimming (ideal sport, no impact)
- Walking (30 minutes per day)
- prenatal yoga
- Pilates suitable for pregnant women
- Exercise bike (without too much resistance)
Quit Smoking
Aside from the obvious risks to the baby, smoking causes chronic coughing, which puts repeated pressure on the perineum. In addition, smoking reduces estrogen production, further weakening the pelvic muscles.
Avoid carrying heavy loads
If you already have a child, avoid carrying them as much as possible (especially after the second trimester). If you have to lift something, first contract your perineum, then lift while exhaling.
Protections to Manage Everyday Leaks
While you wait for your perineum to strengthen (or if exercises are not enough), there are solutions to help you experience your pregnancy peacefully without the constant fear of a leak.
Urinary Leakage Panties
Washable absorbent underwear has become the preferred solution for many pregnant women. Unlike disposable panty liners that move, show, or smell bad, they look like regular underwear, are comfortable, and are environmentally friendly.
Pregnant with urinary leaks?
Special bladder leak underwear offers discreet protection and comfort throughout your pregnancy. Washable and reusable, they're perfect for those small, everyday leaks.
Other Protection Options
- Panty liners for light leaks : Thinner than classic protections, to be changed regularly
- Absorbent towels : For moderate leaks, different tailles available
- Adapted changes : For more severe incontinence (rare during pregnancy)
After Childbirth: When Does It Stop?
The question every pregnant woman asks herself: will the leaks go away after delivery? The answer depends on several factors.
The First Weeks Postpartum
In the days following childbirth, 12% of primiparous women (first baby) still have urinary leaksThis is normal. Your perineum has just suffered a significant trauma. It needs time to recover.
Factors that increase the risk of postpartum leakage
- Vaginal delivery with very long pushing (more than 2 hours)
- Baby weighing more than 4 kg
- High baby head circumference
- Use of instruments (suction cup, forceps)
- Perineal tear or episiotomy
- Multiple pregnancies close together without rehabilitation in between
Evolution in the following months
The good news : For most women, leaks gradually disappear within 3 to 6 months after delivery, especially if you are doing perineal rehabilitation.
- 30-35% of women still have leaks 3 months after giving birth
- only 10% continue to suffer from it beyond 3 months if no rehabilitation has been carried out
- 3-5% of women develop long-term persistent incontinence requiring medical treatment
Perineal Rehabilitation: Mandatory After Childbirth
In France, perineal rehabilitation is systematically prescribed after childbirth (generally 10 sessions). This is THE solution that works to restore a toned perineum and eliminate postpartum leaks..
Postnatal rehabilitation schedule
- 6-8 weeks after delivery : Postnatal visit to your gynecologist or midwife who will prescribe rehabilitation
- 2-3 months postpartum : Start of sessions with a physiotherapist or midwife
- 10 sessions reimbursed by Social Security
- Visible improvement from 4-6 weeks regular rehabilitation
Take Back Control
Bladder leakage during pregnancy affects almost 1 in 2 women, especially from the second trimester onward. Several factors combine to create this problem, including the pressure of the uterus on the bladder, hormones that relax the muscles, and weight gain. But it's neither normal nor inevitable.
Prevention really does work. Starting Kegel exercises as early as 20 weeks of pregnancy reduces the risk of leaks by 30% during pregnancy and after delivery. Ideally, have them supervised by a professional to learn the correct technique. Monitor your weight gain, avoid constipation, quit smoking, and adjust your physical activity.
After childbirth, leaks gradually disappear for most women, especially with pelvic floor rehabilitation. Don't let discomfort prevent you from talking to your midwife or gynecologist. Solutions exist, and you have the right to experience your pregnancy without the constant stress of leaks.
Sources & Scientific References
This article is based on scientific studies published specifically on pregnancy and urinary leakage.
Effectiveness of Kegel exercises during pregnancy
- Mørkved S, Bø K. (2003). Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. British Journal of Sports Medicine. DOI: 10.1097/00006254-200304000-00011
- Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay‐Smith EJC. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database System Rev. DOI: 10.1002/14651858.CD007471.pub4
- Hay‐Smith J, Mørkved S, Fairbrother KA, Herbison GP. (2012). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database System Rev. DOI: 10.1002/14651858.CD007471.pub2
Prevalence and risk factors during pregnancy
- Sangsawang B, Sangsawang N. (2013). Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. DOI: 10.1007/s00192-012-1952-8
- Sampselle CM, Miller JM, Mims BL, Delancey JO, Ashton-Miller JA, Antonakos CL. (1998). Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gynecol. DOI: 10.1016/s0029-7844(97)00475-9
Supervised vs. Unsupervised Exercises
- Gorbea ChV, Velázquez RG, Kunhardt RJ, Medina CO, Azpiroz CL, García BH. (2004). Effectiveness of pelvic floor muscle training for the prevention of urinary incontinence in primigravidae. Ginecol Obstet Mex. PMID: 15098866
- Stafne SN, Salvesen KÅ, Romundstad PR, Eggebø TM, Carlsen SM, Mørkved S. (2012). Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial. Obstet Gynecol. DOI: 10.1097/aog.0b013e3182605f27
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. If you experience urinary leakage during pregnancy, speak to your midwife, gynecologist, or primary care physician.
