Incontinence after Miscarriage
“I just had a miscarriage and now I keep peeing my pants.”
“Why do I have incontinence after my miscarriage?”
“I never leaked before my miscarriage!”
An early miscarriage is when we lose the baby before 12 weeks of pregnancy. Here’s the thing, a loss, no matter how early on is still a loss. Just because your baby arrived before the second trimester, doesn’t mean you were any less pregnant…your body still went through a ton of changes during that time. Here’s a few of those changes that you may notice increases incontinence after a miscarriage:
Hormones and Increased Blood Flow
During early pregnancy we are metabolically active to the point that there’s a 50% increase in flow to our kidneys by the end of the first trimester. (1) These changes mean that urine production is actually at it’s highest during the first 9-16 weeks of pregnancy.
Additionally, estrogen/estradiol increases from the time of ovulation throughout the first trimester before spiking in the second trimester. Estrogen increases muscle laxity and decreases muscle stiffness. After a miscarriage, estrogen drastically decreases and can increase muscle stiffness and reduce the amount the pelvic floor muscles can relax.
Although you may have miscarried before 12 weeks, these drastic hormonal shifts still occurred. Your body still increased the amount of urine it made and still changed the elasticity of your pelvic floor tissue. The good news here is that these hormonal shifts are transient and will usually self-correct around 4-6 weeks after a miscarriage. If you “feel off” or like you don’t have energy beyond this, please find a functional medicine provider near you that can help create a specific care plan for your needs.Pelvic Floor Tightness
Beyond those hormonal changes you experienced after a miscarriage that directly affect the pelvic floor, the added stress/tension you feel may limit your ability to relax and lengthen the pelvic floor. Relaxing and lengthening the pelvic floor helps release tension and allows the body to quickly respond to things like laughing, sneezing or coughing. After a miscarriage, it’s not uncommon for mamas to find comfort in the fetal position or basically pull their pelvic floors upward. It’s like we are trying to hold on to the baby that we lost and keep everything in. Unfortunately, this adds increased tension to the pelvic floor to the point the pelvic floor can’t relax to lengthen and in return it can’t respond quickly to contract and keep pee from leaking. If you feel any pressure, pain or discomfort “down there” after your loss and it continues beyond 4 weeks, please reach out to a pelvic floor rehab provider to help you.Constipation
Remember that drastic decrease in estrogen? Unfortunately, those large fluctuations can also lead to constipation. If you find yourself constipated, it may be helpful to make sure you stay hydrated, eat fiber (if you haven’t eaten a ton of fiber in the past, it’s a good idea to start slow and gradually add probiotics and soluble fiber), exercise, eat cruciferous vegetables like broccoli or Brussels sprouts and meditate (Expectful offers a free meditation for miscarriages).
Like almost everything in line, there is a fine balance in healing following a miscarriage that is unique for each of us. It’s important to find what works (and what doesn’t work) for you.
Find a functional medicine provider:
Institute for Functional Medicine: https://www.ifm.org
Integrative Women’s Health Institute: https://integrativewomenshealthinstitute.com
Find a pelvic floor rehab provider:
Pelvic Guru: https://pelvicguru.com
Pelvic Rehab: https://pelvicguru.com
Can’t find someone local or nervous to have an assessment? You can perform a self-assessment using our guided assessment here: https://drlaurenkeller.com/programs
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