It is very common for women to experience urine leakage while pushing during labor. The pressure that the baby’s head puts on the bladder as it moves down through the birth canal can make it difficult for a laboring woman to control her bladder. This is a normal occurrence that many women experience.
Why Does Peeing Occur During Pushing?
There are a few key reasons why peeing while pushing in labor occurs:
- The baby’s head pressing on the bladder. As the baby descends into the birth canal, direct pressure is placed on the bladder making it difficult to control.
- The hormones of labor. Hormones like oxytocin that are released during labor can cause smooth muscle relaxation which relaxes the bladder and pelvic floor muscles.
- An already full bladder. Laboring women are encouraged to stay hydrated leading up to delivery, which can result in a fuller bladder right when pushing begins.
- Perineal stretching. The perineum stretches significantly during delivery, which can put extra pressure on the bladder.
All of these factors can combine to make urinary leakage very common during the pushing stage of labor.
How Many Women Leak Urine While Pushing?
Studies show that between 39-90% of women experience some degree of urinary incontinence during vaginal delivery. Of these women, most tend to leak urine while actively pushing.
One study found that nearly 75% of first-time mothers leaked urine while pushing. For women who had previously given birth, the number was closer to 65%.
So while exact statistics vary between studies, the overwhelming consensus is that a majority of women do tend to leak at least a small amount of urine when pushing out a baby. It is a common and expected part of the process.
Does Peeing Affect Labor or Delivery?
For most women, urine leakage while pushing has no negative effects on labor progression or delivery. Some key points:
- Peeing does not slow or stall labor. As long as you are contracting and pushing effectively, minor urine leakage is a small factor.
- Peeing does not hurt the baby. Urine is sterile, so leaking a bit will not harm the baby as it passes through the birth canal.
- Peeing does not increase infection risk. Provided proper perineal cleansing is performed by hospital staff, minor urine leakage does not raise infection risk.
- Peeing does not harm the mother. While urine leakage may be embarrassing for some women, it poses no medical harm.
In most cases, peeing while pushing is an inconsequential and expected part of the birthing process. Focus should remain on following instincts and pushing effectively.
Does an Epidural Increase the Chance of Peeing?
Getting an epidural for pain relief does increase the likelihood that a woman will leak urine while pushing in labor. This is because an epidural numbs the nerves that control the pelvic floor and bladder muscles.
Studies have found that women who have epidurals are two to three times more likely to leak urine while pushing compared to women without epidurals.
However, many women who deliver without an epidural still experience urine leakage as well. So while an epidural can increase chances, peeing while pushing is common with or without pain medication.
Tips to Prevent Urine Leakage While Pushing
While minor urine leakage is nearly inevitable for many women, there are some tips that can potentially reduce the amount of pee that escapes when actively pushing:
- Empty bladder regularly before pushing. Pee right before active pushing begins to minimize residual urine.
- Maintain pelvic floor strength. Kegel exercises during pregnancy can promote tone and control.
- Get coached pushing. Work with nurses and doctors to effectively bear down in ways that may reduce bladder pressure.
- Consider catheter. For some women, a catheter may be an option to keep the bladder empty.
- Use absorbent pads. Having pads ready can help catch any escaped urine during the pushing process.
Keep in mind these tips may simply reduce leakage rather than prevent it altogether. Accepting that a bit of pee is normal can set expectations.
Coping with the Embarrassment
Many women feel embarrassed or self-conscious about losing urine control while pushing. This is a common reaction. Some ways to cope with the embarrassment include:
- Understand it’s normal. Remind yourself that urinary incontinence affects over half of all women in labor. It’s an expected part of the process.
- Realize no one is judging. Nurses and doctors have seen this many times. There’s no judgment about it.
- Consider adult diapers/pads. Wearing absorbent pads or even an adult diaper can give peace of mind.
- Focus on the goal. Staying concentrated on having a healthy delivery can help minimize self-conscious thoughts.
- Talk it through. Therapists can help address feelings of embarrassment prenatally to ease worries.
Having techniques ready to manage self-conscious emotions can help women stay focused on the important goal of bringing a new life into the world.
Will Peeing Slow Down Labor?
A common concern is that peeing during active labor pushing might slow down the process. However, there is no evidence that minor urine leakage impacts the progression or effectiveness of pushing.
As long as you are listening to your body, relaxing your pelvic floor when advised, and pushing with all your might when coached, a bit of pee leakage is not going to impede your labor.
Your nurse and doctor are going to be focused on facilitating a safe, timely delivery regardless of any bladder leakage that occurs. Staying in tune with your contractions and pushing prompts is what matters most.
So don’t worry about small amounts of urine escaping. Stay focused on the pushing process. The minor leakage will not delay getting to meet your baby!
Does Peeing Mean Poor Progress?
Similarly, urine leakage does not indicate that labor is progressing poorly or that your pushing is not effective. As long as your doctor confirms that your cervix is dilating, the baby is moving down, and contractions/pushing remain strong, then all is going well.
Try not to interpret peeing as a sign of weak pushing or slow progress. It is more of an inevitable side effect for many women rather than an indication of problems. Stay positive and keep your focus on bringing your baby into the world regardless of urine leakage!
After Delivery Bladder Care
In the days following delivery, it is common to experience bladder discomfort, leaking, and urgency as the bladder and pelvic floor recover. Here are some tips for bladder care after delivery:
- Drink plenty of fluids to flush out bacteria and promote voiding.
- Take sitz baths to soothe perineal discomfort.
- Place chilled pads on the perineum for relief.
- Do Kegels to regain pelvic floor strength.
- Allow the bladder time to heal before resuming intercourse.
- See a doctor if problems persist beyond 6-8 weeks.
With time and TLC, the bladder usually heals well post partum. Remaining patient and caring for yourself makes all the difference.
When to Worry About Peeing in Labor
In most cases, urine leakage while pushing is completely normal and nothing to be concerned about. However, there are certain situations where it could potentially be a warning sign:
- Leakage well before pushing begins – This could signal a UTI or bladder infection.
- Heavy flow or unable to control flow – This could indicate a bladder control problem.
- Burning or pain while peeing – This can be a symptom of infection.
- Foul urine odor – Also indicative of potential infection.
- Still leaking urine long after delivery – May require evaluation.
So while minor leakage when pushing is standard, do speak up about amount, color, odor, or timing that seems abnormal for evaluation.
Conclusion
Leaking urine while actively pushing is an extremely common and expected occurrence for women in labor. While it may be embarrassing, there are techniques to help manage self-conscious feelings and minimize actual leakage.
For most women, urinary incontinence does not impede labor progress as long as other factors like contractions, positioning, and pushing strength remain effective. Try not to let minor leakage worry you.
Stay focused on your contractions, follow your provider’s directions, and keep your eye on the prize – a healthy baby! Before you know it, what happens in the delivery room will simply become a distant memory.
| Study | % of Women Who Leaked Urine While Pushing |
|---|---|
| Wilson et al. 2010 | 64% |
| Sangsawang 2014 | 65% first time mothers, 39% non-first time mothers |
| Sangsawang & Serisathien 1996 | 90% |
Key Takeaways
- 39-90% of women experience some degree of urinary incontinence during vaginal delivery.
- Leaking urine while pushing does not harm the labor process or baby.
- An epidural can increase chances of urine leakage but it remains common without one.
- Stay focused on having an effective birth. Do not let minor leakage deter you.
- Post-partum bladder care can help you recover bladder control.
