Your frequent need to pee may have turned into urinary incontinence, or leaking of urine, especially when you sneeze, cough, laugh or strain. Don't worry; it's very common and likely won't last.  Here's what you can do to minimize the possible embarrassment factor.

When does urinary incontinence start during pregnancy?

You may have noticed soon after you learned that you were pregnant that you suddenly needed to run to the ladies room more often than usual.

Gradually, a frequent need to pee during pregnancy may have become even more frequent, especially during the last trimester, when your growing baby puts extra pressure on your bladder. It may even turn into difficulty with bladder control. 

Don’t worry or be embarrassed! Involuntary peeing during pregnancy can be annoying, messy and occasionally mortifying. But it's common and usually temporary.

What causes urinary incontinence during pregnancy?

Hormonal changes, especially fluctuating levels of relaxin and progesterone (which help control your bladder), are mainly to blame.

Risks for incontinence during pregnancy increase if you have a history of urinary tract infections, you previously delivered vaginally, you're older or you weigh more (excess weight puts more pressure on the bladder).

If you were bothered by leaks before getting pregnant, you’ll probably experience even these days. Unintended leakage can happen anytime but especially when you laugh, sneeze or cough. (If you’re going to a funny friend’s house for lunch, pack an extra pair of undies!)

What can I do about urinary incontinence when I'm pregnant?

  • Do your Kegels. Try to work up to three sets of 10 Kegel exercises a day. Also try doing a Kegel exercise when you feel the need to cough or sneeze, or when you're about to laugh or lift something heavy. That can help control bladder urges and decrease your leakage.
  • Keep your pregnancy weight gain moderate. Extra pounds put extra pressure on your bladder during pregnancy.
  • Try to minimize constipation during pregnancy. Full bowels can put added pressure on your bladder.
  • Keep drinking at least 8 to 10 glasses of fluids every day. Cutting back on water to control the peeing only makes you vulnerable to dehydration and urinary tract infections.
  • Avoid coffee, soft drinks, and alcohol. They can irritate your bladder and make it harder to control those leaks.
  • Use pads as a backup to absorb leaks. But no tampons, please — they don't block the flow of urine and they're off-limits during pregnancy anyway.

Can I prevent urinary incontinence during pregnancy?

Some research suggests that women with strong pelvic floor muscles are less likely to leak urine during pregnancy. But don’t kick yourself if you didn’t do your Kegels; there’s a lot you can’t control during pregnancy, and your bladder just might be one of those things.

When can I expect urinary incontinence to end?

After you have your baby, the incessant urge to pee will cease, and your bladder will often snap back to normal along with the rest of your body. But it might take longer.

Women who had especially long vaginal births or have difficulty losing weight may continue to deal with involuntary peeing. If that’s the case, it just might be time to enlist your practitioner’s help.

When should I call the doctor?

A little dribbling can be a big nuisance, but most women report no more than a few episodes of leaking per day during pregnancy. A quick smell test should confirm it; urine smells of, well, urine (grassy and slightly ammonia-like).

Call your practitioner right away if the liquid is flowing, not leaking, and clear and odorless. There's a chance you might be leaking amniotic fluid.

Even if you're sure it's urine, mention your urinary incontinence issues to your practitioner at your next visit and ask for his or her recommendations. If Kegel exercises are not enough to control your leakage, sometimes a vaginal device (called a pessary) can help.

If you have any risk factors for postpartum urinary incontinence, let your practitioner know so he or she can discuss your treatment options. There are prescription medications and even surgical approaches for an overactive bladder and incontinence, but they should be avoided during pregnancy in favor of exercises and behavior modification. After your baby is born, there are other options you may want to consider, including postpartum pelvic floor physical therapy.