Many postpartum women have difficulty with bladder urgency (OAB). As a pelvic health specialist I’m here to explain why that happens and practical ways to control bladder urgency that put you back in charge!
As a pelvic health specialist I hear a lot about bladder urges and the difficulties that many postpartum moms are having controlling bladder urgency. It’s enough that as a new mom you are super busy, but then to have to worry about finding a toilet all the time. Yikes!
I’m thinking of this as I’m talking to a new mom who, like most pregnant moms, was going to the bathroom frequently prior to the delivery of her child. Frequent bathroom breaks while pregnant is normal due to the babies growing weight.
But now, even after having her baby the bladder urgency continues.
She’s even gone to her doctor to get checked for a bladder infection, but test results came back negative. That’s good news but frustrating at the same time, because the urgency continues.
She feels like her bladder is ‘lying to her’ because when she does go to the bathroom very little comes out.
It’s so bad she is now looking for the bathroom every hour or less. What’s worse, all of this worry is affecting her mental focus as well. After listening to her tell me about her bladder and asking her questions I tell her one simple truth about bladder urgency.
Bladder urges are suggestions, NOT commands.
And here’s the reason why. When your bladder is filling up, it is mostly quiet until it reaches the half-way point. Once your bladder is half full it will give you a signal or gentle urge to let you know it has reached that mark.
If you act on that first urge, it is likely that a rather small amount will come out. If you continue to act on first urge, your bladder never fully stretches to reach capacity and in response to the constant emptying, your bladder slowly becomes smaller.
Your now smaller bladder reaches half-full, you respond by emptying and the negative cycle continues. It gradually continues this way until you find yourself constantly looking for a toilet. Trust me, you don’t have to live this way!
Worried that if you hold it, it will be hurting your bladder?
Your bladder is a muscle that is meant to stretch. But if this is new to you, the sensation of stretching can be uncomfortable at first. For more tips and information on bladder filling, check out my blog on What’s ‘Normal’ for Bathroom Breaks.
So how do you get out of this cycle of bladder urges?
As a pelvic health specialist I often teach bladder urge suppression techniques to gain control.
Here are my favorite tips to help mom’s regain confidence over bladder urges.
- When you get the first urge, STOP and DO NOT run to the bathroom! Take a moment before heading off to the toilet. Did you just go a little while ago? Do you really feel full, or is this just an automatic response? Sometimes just the simple awareness of what is going on is enough to shift our mindset and get the urge to settle down. If not, try the following steps.
- Quickly contract your pelvic floor muscles 10 times or more. These are the muscles in the vaginal area, so think about closing the vaginal opening and lifting them upward like an elevator. These are also the same muscles you use to hold back urine. After ten quick ‘elevators’ you can keep holding the muscles in, if you feel like that may help.
- Positive self talk is important! Calming words to yourself are essential so that you stay out of panic mode and your brain doesn’t feel under threat. I recommend a few positive mantras such as:
- I’ve got this.
- I have this under control.
- I can do this!
- If you can, sit down or cross your legs. If that’s not enough, sit on your heel, or place a towel roll between your sit-bones. Pressure in the area will help with urge suppression as well.
- Distraction! After all of the above steps, shift your focus to something else. Think of all the times you were super busy and didn’t feel bladder urgency even after a long stretch of time.
Most of all, take a few breaths and wait for the urgency to pass.
Once the urgency has passed, do a mental body scan and see how you feel. Do you feel full and still need to go, or can you wait awhile?
Don’t feel full and decide you can wait. That’s a plus. Yay!
The ability to hold is important because we don’t always have ready access to a toilet and so being able to hold off when you need to is important. Holding off also builds confidence, when you have the ability to wait, life feels a whole lot calmer.
What if I do feel full? Not to worry!
In that case please go and empty your bladder. You don’t need to needlessly hold if you really have to go. What’s important in this case is getting there without hurrying. Instead, calmly walk to the bathroom. If you hurry it could trigger a familiar panic feeling and the urgency may return.
In either case, mastering bladder urges is important so that you put YOU back in charge!
Once my new mom mastered her bladder urges, it opened up a world of confidence and possibility. Her world was no longer restricted to bathroom seeking and she no longer had fears about bladder urgency striking at any moment. Freedom!
Want a list of the steps above? Grab a free printable here of the above steps to have on hand when you need them.
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Wishing you a Happy Bladder! 
Tami Lines is a licensed Physical Therapist with certifications in Pelvic Rehabilitation and Women’s Health Coaching. She is the founder of Pelvic-Health-Matters. Tami has over 15 years of experience with expertise in bladder Health, and pelvic floor muscle dysfunction for adolescent and adult women. She is also a mom of two wonderful young adults working their way through college.
Monteiro S, Riccetto C, Araujo A, Galo L, Brito N, Botelho S. Efficacy of pelvic floor muscle training in women with overactive bladder syndrome; a systematic review. Int Urogynecol J. 2018; 29:1565-1573.
Lukacz ES, Sampselle C, Gray M, MacDiarmin S, Rosenberg M, Ellsworth P, Palmer MH. A healthy bladder: a consensus statement. Int J Clin Pract. 2011; Oct; 65 (10): 1026-1036.
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