Postpartum Bladder Changes: What’s Normal and What’s Not
Here’s something that rarely comes up in prenatal classes: nearly half of all new mothers experience some degree of urinary leakage in the first year after giving birth. That’s 45% of women — yet most quietly endure it, convinced it’s just another part of motherhood they have to live with.
A few weeks ago, one of my patients, Rachel, came to see me. She was eight months postpartum and looked completely drained.
“Dr. Liang,” she said, “I leak every time I pick up my baby. My mother-in-law says this is just how it is after having kids. But I’m only 29. Is this really forever?”
In my 15 years as a urologist, I’ve had this exact conversation hundreds of times. The truth is — temporary bladder changes are common after childbirth, but that doesn’t mean you’re doomed to deal with them forever.
What Really Happens to Your Bladder and Pelvic Floor
During the first 6 to 8 weeks postpartum, some bladder changes are completely expected. These may include:
- A little leaking when you cough, sneeze, or laugh
- Needing to urinate more often than usual
- A feeling that your bladder isn’t emptying completely
- Mild urgency or pressure in the pelvic area
These usually improve as swelling goes down and your muscles start to recover.
When It’s Time to Get Checked
Some symptoms, however, are not normal and need medical attention. Please reach out to a doctor if you experience:
- Severe difficulty starting to urinate or completely emptying your bladder
- Burning or pain when urinating
- Blood in the urine
- Fever alongside urinary symptoms
- Leakage that’s worsening over time
- Urine leakage so frequent it affects your daily life or sleep
I often tell my patients: if you’re changing pads several times a day because of leakage, or if you’ve stopped doing activities you love out of embarrassment or fear, it’s time for an evaluation.
The Most Common Postpartum Bladder Issues I See
- Stress Incontinence
This is by far the most common. It’s when you leak urine during activities like laughing, coughing, sneezing, or exercising.
For example, Jennifer, a mom of twins, told me she couldn’t do jumping jacks without leaking. “I used to run 5Ks,” she said, “now I can’t even work out at home without an accident.” - Urgency or Frequency
Some women feel the need to urinate often, or experience sudden strong urges that are hard to control. This can happen when the bladder becomes overly sensitive after pregnancy. - Incomplete Emptying
Sometimes the bladder muscles don’t contract properly, or the bladder itself shifts position slightly after delivery. This can lead to that constant “still need to go” feeling, or recurring urinary infections. - Painful Urination
This isn’t normal and usually points to an infection or tissue irritation that needs prompt care
Recovery: What to Expect
At Harbor-UCLA, I treated athletes with exercise-associated hyponatremia—a dangerous drop in blood sodium caused by drinking too much water.
One triathlete, Jessica, ended up in the ER after a race because she forced herself to drink every 15 minutes. Her sodium levels dropped so low she became confused and nauseous.
Overhydration stresses your kidneys and, in extreme cases, becomes life-threatening.
So, How Much Do You Actually Need?
Most women gradually regain normal bladder control within three to six months after giving birth. But here’s what I learned during my fellowship at UCLA — waiting and hoping for it to “get better on its own” isn’t always the best plan.
Starting gentle pelvic floor exercises early on and addressing issues as soon as they appear can make a huge difference in long-term recovery.
Here’s a realistic timeline based on what I see in my practice:
- Weeks 1–6: Expect mild symptoms but gradual improvement
- Months 2–3: Noticeable progress in most women
After 6 months: If things haven’t improved or are getting worse, it’s time to get evaluated
What Really Works
Pelvic Floor Physical Therapy is my go-to treatment for most postpartum bladder issues. These specialized therapists assess your individual muscle strength and coordination — and guide you through targeted exercises. It’s much more effective than just “doing Kegels” on your own.
Take Amanda, one of my patients. After her third child, she had significant stress incontinence and had to wear pads daily. Eight weeks into guided pelvic floor therapy, she no longer needed them.
Other treatment options can include bladder training, lifestyle adjustments, or in some cases, minimally invasive procedures — but most women see major improvement with therapy alone.
My Message to New Mothers
If you’re struggling with bladder control after giving birth, you’re not alone — and it’s not something you just have to live with. These changes are common, but they are absolutely treatable.
You’ve already done one of the hardest things your body can do. Now, it’s time to give it the care it needs to recover fully.
If you’re still experiencing bladder symptoms months after delivery, it’s worth getting checked. With the right evaluation and treatment plan, most women return to normal function — without leaks, discomfort, or embarrassment.
