Take Control of Your Bladder During Pregnancy

You're bladder can take a beating during pregnancy.

It gradually gets less space and less support to function as you grow.

With these changes your bladder may send you mixed signals and create new habits.

Yes, your bladder talks to you. It sends signals to let us know when it is appropriate time to go pee.

How does your bladder do this?

The bladder is an amazing muscular organ. As it fills with urine it stretches. When it stretches there are receptors in the fibers that senses by how much. These receptors send the signal to the brain to tell us when the bladder is "full." The brain then decides if it's time to go pee.

When we're little the bladder doesn't signal until it's actually appropriately full.

Over time and during certain stages in our lives the bladder can learn new habits based on our lifestyle.

Your bladder is influenced by your diet, pregnancy, job, pelvic floor awareness, movement, bowel habits, gut health, and your reaction to when you feel an urge.

The habits you formed prior to pregnancy can be an indicator of your bladder control.

Here are some simple tips for bladder control to follow while pregnant that'll keep your bladder - brain communication balanced.

Tip 1

Drink mostly water!

There are drinks and foods that can irritate the bladder.

The main culprits are drinks that are caffeinated, carbonated, citric, and sugary.

When you drink these it's like having a bad party guest in your bladder. Your bladder wants it to leave.

So instead of the bladder signalling when stretched to capacity it's signally because it's irritated. When this happens on a regular basis the stretch receptors become over sensitive and will signal when the bladder is barely full.

Leading to more urges and frequent trips to the bathroom.

Tip 2

An urge is a signal not a command.

Because your bladder may signal when it's not actually full you need to be aware of when it's actually appropriate to pee.

During pregnancy, your frequency will increase, but not by much and not until later trimesters.

You can still work within the normal range of every 2 to 4 hour during wakeful hours to pee.

So when you feel the need to pee, ask yourself "when was the last time I went to the bathroom?"

If your answer is 1 hour ago, you may not really need to go. If your answer is 2 hours or more then good to go.

Tip 3

Drink throughout the day rather than large amounts all at once.

Sometimes we forget to drink or we get busy that when we remember we down a whole bunch of water at once.

This puts the bladder under more pressure to function. And during pregnancy when space comes at a premium your bladder is going to have a hard time holding on to the pee if it's walls can't expand enough.

Tip 4

Know how to contract and relax your pelvic floor.

Your pelvic floor works with your bladder to function. Not only does it keep the bladder in proper position it involuntarily contracts to keep pee in and relaxes to let pee out.

When you feel an urge and your brain decides if it's time to pee or not, it'll message the pelvic floor to stay closed until you reach the toilet and then to relax when seated.

Sometimes you'll need to voluntarily contract the pelvic floor to make it to the bathroom. By contracting your pelvic floor it can help ease the urge and make sure no pee leaks out.

But then once you reach the toilet you need to know how to fully relax the pelvic floor (so no hovering ladies!) to pee.

Tip 5

With the extra weight, less space and weakened core there is also the possibility of leaking pee when pressure is placed on the bladder.

To prevent that from happening you need to energize and activate your deep core to keep the pee in.

The deep core includes the pelvic floor (bottom), transverse abdominus (front), respiratory diaphragm (top) and multifidus (back). When they are all activated at the same time you create a support all around the pelvis.

So whenever you sneeze, cough, laugh, lift, push, pull, or anything else you do that you feel pressure down into the pelvis contract your deep core.

These tips will come in handy through out your pregnancy and beyond.

If you want to learn more about supporting your body and bladder through pregnancy check out Expecting Pelvic Fitness for even more pelvic health education!



During pregnancy constipation can become a problem. The combination of slower digestion, less room for food, and iron supplements makes it harder for your body to poop.

After birth weaker abdominals or unbalanced seperation, scar tissue, pain medication, and lack of activity can lead to constipation.

Constipation is defined as having less than 3 poops a week. This can cause straining, pressure on the bladder which may lead to incontinence or urinary urgency, and hemorhoids. Chronic constipation which is considered if you've been constipated for longer than 3 months.

When you have difficult pooping, you tend to strain. This straining can stretch the pelvic floor weakening the muscles and tissues. Not being able to poop can make you irritable, sluggish, and can lead to pelvic floor dysfunction.

There are ways to help avoid constipation during pregnancy and after birth.

Here are a few of my tips to stay regular!

1. Stay active

Movement and exercise helps your gut stay balanced. It increases blood flow to the gut. It improves tissue mobility and intestinal motility.

2. Be core aware

Have a strong and functional abdominal wall gives the intestines support. This means making sure that you reconnect to the abdominals properly after birth and being tested for a diastasis recti (dysfunctional abdominal separation).

3. Eat recommended daily fiber

Mix up the type of fiber you do eat. Eating fruits, vegetables, beans, and grains ensures you get both soluble and insoluble fiber, which keeps your gut more balanced.

4. Drink recommended daily water

During pregnancy and postpartum your water intake should increase than your regular amount due the increased demand on your body. Drinking at least half your body weight in ounces of water is recommended.

5. Discuss iron intake with practitioner

If you need to take an iron supplement, there are ones out there that are non constipating.

6. Massage

If you had a csection doing scar massage will help make sure no scar adhesions disrupt your digestions.

7. Breath

Using your breath to help you relax the pelvic floor.

When you poop your pelvic floor is meant to relax. This naturally happens when you inhale. Focusing on opening your pelvic floor on inhale rather than holding your breath will get the respiratory diaphragm to help push the poop out while the pelvic floor is relaxed.

If you are prone to constipation, there is no better time to focus on staying regular than now.

The Purest Form of Pelvic Health

Now that we have a newborn in the house again, this means DIAPERS...

With our daughter we cloth diapered. So we decided to cloth diaper again.

But what I learned when my daughter was a babe is what I believe to be the purest form of pelvic health, called elimination communication.

Elimination communication is following your babe's verbal and physical cues when they need to go to the bathroom.

You've all heard a babe grunting or a toddler hide in the corner when they poop. These are less subtle than the noises they make when they need to pee. But it is the way your child expresses his needs. Just like the different cries for being hungry, tired or wet.

So elimination communication is essentially respecting your babe's needs by listening and following their cues for bladder and bowel control. Thus establishing the earliest pelvic health habit.

It is an incredible feeling to have your babe smile up at you after they have finished pooping on the toilet!

Since we were successful with our daughter, we decided to give it a go again with our son. The first week he was born, I pulled out our little potty bowl and followed the same steps I did with my daughter.

After every nursing session I would wait about 5-10 minutes then offer him the potty bowl and cue by saying "psssss" or grunting. My verbal cues re-enforced his cues and eventually he was becoming more vocal when he needed to pee or poo.

Once we had established I would listen to his needs, I now ask him if he needs to go both verbally and with sign language. Then based on his response or the timing of when he went last I bring him to the toilet, holding him in a secure squat position.

I believe that listening and following your babes cues, just like with feedings, you're showing them they are respected and teach them they know their body.

This creates a good habit of communication, since they can't get to the toilet on their own, and helps establish good bladder and bowel control and hygiene.

In other countries this is the norm. Diapers are not used very often if at all and babes are "toilet trained" in infancy, by listening to the infants own cues.

Elimination communication is not for everyone. And we are not as hard core as I could be. But I strongly believe both my children have better toileting habits for it. My daughter has never been constipated, even when she began solid foods. My son already has a regular bowel movement routine, which he established himself!

Yes, there were many hard times with my daughter, especially when our routine was thrown off by a milestone or a trip. But it was well worth it!

I bring the same compassion and devotion to your care.

  • I listen.
  • I observe.
  • I communicate.
  • I work with you to build your body confidence.
  • I empower you to connect with your body again on a deeper level.
  • I expand your knowledge about your health.
  • I support you through flare ups and set backs
  • I help you establish habits that create long term pelvic health

So I begin another elimination communication journey, or the earliest stages of pelvic health and wellness, with my babe.

How can I help you?

What Is a Maternal Pelvic Health Specialist?

Last week a patient asked me a very good question...

"Who should I speak with about staying active and exercise during pregnancy...because I don't feel comfortable doing that with my OB?"

I thought this was a very valid question, since she is not pregnant yet and is hoping to conceive in the near future. But then again, I must have failed at my job, for not educating her enough on what physical therapists, i.e. I do.

So here's the answer to her question: a women's health physical therapist.

Why? Physical therapists are specifically trained to:

  • understand the musculoskeletal system and our structure
  • knows the mechanics of the joints
  • how the muscles function together
  • how the nervous system plays a role in our function
  • what our mobility is suppose to look like
  • how to test for imbalances, weakness, dysfunction, tissue tension and much more related to our structure
  • distinguish best practice for diagnoses and problems to reach our patients goals with the most conservative path as possible
  • know what exercises are appropriate for certain diagnoses and problems [and which ones will do harm]
  • apply manual therapy techniques when appropriate to enhance the exercises needed to reach desired goals

Really the list can go on and on!!!

OBs and other medical doctors (not including physiatrists and DO) are not trained as in depth on the musculoskeletal system and certainly not on how to treat structural and mobility issues.  They are highly trained on knowing how to treat ailments related to the reproductive system and maternal care (or whatever the specialty is).

But their profession as a whole is lacking in knowledge about how to stay active, structurally pain free, and what exercises or manual therapy treatments are necessary for certain problems.

That is what physical therapists do!

More specifically when you are experiencing problems during pregnancy like:

  • back or pelvic pain [really any form of pain not related to the baby or reproductive organs]
    • Because really most aches and pains during pregnancy are related to our changing posture and joint instability causing tight and imbalanced muscles
  • want to stay active, but don't know how
  • pelvic floor dysfunction...incontinence, constipation, etc
    • Which may only get worse after birth
  • want more information about preparing your body for labor and delivery
  • nausea, swelling, headaches

...and want to do everything possible after birth to support your body in recovery

Then a women's health physical therapist, especially one who has been trained in maternal care and even better one who also has a deeper understanding of the fascial system and core cylinder is the BEST provider to go to of all your concerns about your body during pregnancy.

I've said it before, this country is well behind others in supporting expecting and new moms with the structural changes that occur in our bodies.  It's time to change that and offer moms the choice to see a physical therapist during all stages of pregnancy, regardless of specific diagnoses.  Because let's face it, even if we feel great, there is always something we can learn about our body that will benefit us in the long run (me included!)

a women's health physical therapist, especially one who has been trained in maternal care and even better one who also has a deeper understanding of the fascial system and core cylinder is the BEST provider to go to of all your concerns about your body during pregnancy.

To be clear my job is really to help all moms reach her greatest physical potential, it's not just to be a physical therapist.  So pass the word on to all moms [in all stages] you know, that I can bring the best out of their body!!