Morning Sickness and Urinary Incontinence During Pregnancy

27 Apr

Pregnancy brings incredible changes to the body, including the bladder and pelvic floor. Many women experience urinary symptoms such as frequency, urgency, nighttime urination (nocturia), and stress urinary incontinence (SUI) especially as pregnancy progresses.

These symptoms are common, often underreported, and usually manageable with education, exercises, and support.

How Common Are Urinary Symptoms in Pregnancy?

Research shows that storage symptoms are the most common during pregnancy:

Nocturia (waking at night to urinate): 72%
Frequency: 44%
Urgency: 39%
Stress urinary incontinence (SUI): 19%

Symptoms usually increase over the course of pregnancy. While nocturia, frequency, and urgency often improve after birth, SUI may continue postpartum, particularly in women who experienced incontinence during pregnancy.

Interestingly, many women don’t report urinary symptoms to healthcare providers, but early intervention can improve comfort and prevent long-term issues.

Why Does SUI Happen During Pregnancy?

Pregnancy affects the urinary system in several ways:

Hormonal Changes

Progesterone relaxes smooth muscles, increasing bladder capacity but reducing urethral tone.
Relaxin influences tissue growth and elasticity but can reduce urethral pressure, contributing to leakage.
High progesterone in the first trimester correlates with a higher risk of SUI throughout pregnancy.

Anatomical and Physiological Changes

The bladder is displaced upward and forward as the uterus grows.
Increased weight and abdominal pressure on the bladder and pelvic floor can weaken support and increase urethral mobility.
Collagen changes during pregnancy reduce tissue tensile strength, affecting the pelvic floor’s ability to support the bladder.

Risk Factors for SUI

Previous childbirth (multiparity)
Higher pre-pregnancy BMI (>30)
Advanced maternal age
Smoking
Coffee consumption
History of urinary leakage prior to pregnancy

Morning Sickness and SUI

Morning sickness nausea and vomiting can increase abdominal pressure, placing extra stress on the pelvic floor and contributing to SUI.

Tips to reduce leakage during morning sickness:

Eat regular meals to maintain energy and reduce vomiting episodes
Empty your bladder every 2–3 hours
Posture matters:
Avoid squatting from a weak position
Keep your spine straight
Rest elbows on thighs or a bench if bending
Standing tips: Cross your legs for a stable base and engage core muscles

These strategies help protect the pelvic floor while supporting daily activities.

Preventing and Managing SUI During Pregnancy

Pelvic floor muscle (PFM) training is highly effective:
Pregnant women who completed PFM exercises were less likely to have SUI at 36 weeks (32% vs 48%) and postpartum (20% vs 32%).
Exercises strengthen the pelvic floor, improve bladder support, and reduce leakage.

Other supportive measures include:

Maintaining a healthy weight
Avoiding chronic straining
Postural awareness and core activation
Regular pelvic floor assessment by your osteopath or physiotherapist

How Osteopathy Can Help

Osteopathic care can support women with SUI during pregnancy by:

Assessing pelvic floor function and bladder positioning
Teaching breathing, posture, and movement strategies to reduce bladder pressure
Providing manual techniques to improve pelvic and abdominal alignment
Guiding safe pelvic floor exercise programs

Early intervention can prevent persistent urinary incontinence postpartum and improve comfort throughout pregnancy.

Key Takeaways

Urinary symptoms, including SUI, are common during pregnancy.
Morning sickness can increase pelvic floor stress and contribute to leakage.

Pelvic floor exercises, postural strategies, and lifestyle adjustments can prevent or reduce SUI.
Osteopathy provides a safe, supportive approach to maintain pelvic floor and bladder health.

If you’re experiencing urinary leakage or discomfort during pregnancy, speak with your osteopath or healthcare provider. Early support can help you maintain confidence, comfort, and quality of life.

You can also find out more about our pelvic health consults here.