Almost every expectant mother has been warned to expect some symptoms of urinary incontinence during pregnancy–everything from urinary urgency and frequency to actual urinary leakage. As the baby grows and takes up more room in the abdomen, internal organs, such as the bladder, are pushed into an increasingly smaller space. The result? Urinary incontinence issues.
But new studies show that it’s not just baby who contributes to women’s urinary incontinence during pregnancy. Excessive weight gain during pregnancy is another issue to consider. Whether a woman is pregnant or not, she is at risk for urinary incontinence if she carries too much extra weight. Every extra pound below the collarbone and above the pelvis puts downward pressure on the bladder and urinary system, causing symptoms of urinary incontinence.
Gain the Right Amount to Reduce Risk of Urinary Incontinence
During pregnancy many women fall prey to the idea that they are “eating for two,” mistakenly believing that this means they can eat twice as much as they normally do. Not so.
In fact, women who have a normal body mass index (BMI), or who started at a normal weight before pregnancy do not need to increase their caloric intake during the first trimester according to the American Academy of Nutrition and Dietetics. The same organization recommends that women at a healthy weight increase calories by 350 calories per day during the second trimester, and 450 calories per day during the last trimester. Women who start out under or overweight should work with their healthcare providers to adjust these calorie guidelines accordingly.
Eating the right number of calories during each trimester should result in healthy rather than excess weight gain, which decreases a woman’s chance of urinary incontinence symptoms both during pregnancy and after delivery. According to the Institute of Medicine, underweight women (with a BMI of 18.5 or less) should gain between 28 and 40 pounds. Normal weight women (BMI between 18.6 and 24.9) should strive for an overall weight gain of 25 to 35 pounds, while overweight women (BMI between 25 and 29.9) need to gain only 15-25 pounds. Obese women (BMI of 30 or higher) are encouraged to gain just 11 to 20 pounds.
Studies show that women who gain more than the weight recommended by the Institute of Medicine tend to have more trouble losing weight post-partum (http://bit.ly/15o3ait). Again, the excess weight is a definite contributing risk factor to women’s urinary incontinence.
The Importance of Shedding Baby Weight
If you don’t think that a few extra pounds of baby weight puts you at risk for urinary urgency, frequency, or leakage, consider these studies. In one study, overweight women with urinary incontinence who lost 8 percent of their body weight saw a 47 percent decrease in leakage accidents. Other studies demonstrate that losing 5 to 10 percent of excess weight is as effective for alleviating urinary incontinence symptoms as any other form of conservative treatment.
If you are unsure of how much weight you should gain during pregnancy, and how much weight you should lose after delivery, ask your healthcare provider. We stress that you may need to ask your healthcare provider because some may not volunteer that information.
In one recent study, only 42% of women received information on appropriate weight gain from their healthcare providers, while 22% of overweight women were advised to gain more than the recommended amount of weight (http://huff.to/13pfqxT). According to Glenn D. Braunstein, M.D., many healthcare professionals may be hesitant to broach the subject of weight gain because of the sensitivity of the topic. Others may simply feel ill-equipped to handle the conversation. That is why it is important for you to ask for the weight gain and post-partum weight loss information that is appropriate for your situation.
Dr. Braunstein points out that asking for this information before your baby is born is important because chances are that you will be too busy or tired to raise the subject after delivery. Yet, excess weight is a significant risk factor for women’s urinary incontinence. If you don’t want urinary urgency, frequency, and leakage to interfere with the joy of mothering your new baby, get your weight gain and weight loss facts straight before delivery. Then, have a plan that will help you achieve a healthy level of weight gain during pregnancy, and lose the excess baby weight at a healthy rate post-partum.
Stay tuned for upcoming articles on how to shed the “Mommy middle” after delivery to reduce your risk of post-partum urinary incontinence.
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