Quick Reference Guide
Managing Postpartum Incontinence
A sneeze while holding the baby, a leak on a walk. Up to about half of new mothers leak in the months after delivery. Common is not the same as permanent. Here is the whole picture on one page.
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What it can feel like
Pregnancy load plus labor can stretch, weaken or tear the pelvic floor, so the bladder seal and its support do not simply bounce back.
It may be stress leaks from pressure, urge leaks that arrive as a sudden “now,” or both. Vaginal birth raises the risk, forceps or vacuum more so, but cesarean recovery can still leave weakness from the pregnancy itself.
Many women improve in the first few months. Symptoms that linger are a medical issue, not a motherhood badge, and they are treatable.
What you can try yourself
After your OB or midwife has cleared you:
- Start gentle, correct pelvic-floor lifts. Squeeze up. Do not bear down.
- Use “the knack.” Brace the floor before a cough, sneeze or baby lift.
- Protect healing tissue. Avoid heavy straining and high-impact exercise until you are cleared.
- Treat constipation. Stool softeners and fluids beat pushing, every time.
- Exhale on effort. Do not hold your breath picking up the car seat.
- Track leaks, heaviness, emptying and pain with intimacy.
- Know the myth. “Every new mom leaks, just wait it out” is not a rehab plan.
What standard medical care looks like
- The postpartum check with your OB or midwife before starting focused rehab.
- Pelvic-floor physical therapy. Gold-standard first-line care after birth.
- Confirming stress versus urge versus mixed leaks, and screening for infection and significant prolapse.
- Guidance on returning to running, lifting and core work — the timing matters more than the enthusiasm.
- Local estrogen or other hormone support when breastfeeding-related dryness is an issue.
- Pessary or surgery only for selected, more severe cases after shared decision-making.
Where it stalls: time and home Kegels help many women and leave others still leaking while juggling a newborn, which is the worst possible moment to be told to be patient.
Where Ivy Collaborative Healthcare fits
Emsella is an FDA-cleared HIFEM chair for urinary incontinence. You sit fully clothed for 28 minutes while it delivers roughly 11,200 supramaximal pelvic-floor contractions per visit — useful precisely when doing Kegels well is hard to fit around a newborn.
- A typical course is six visits over about three weeks, with no downtime.
- Usually considered about six to eight weeks after a vaginal birth or cesarean, once your clinician has cleared you.
- Generally compatible with breastfeeding. It is not used during pregnancy.
- Physician-directed care with Dr. Jocelyn Bayliss, MD.
It complements pelvic PT, OB follow-up and a gradual return to exercise rather than replacing any of them. Pacemakers, defibrillators, metal in the pelvis or hips and certain implanted electronic devices are common reasons someone is not a candidate.
When to get seen urgently
- Fever
- Heavy bleeding
- A bulge you cannot reduce
- Any wound that looks or feels wrong
Ask your OB or midwife at the six-week visit if leaks or pressure are still there. That is exactly the appointment for it.
Leaking after birth is common. Staying that way is not required.
Once your clinician has cleared you, a free Wellness Assessment is the next step.
Or start with the short questionnaire — opens the patient questionnaire
This guide is general education, not medical advice, and does not create a doctor-patient relationship. It is not a substitute for evaluation by a qualified clinician. Individual results vary. Eligibility is determined after physician screening.