If you had urinary incontinence after 1st birth...

[2ndTimeAroundMum]

Did it get much worse after your second vaginal delivery?
i'm currently 34 weeks and debating a CS as i had horrific urinary incontinence post forceps delivery 4 years ago. It improved but its still bad - leaking with laughing, walking, sneezing etc! I'll definitely need surgery in future. Have had pelvic physio and tried squeezy but recovery is plateaued now 4years after DC1.
I would love a vaginal birth but if i return to that horrific level of incontinence i'd be devastated.
I am seeing my consultant next week but would love to hear your experiences!

I can’t help with a second VB but I had moderate urinary incontinence after DD was born (similar story - long pushing stage of 3 hours, forceps) so when I fell pregnant with DS I was absolutely set on a CS, which I had.

I managed to get it mostly fixed through physio and exercises just before DS was conceived, it got worse again with it during my second pregnancy but pretty much disappeared after DS was born and I’m done with babies. It’s at a level I can cope with 99% of the time (I do wear pads when I have a cough or cold!) so I’m happy I went with the ELCS. Obviously I have no idea how a second VB would have gone, and CS isn’t a walk in the park, but I just didn’t fancy risking it. The CS has left me with other changes (mostly body shape!) but on balance it was worth it.

Thanks for your reply @ShadowPuppets
Im really 50/50 at the moment, would like a VB as i want to experience doing it myself without an epidural or instrument but have no guarantees that's going to happen.
My other thought is that a CS is another scar which might make future surgery difficult.
Glad to hear you are at peace with your decision. Have no doubt a CS is a difficult recovery as well x

Mine didn’t get worse with subsequent vaginal births. My only option was/is surgery but I refused mesh from the get-go (now few decades back), which limits options and no one has a fox so incontinent it is.

@HoppingPavlova thanks for replying. So sorry to hear you've had to put up with this problem!
There are alternatives to the mesh now, mainly using your own tissues i think so might be worth revisiting surgery if it's still bothering you x

I'd like to see responses to this too. I very very very rarely have any issues nowadays - only verrrry occasionally with violent vomiting really. I had two ventouse deliveries and we are really wanting a third child but I'm really concerned about pelvic floor impact...the pregnancy itself too as I get hypermesis so did have some incontinence with that in my second pregnancy. And obviously I've now had TWO assisted deliveries with episiotomies so the area must be somewhat knackered...

@WeightoftheWorld judging by what you've said I think you're doing good! Unlucky to need 2 instrumental deliveries 😞. I'll also update you on what the consultant says in case it helps!

How did it go OP? What kind of birth did you choose and how are you doing? Hope it all went well.
i’m 17 months post partum still with dreadful incontinence too!

@BathtimeScroller hi! I chose an elective c section (other complications influenced this too). It was painful and took about 6 weeks to feel anywhere near normal in general but my incontinence went back to its pre-pregnancy state. Will still likely need intervention later in life but happy that it hasn't deteriorated further after number 2. Just have a nice scar to add to the knackered pelvic floor 😂. I think realistically a second vaginal birth would have made it worse at least temporarily. Are you thinking of number 2 soon?

So glad it went well! I totally understand that constant worry you must have had for your whole pregnancy. I’d take the scar over the level of incontinence I had straight after birth to be honest 😂 have you thought about trying bulkamid or anything?

yeah I think we’ll probably start trying later in the year but honestly the thought of going through all this again terrifies me. I did actually speak to a girl whose incontinence did get a lot worse after her c section delivery! Not the pregnancy, just the c section. So that’s thrown me off! Glad this didn’t happen to you though

@BathtimeScroller Oh that seems very unlucky following a c section, haven't really heard of that.
I will consider bulkamid for definite as an interim measure. Think they still offer that if your family isn't complete so you could have it done regardless of having a second baby!
The section may be the best option for you to try and control the impact on you. It's a hard choice.
I was really bad though. Couldn't even walk at a leisurely pace on the flat without leaks 😭

Yeah I think you’re right that it might be sensible to go for a c section.
Are you still having the issues when walking or has it improved since then? I have issues with walking sometimes, usually around ovulation. On a good day I can walk for around 7000 steps before leaking but on a bad day can barely walk to the end of my street and without leaks! I think I have nerve damage affecting the signal to my bladder and urethra

It seems highly unlikely that a CS caused worsening incontinence. Just have a think about the anatomy of a pregnant woman, the position of the pelvic floor and the process of a CS. The CS doesn't touch the bit that gets weakened/damaged and results in incontinence.
There must be other factors that we don't know about.

There’s many reasons for incontinence though, it can be weak muscles, torn muscles, torn ligaments, nerve damage from pushing too long/in a bad position or nerve damage from the epidural. It’s not as simple as just the pelvic floor muscles especially not in severe cases. So in her case I would imagine she had nerve damage and something about the c section caused more irritation to the nerve. Albeit I think she was very unlucky