What Can Cause Bladder Problems after a C-Section?

It made the news this October that C-Sections have nearly doubled since 2000. Reasons for this decision include the fear of labor pain, sexual dysfunction and of course the fear of incontinence related to vaginal delivery.

It is known that women who have a natural birth have a higher chance of developing incontinence in later life. It has therefore become especially common for pregnant women who have previously experienced leakage post childbirth to be scared of natural childbirth. Professor Gerard Visser, chair of FIGO’s Safe Motherhood committee, asserted, “worldwide there is an alarming increase in caesarean section rates". However, experts are becoming more adamant that women should not choose this option just to avoid incontinence.

A Caesarean delivery                                                                                                                               

Did you have a C-Section delivery? Post a question on our forum and share your experience.

Experts worry that women are not aware of the potential complications of having a caesarean section. Glossing over the risks and side effects of a C-Section is common. Maternal death and disability rates are higher with C-Sections. It is also known to increase chances of conditions such as asthma. Surprisingly, research has even shown that susceptibility of incontinence is to some degree genetic. A substantial number of women who choose C-sections over vaginal birth do end up leaking. Research from the Norwegian study of 15,000 women found the rates of incontinence by age 50 were similar.

How Can C-Sections affect Continence?

Those who choose a C-Section should remember that any childbirth causes tears and strain on the body. As researcher Goldberg explains, “things tend to equalize due to wear and tear and gravity”. As in any pregnancy, as your baby grows, your uterus then becomes heavier. Your supporting structures then therefore become stretched and weakened. Hormones during pregnancy also contribute to the loosening of ligaments and muscles. A study in 2011 even found that a C-Section only drastically lowers the risk of bladder problems if a woman delivers all of her children that way. The study found that 55% of women who had vaginal birth experienced incontinence. In comparison, 59% of women who had one baby via vaginal birth and one caesarean had incontinence. Glazener explains, “unless women are resolved to have all their deliveries by the abdominal route, caesarean section doesn't necessarily protect from incontinence”.

Unique to C-Sections, however, is the C-Section scar. During a C-Section, an incision is made. This means a scar may form as part of the healing process. A temporary scab can form to close the edges of the incision. As a result, the body creates scar tissue from collagen. This scar can extend into deeper layers below the skin. The collagen fibres in scar tissue are formed in a linear single direction. This pattern of fibers creates a variety of problems, including bladder problems. A C-Section scar can attach to the front wall of your bladder, causing urge incontinence and frequent urination. Physical therapist Kristen Maike explains “as everything shrinks back down after the birth, the scar begins tugging on the bladder. This makes it feel like you have to pee”.

40 year old Ellen, a Doctor and mother, is one of many women who experienced the side effects of a C-Section scar. After her C-Section, her left leg was not responding well to the brain telling it to move due to its nerves being trapped. Her scar was shutting off the muscles of her left leg and anterior pelvic muscles, causing incontinence. Neurokinetic Therapy was used to reprogram her neurological system and restore muscular control and coordination. She was eventually able to regain leg movement and her incontinence cleared.

When is a C-Section Urgently Needed?

A C-Section consists of delivering the baby through a cut made in the abdomen and womb. It can be necessary for the following reasons:

  • Your labour isn’t progressing as expected
  • Your baby is in a bottom-down, or breech, position
  • Your baby is in a sideways position or keeps changing position
  • Yours or your baby’s health is at risk
  • Your baby is too large for vaginal birth
  • You have a serious medical condition, such as Diabetes or heart disease
  • You are expecting twins


Who is More at Risk of Incontinence after a C-Section?

Women with gestational diabetes and women who smoke often are risk factors for developing. However, just like vaginal birth, it is not impossible for things to go wrong. One risk is damage to your bladder or tubes that connect the kidneys to the bladder during the incision. This often requires further incontinence surgery.

Are you currently pregnant and experiencing leaks? Read about managing incontinence during pregnancy. 

Most women see improvements or completely stop leaking after a C-Section with the help of pelvic floor exercises. Expert Maike asserts, “it’s worth checking with your Doctor or a pelvic floor physical therapist to ensure you are doing these exercises correctly”. You can read about how to do pelvic floor exercises here.

Incontinence also requires the ideal protective products to manage leaks. For light incontinence, we recommend small shaped pads and pull up pants. If your incontinence is heavy to severe, we recommend using pull ups, all in ones or large pads.

Here are some of our product recommendations:

Lille SupremFit  


Ideal For:

Moderate to Severe Incontinence

Prices Online:                                        

Incontinence Supermarket: £6.55 to £12.63

(Packs of 20, 22, 24, 26)

Allanda: £6.80 to £12.99

(Packs of 20, 22, 24, 26)


TENA Pants

Ideal For:

Moderate to Heavy Incontinence

Prices Online:

Incontinence Supermarket: £5.49 to £14.79

(Packs of 8, 9, 10, 12, 14, 15, 18)

Allanda:  £5.76 to £15.84

(Packs of 8, 9, 10, 12, 14, 15, 18)

Attends Contours

Ideal For:

Light to Heavy Incontinence

Prices Online:

Incontinence Supermarket: £6.23 to £10.99

(Packs of 21, 28, 35, 42)

Allanda: £6.05 to £10.99

(Packs of 21, 28, 35, 42)

Did you know that hip replacement surgery can actually cause incontinence? Read 4 Causes of Incontinence after Hip Replacement Surgery

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