The pattern of perinatal urine leakage — a template for care

It is conservatively estimated that 1:3 Australian women leak urine following childbirth, an often unacknowledged, invisible and under-reported outcome. A framework for midwifery practice arose from the findings of a prospective, longitudinal study aimed to improve bladder outcomes for childbearing women (Stainton et al. 2005). This longitudinal study included bladder history and function as well as pregnancy, birth and postpartum factors of 124 women from first trimester through the first year postpartum. The identification of women who leak before their first pregnancy as being 4.14 times (p=0.02) more at risk for postpartum incontinence has significant implications for the provision of antenatal care that includes a history of bladder function. A pattern of urine leakage from early pregnancy through the first postnatal year provides a template for the timing of appropriate education, intervention, preventative care and referral. The language used is the key to midwives engaging women in discussing bladder health issues.