Leaking When You Laugh, Sneeze, Cough, or Jump? Here’s Why (and How to Fix It)

From the moment you saw that faint pretty pink line to the moment you saw that pretty (slightly pink) face, little did you know that dealing with the constant issues of “tinkling” could forever haunt you. The real song should be “First comes love, then comes marriage, then comes tinkling your pants after the baby carriage!”

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I am Abigail Prushansky, A Board-Certified Family Nurse Practitioner and a Board-Certified Nurse Midwife. I started Full Circle Premium Health to have a safe, compassionate and empowering place for Women to call home. As a dedicated Mother and Women's Health Provider, I aim to champion the autonomy of every woman I care for. Often, we are being told to "let it go," "this is part of the course," "it'll pass, just be patient," and so on. Well, this stops here, and it stops now. Whether its pregnancy or hormonal transitions, our bodies and our self-esteem can be challenged daily. And since no one tells a man to "just deal with it," WHY should we?  

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Myth Busting: Is Leaking Normal After Baby?

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You may have heard:

• "Oh, you're in the first trimester — peeing more is totally normal!" (correct!)
• "You're in the third trimester — your baby is pressing on your bladder!" (correct!)
  
  

But after labor and delivery?

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We expect everything to "bounce back" to how it was before — and for many women, that simply isn't the case.

 Every week, women walk into my office — for annual checkups, hormone therapy, problem visits — and share a quiet confession:

 "I pee a little when I laugh, cough, sneeze, jump, or run... but I had kids, so I guess that's just life now."

Important Reminder: Leaking is common, but it is not normal.
And it’s not something you have to just "live with."

Somehow, society has left us women thinking that these are normal issues that are just normal consequences of pregnancies, vaginal deliveries, and the natural aging process. Women are embarrassed to discuss it, even ashamed at times, so I make sure to ask every woman who walks through my doors if they’re having any symptoms of stress incontinence and then we discuss their options. 

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What Is Stress Incontinence, Exactly?

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Stress urinary incontinence (SUI) is when you leak a little when you do things that put pressure on your bladder. Think everyday actions such as coughing, sneezing, laughing, lifting heavy objects, or exercising. 

In medical speak: Stress incontinence is a common type of urinary incontinence characterized by the unintentional leakage of urine during activities that put pressure on the bladder. 

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What Causes Stress Incontinence After Pregnancy?

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Several factors can contribute to the development of stress incontinence. In women, pregnancy and childbirth are among the most common causes, as they can stretch and weaken the pelvic floor muscles. 

Here are the most common causes:

• Pregnancy and childbirth (especially vaginal deliveries)
• Hormonal changes from menopause
• Obesity (extra pressure on the pelvic floor)
• Chronic coughing (like with asthma or smoking)

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High-impact physical activities over time

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And for those who think this issue won’t pertain to them because they’ve had a Cesarean Section over a vaginal delivery … think again. A C-section doesn’t mean the “tinkle” fairy will give you a free pass.

What Can I Do About It? (Good News — You Have Options!)

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Let’s talk solutions!

Managing stress incontinence typically involves a combination of lifestyle adjustments and targeted treatments. Here’s what I typically recommend to my patients: 

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Lifestyle Changes

• Weight loss (if needed)
• Limiting caffeine and alcohol
• Avoiding heavy lifting
• Tweaking exercise routines (without giving up your favorite classes!)
  
  

If you find yourself leaking with high impact exercises like running, squatting, or jumping, you can trade those exercises in for those on hands/knees or lying down on your back. Without the added red-headed stepchild of gravity, often you can get the same body work in but using other positions to do it. Just ask your instructors for more specific modifications based on what workouts you typically do. Like running but can’t manage it without leaking? You can trade it in for a seated cardio work out like cycling or rowing. 

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Pelvic Floor Exercises

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Pelvic floor exercises, often referred to as Kegels, can help strengthen the muscles that support the bladder and urethra- but only if done correctly.

You would be shocked at the number of women who think they’re doing a Kegel right. But when I check during a manual exam I feel no movement.  

Often, I have found that women think they are doing the right movement or eliciting the right pelvic areas but that is not the case. 

Women can always try to do their own “manual” exam. With a clean washed finger, insert one finger into the vaginal and press down on the perineum (the area between the vagina and the rectum). Then, try to Kegel against your finger. This can often work for women who are unsure if they are eliciting any type of movement. A true Kegel is not “stopping your urine stream” but actually working the musculature of the pelvic floor. 

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Pelvic Floor Physical Therapy 

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Working with a licensed pelvic floor physical therapist can be life-changing! 

But — it’s a commitment. Expect:

• 1–3 sessions a week in the office
• Daily exercises at home
• 6–12 weeks for true improvement

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Tips to Find the Best Pelvic Floor PT

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Unfortunately, a licensed physical therapist does not need any special certifications to claim they have knowledge in the pelvic floor. If you are interested in pelvic floor work, your OB/GYN should be able to refer you to someone who has been specifically trained in this area.  

Pelvic Floor PT Might Be Covered by Your Insurance
Some insurances cover services so if budget is an issue, this is a great option for some. Most will need a referral from your OB/GYN. If you want to know if your insurance covers it, up to how much, and how often, you will need to contact your specific insurance company to find out. 

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Who is Pelvic Floor PT Best For?

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Success relies on daily commitment, correct form, and guidance from a trained pelvic floor therapist. Over time, as strength and control improve, the frequency of sessions may decrease. If that sounds like too much work, I move to option two.

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VTone procedure by InMode

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The is a non-invasive, FDA-cleared treatment designed to strengthen and tone the pelvic floor muscles using intravaginal electrical muscle stimulation (EMS). It gently contracts the pelvic floor muscles through a small, smooth applicator, helping to improve muscle control and reduce symptoms of stress urinary incontinence. 

The treatment is quick, typically lasting around 20-30 minutes, and requires no downtime. The level of EMS increases over time as the patient gets used to it and the muscles strengthen. 

Most patients benefit from a series that starts at twice weekly for four weeks, once weekly for four weeks, and then once a month for 2-4 months, although the number of sessions vary depending on severity. 

While this too is a commitment, there is no downtime and no homework. Plus, most of my ladies scroll through Instagram or TikTok or even take a little nap during the 20–30-minute sessions! 

Budget, the prices vary from office to office with treatments being anywhere from $250-$500 per session with package discounts. 

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Who is VTone Best For?

If you want a non-invasive, no-homework approach. 

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Morpheus8 V by InMode

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This is another non-invasive, FDA-cleared treatment designed to rejuvenate vaginal and vulvar tissues using a combination of microneedling and radiofrequency (RF) energy. This dual-action approach stimulates collagen and elastin production, leading to improved tissue elasticity, enhanced lubrication, and tightened vaginal walls. It's particularly effective for addressing concerns such as vaginal laxity, dryness, and stress urinary incontinence. 

My patients are topically numbed for about forty-five (45) minutes prior to the treatment, which is about twenty (20) minutes in length. The treatment is typically well-tolerated, with minimal downtime of nothing in the vagina for about one week. 

Most of my women report zero pain during and a slight “soreness” the next day. They begin to see the start of improvement in symptoms usually in about a week, which continues to improve over the next few months.  

A series of 3 sessions, spaced 4-6 weeks apart, is often recommended to achieve optimal results. This is a more expensive option but is only roughly three treatments. My clients, depending on severity, are getting anywhere from 6-18 months of symptom relief. 

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Who is Morpheus8 V Best For?

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If you want maximum tissue rejuvenation and have a more severe care of incontinence.

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Takeaway- You Have Options

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Stress urinary incontinence might be incredibly common after you have a baby- about 1 in 3 women experience it - but that doesn’t mean it’s normal. 

You do not have to live this way. You deserve to feel strong, confident, and supported.

Whatever route you decide to try, just be open with your provider about your symptoms and have a discussion on what your options are because there ARE options!

And hey, maybe it's time for a new version of the song: “First comes love, then comes marriage, no more tinkling your pants after the baby carriage!” 

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