Associations of Urinary Incontinence with Postpartum Physical Activity: A Cross-Sectional Study

Urinary incontinence (UI) in postpartum women is often regarded as a quality-of-life issue¹—common, expected, and rarely prioritized in clinical care unless a patient specifically raises concern.² But emerging research challenges this narrow view.

In our recent study published in Midwifery, we examined whether UI was associated with physical activity among postpartum individuals.³ Results showed that greater UI severity corresponded to lower weekly moderate-to-vigorous physical activity. These findings underscore a critical shift in how we should approach UI—not just as a bothersome symptom, but as a barrier to physical activity, which creates vulnerability to broader physiologic risk.⁴

UI as a Barrier to Recovery and Prevention

The postpartum period is a vital window for women’s recovery and long-term health.⁵ Regular Moderate-to-vigorous physical activity (MVPA) is an essential health behavior due to its protective effects against mental health conditions and diseases that are especially important in the months after delivery.⁴ When UI interferes with physical activity, it may contribute to downstream mental health and cardiometabolic risks, compounding the burden of untreated pelvic floor dysfunction. Without acknowledging this barrier, we may unintentionally overlook a modifiable contributor to postpartum inactivity and lifespan health risk.

Clinical Implications

Screen for UI routinely in postpartum visits, even if the patient doesn’t bring it up.
Recognize UI as a potential barrier to physical activity, which may affect recovery and CVD prevention.
Refer to pelvic floor physical therapy early. Many patients don’t realize effective treatment exists.
Consider UI severity and persistence as a reason to monitor broader cardiovascular health—particularly in patients with additional risk factors.

Where We Go Next

To better serve postpartum individuals, we must broaden how we conceptualize urinary incontinence in clinical and research settings. UI should be evaluated not only for its quality-of-life impacts but also for its role in shaping long-term health behaviors and outcomes. Future work should aim to clarify the systemic consequences of UI. Policy is needed to improve early identification and multidisciplinary management of UI across healthcare settings.

Acknowledgements: The author thanks Drs. Kara Whitaker, Lucas Carr, Jessica Gorzelitz, and William Story for their contributions to the foundational work on postpartum health and physical activity.

Written by: Lisa VanWiel, PT, DPT, PhD, Assistant Professor, Department of Health Professions, University of Wisconsin–La Crosse, La Crosse, WI

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