A little leaking when you cough, sneeze, laugh or lift your baby is very common in the months after giving birth. Many women assume it is just part of being a mother and say nothing, even to their doctor. It is common, but it is also worth looking at, because the cause is usually something that can be assessed and addressed.
During pregnancy and birth, the pelvic floor muscles and the tissue around the bladder neck are stretched and sometimes injured. Leaking with effort, such as coughing or jumping, is usually stress incontinence. A sudden strong urge that you cannot hold is a different pattern, called urgency, and it is managed differently. Some women have both. Because the two can look alike from the outside, guessing does not work well.
Many women improve over the first months with correctly taught pelvic floor muscle training. The word correctly matters: a good share of women squeeze the wrong muscles or hold their breath when they first try. Constipation, a persistent cough and heavy lifting add load and can slow progress. Leaking that is not improving, or that began only after the early weeks, deserves an assessment rather than more waiting.
See a doctor if leaking is not improving by around three to six months after birth, if you have a heavy or dragging feeling in the vagina, if you cannot fully empty your bladder, if urine leaks without you noticing, or if you have burning, blood in the urine or fever. A pelvic floor assessment checks how well the muscles contract and whether prolapse is present. Consultations are in English or Thai, with a fee of 1,500 to 3,000 baht by complexity plus a 300 baht clinic service fee.