Urinary Difficulty after Childbirth

Etiology

Urinary difficulty after childbirth includes a range of urinary problems, from difficulty in urination and retention of urine, to their opposites, frequency of urination and incontinence of urine. They can be dealt with together because the cause is always a deficiency occurring after childbirth, and addressing the underlying deficiency cures the urinary problems. It is important to stress that the mother’s conditions included under this chapter’s heading are urinary problems without fever or pain; thus, from a Western point of view, they are urinary problems without a urinary infection.

  • Excessive strain during labour
  • Injury to the bladder

Pathology

The pathology of urinary difficulty after childbirth, according to the traditional theory, is always one of deficiency and primarily of the Spleen or Kidneys. Deficient Spleen-Qi may cause sinking of the Qi of the Bladder and thus frequent urination or incontinence; or it may fail to transform and transport fluids so that urine is retained. Deficient Kidney-Qi fails to provide Qi to the Bladder for its function of Qi transformation, there is not enough Qi to hold the urine, and frequency and incontinence result. Alternatively, Kidney-Qi may be so deficient that there is no strength to push the urine out and retention of urine ensues.

Identification of Patterns and Treatments

The treatment principles for urinary difficulty after childbirth depend on the specific pattern diagnosed. Common patterns include:

  • Spleen-Qi deficiency
  • Kidney-Qi deficiency
  • Qi stagnation
  • Kidney-Yang deficiency

Spleen-Qi deficiency

Clinical manifestations:

  • Frequency and incontinence of urine
  • Pale tongue with teeth marks
  • Weak pulse

Treatment principle: tonify the Spleen and transform fluids.

Kidney-Qi deficiency

Clinical manifestations:

  • Frequency and incontinence of urine
  • Lower backache
  • Tiredness
  • Pale tongue with white coating
  • Deep, weak pulse

Treatment principle: tonify the Kidneys and consolidate the Ming Men.

Qi stagnation

Clinical manifestations:

  • Difficulty and retention of urine
  • Abdominal distention
  • Emotional symptoms such as irritability or depression
  • Tense pulse

Treatment principle: move Qi and resolve stagnation.

Kidney-Yang deficiency

Clinical manifestations:

  • Difficulty and retention of urine
  • Lower backache and leg weakness
  • Cold sensations in the lower back and legs
  • Pale tongue with white coating
  • Deep, weak pulse

Treatment principle: warm the Kidneys and reinforce the Yang.

Prognosis and Prevention

The prognosis for urinary difficulty after childbirth is generally good, as long as it is treated promptly and effectively. The best prevention is to strengthen the mother’s Qi before childbirth through healthy eating and lifestyle, and to avoid excessive strain during labour.

Western Viewpoint

From a Western perspective, urinary difficulty after childbirth may be caused by physical trauma to the bladder or other urinary tract structures during labour, or by postpartum hormonal changes. Treatment may involve medications to improve bladder function and control incontinence, as well as physical therapy to strengthen the pelvic floor muscles.