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There are many things that make it more likely that you'll get stress incontinence.

Most women start getting problems with leaking urine after they have a baby. A survey of more than 15,000 women under 65 showed that stress incontinence happens to:¹

• About 5 in 100 women who haven't had a child
• About 7 in 100 women who have a baby by cesarean section
• About 12 in 100 women who have a baby through the vagina.

The number of children you have also increases your risk. About three-quarters of women who have had three births through the vagina get some urine leaking out.²

Doctors think that your pelvic floor muscles get weakened as the baby passes through your vagina.² These muscles help to support your bladder and hold in urine. If they don't work properly, urine can leak out. But these muscles may also come under pressure during pregnancy itself. This may be the reason that even women who have a cesarean delivery are at increased risk of stress incontinence. Having a baby by forceps delivery (where doctors use force to pull a baby out through your vagina) can be especially harmful to these muscles.

Very few women younger than 30 (only about 3 in 100) get incontinence. But the risk goes up as you get older. About a third of women older than 80 get incontinence.³

As you get older, your muscles get weaker. This includes your pelvic floor muscles. And as you go through menopause, your body makes less of a hormone called estrogen. Estrogen helps to keep your muscles healthy, especially the sphincter muscles at the bottom of your bladder. So during menopause, these muscles may get weaker.⁴

Your pelvic floor muscles and your sphincter muscles help keep urine in your bladder. If they get weak, urine can leak out.

If you smoke, or have smoked in the past, you're twice as likely to get incontinence as a non-smoker.⁵ Doctors think that smoking might increase the risk of stress incontinence because you’re more likely to cough if you smoke and the chemicals in smoke may affect the bladder and muscles around it.

If you're very overweight (obese), the extra pounds you carry put more pressure on the muscles around your bladder. This can make them weaker and less able to hold urine in your bladder.

If you have a cesarean section, a hysterectomy or another kind of surgery in this area, there is a small chance that some of the muscles could be damaged. This could make it more likely that you'll get stress incontinence. But this is rare.

Illnesses that make you cough a lot, such as bronchitis, put extra pressure on the muscles in your abdomen. This includes the muscles around your bladder neck. If these get weaker, it can lead to stress incontinence.

There's some evidence that if you have a sister who has stress incontinence, then you're more likely to get it than if you have a sister who doesn't have it.⁶ This suggests that there might be genes that you inherit from your parents that make you more likely to get stress incontinence.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.