M., you can definitely go to your doctor about this but MOST doctors aren't going to know what you can do for this. There are a few things I can think of that MIGHT be happening. 1) You have a separation of your rectus abdominus muscle (diastasis recti) which is so weakening your core that you are having incontinence. You should call The Tummy Team (www.thetummyteam.com) today. They operate out of Vancouver, WA and have amazing results with this. 2) You have some kind of nerve impingement, so that messages from your brain to your body aren't getting all the way through and causing your muscles to be weaker than usual and causing incontinence. A chiropractor can address this. A really good one is Judith Boothby at Third Way Chiropractic (www.thirdwaychiropractic.com) in SE Portland. She's very gentle and works with all ages and stages including infants and pregnant or postpartum women. 3) You have a pattern of tension in your pelvic floor and/or vaginal muscles that is making your kegels ineffective. Tami Kent (www.wildfeminine.com), who is a well-known pelvic floor physical therapist and lives and works in Portland, will tell you that sometimes when you're doing a kegel, you're not actually engaging all those muscles. Sometimes, you have muscles that you keep tight all the time, so they are fatigued and they don't have the strength to tighten any more.
Don't let anyone tell you that there's nothing you can do and don't let them tell you that you need surgery. Some of these practitioners aren't exactly cheap, but nobody wants to be incontinent for the rest of their lives, so I'd say that the amazing work they do is completely worth whatever they are charging. Best of luck!