urine in pregnancy

Overview

During pregnancy, your kidneys and bladder work harder to filter extra fluid and remove waste from your body and your baby’s. This can cause changes in your urine and how often you need to pee. Sometimes, these changes are a sign of a problem like a urinary tract infection (UTI) or high blood pressure. This article helps you understand what to expect and when to get help.

Very common. Most pregnant women notice differences in their urine or bathroom habits. UTIs affect about 1 in 10 pregnant women.

Anyone who is pregnant can have urinary changes. You may be more at risk if you've had a UTI before, have diabetes, or are pregnant with multiples.

Symptoms

Common symptoms

• Needing to urinate much more often than usual
• A constant urge to pee even when you just went
• Mild pressure in your lower belly
• Urine that looks darker or smells stronger (this can be from dehydration)
• Feeling like your bladder isn't fully empty

Symptoms in children

• Not applicable — this information is for people who are pregnant, and pregnancy cannot occur in children.

Symptoms in older adults

• This information is specifically about pregnancy. It does not address urinary problems in older adults who are not pregnant.

Causes

Main causes

• Hormones during pregnancy relax the muscles of your urinary tract, which can slow the flow of urine and let bacteria grow.
• Your growing uterus presses on your bladder, so you need to pee more often.
• Your kidneys filter more blood and make more urine than usual.
• Bacteria from the bowel can sometimes enter the urinary tract during pregnancy.

Risk factors

• A past urinary tract infection
• Diabetes
• Being immunocompromised (having a weaker immune system)
• Using a urinary catheter
• Having had multiple pregnancies

When to see a doctor

See a doctor urgently if:

• If you have pain or burning when you pass urine, fever, chills, blood in your urine, or severe back or belly pain, contact your doctor or midwife the same day.

Book a routine appointment if:

• You will have your urine checked at your first prenatal visit and at many later visits. This is routine and important.

Diagnosis

Your provider will ask about your symptoms and check a sample of your urine. They may also check your blood pressure because problems with urine and blood pressure can be related.

Tests that may be done

• A urine dipstick test — a quick test where a strip is dipped in your urine to check for infection, sugar, or protein.
• A urine culture — a sample of urine sent to a lab to see if bacteria are present and which medicine would work best.
• Blood tests — if your provider is checking your kidneys or for preeclampsia.
• An ultrasound of your kidneys — rarely needed, but can be done if there are concerns.

What to expect at your appointment

Testing your urine is simple. You will be given a sterile cup and instructions to collect a mid-stream sample. You should not feel any pain. The results may be available immediately or after a few days.

Treatment

Treatment depends on what is found. If you have a urinary tract infection, your provider will prescribe a medicine to treat the bacteria. If protein is found in your urine and your blood pressure is high, you may need closer monitoring during your pregnancy.

Self-care at home

• Drink enough water throughout the day so your urine is pale yellow or clear.
• Empty your bladder when you feel the urge — don't hold it in.
• After using the toilet, wipe from front to back to keep bacteria away from the urethra.
• Empty your bladder soon after sex.
• Wear cotton underwear and avoid tight-fitting trousers.

Medical treatments

Your doctor or midwife may prescribe an antibiotic that is safe to use during pregnancy. It is important to take the full course, even if you feel better. If you have high blood pressure or protein in your urine, your care team will talk with you about monitoring and any treatment that is needed. Never take any medicine without asking your provider first.

When is surgery considered?

Surgery for urinary problems is rarely needed in pregnancy. Very occasionally, a kidney stone that blocks urine flow may need a small procedure, but your care team will only consider this when medically necessary.

Living with this condition

Plan for extra bathroom breaks, especially at work or when travelling. Keep a water bottle nearby, but stop drinking large amounts an hour or two before bed if nighttime peeing bothers you. If you are being treated for a UTI, finish all your medicine and get plenty of rest.

Lifestyle tips

• Do pelvic floor exercises (often called Kegels) to support your bladder and pelvic muscles.
• Try to avoid drinks that irritate the bladder, like coffee and fizzy drinks.
• Set a habit of going to the toilet every 2–3 hours during the day, even if you don't feel the urge.
• Keep up with your prenatal appointments so any problem is found early.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains. Gentle exercise like walking or prenatal yoga is safe for most pregnant people and helps keep your body healthy. If you have diabetes, controlling your blood sugar is especially important for your kidneys.

Mental health and emotional wellbeing

Dealing with pregnancy health worries can be stressful. It's normal to feel anxious or overwhelmed at times. Talk to your partner, family, or friends about how you feel, and tell your care team if you are struggling. If you are in crisis or feel you cannot keep yourself or your baby safe, call your local emergency number right away. You are not alone, and support is available.

Prevention

You cannot prevent all urinary problems, but you can reduce your risk. Drinking plenty of water, using good bathroom habits, and staying active all help. Attending your prenatal visits means problems are spotted early.

Vaccines

There is no vaccine that prevents urinary infections. However, staying up to date with recommended vaccines before and during pregnancy helps protect your overall health.

Screening programmes

Screening is part of routine prenatal care. Your urine is checked at many appointments, and your blood pressure is measured at every visit. These simple checks can detect problems like preeclampsia early.

Complications

If left untreated

• An untreated urinary tract infection can spread to your kidneys and cause a more serious illness, with fever, chills, and back pain.
• High blood pressure with protein in your urine (called preeclampsia) can be dangerous for you and your baby if not monitored and treated.
• Severe dehydration can reduce your kidney function and affect your baby's wellbeing.

Long-term outlook

With regular prenatal care and timely treatment, most urinary problems in pregnancy are managed safely. Even if an issue is found, there is much that can be done to protect your health and your baby's health. Most women go on to have a healthy pregnancy and baby.

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