If you've had a urinary tract infection (aka a UTI) before, you know the burning sensation that comes when you go to the bathroom. During pregnancy, UTIs are even more common, so much so that they are the most common bacterial infection in pregnancy.[1]
What's more, you may experience no symptoms at all, which can cause problems if left untreated. Fortunately, this common infection is easily managed, so if you get one, you can stay healthy and a lot more comfortable.
What is a UTI?
A UTI is a bacterial infection of the urinary tract, which includes the bladder (where it’s called cystitis), the urethra (called urethritis) or, in more serious cases, the kidneys (pyelonephritis).[2]
The urinary tract functions to remove waste and extra water from the body. It's made up of two kidneys, where urine is produced, two ureters, which carry urine to your bladder, the bladder itself, which collects and stores the urine, and the urethra, the tube that sends the urine out of your body.
Changes in both the structure and function of the urinary tract occur in pregnancy, and this can result in increased risks of both UTIs and kidney infections. Bacteria from normal vaginal, perineal and gut flora are the main culprits of UTIs, with E.coli as the most common. Once these bacteria trespass into the urinary tract, they multiply fast, resulting in infection.
How common are UTIs during pregnancy?
Between 2 and 13 percent of women can expect to develop at least one UTI during pregnancy.[3] Because some women have no symptoms of a UTI during pregnancy, your practitioner will have a clean void urine culture done at your first prenatal visit.
Kidney infections are about twice as common in expecting women as non-pregnant women. That said, they're still quite rare, occurring in only about 2 percent of pregnancies. Symptoms include fever, chills, nausea/vomiting and pains in the lumber and mid-back regions.
More on Pregnancy Health
UTI symptoms during pregnancy
Every woman’s body is different, so be sure to tell your doctor about any pain or discomfort you feel promptly — especially if you experience any of these typical UTI symptoms:[4]
- Burning sensation during urination
- More frequent trips to the bathroom to urinate (though frequent urination during pregnancy alone is common and harmless)
- Intense urge to urinate while the amount of urine expelled is small
- Cloudy, dark, bloody or foul-smelling urine
- Low-grade fever
- Lower-abdominal pain or discomfort
- Pain that occurs on one or both sides between the upper abdomen or on the back; this could indicate a kidney infection, which should be treated immediately
- Chills, nausea, vomiting and/or high fever, which can be signs of a kidney infection
What causes a UTI during pregnancy?
Several factors can lead to a UTI during pregnancy, including:
- Changes in your body. Women have a higher risk for UTIs compared to men because the urethra is shorter, which makes it easier for unwanted bacteria to enter the bladder. But pregnant women are even more prone as changes in hormones result in relaxation of the urethra that makes urine more likely to reflux, or move backwards. Your growing uterus also puts added pressure on your bladder, making it more difficult to completely empty it of the urine.
- Bacteria from the bowel. UTI-causing bacteria can come from several places. By far the most common bacterial invader, E. coli, comes from the bowel. Because the urethra is located close to the rectum, bacteria can be transported up the urethra. Wiping from front to back (instead of back to front) every time you use the bathroom can help keep bacteria away from this area.
- Intercourse. Sex during pregnancy is perfectly healthy (unless your doctor tells you otherwise) — but there is a downside: It also has the potential to lead to a UTI, as bacteria near the vagina (including E. coli) may be pushed into the urethra during intercourse. It may not be romantic, but it’s important to urinate before and after sex to move that bacteria along.
There are also other risk factors. If any of these apply to you, be sure to discuss them with your doctor so you can be closely monitored for signs of an infection:
- A history of recurring UTIs or a kidney infection
- Gestational diabetes
- Having had several children
- Obesity
- Sickle cell disease
- Previous urinary tract surgery
- Damage to nerves that control the bladder because of Parkinson's disease, multiple sclerosis or physical injury
UTI diagnosis and treatment
Think you may have a UTI? The standard way to diagnose one (during pregnancy or otherwise) is a urine culture. Most doctors will ask for a “clean catch” sample, where you pee into a cup midstream after carefully wiping your outer vaginal area.
If you are diagnosed with a UTI, your doctor will likely provide a pregnancy-safe antibiotic for seven to 14 days to get rid of all of the bacteria. Be sure to take the recommended full course, even if you start to feel better midway through treatment, and drink plenty of water.
If the infection has reached your kidneys, your practitioner may suggest staying in the hospital, where you can receive IV antibiotics.
Keep in mind: Because an untreated infection can lead to serious complications in pregnancy — including kidney infection and, potentially, an increased risk of fetal growth restriction, preeclampsia and preterm birth — notify your provider immediately if you have any UTI-like symptoms.
Also remember, not all women have symptoms of a UTI. So, likewise, the urine tests at your regular prenatal visits are really important. (Have you scheduled your next appointment yet?)
Preventing UTIs during pregnancy
While UTIs might happen whatever precautions you take, a few steps can help reduce the odds you’ll suffer from a UTI during pregnancy:
- Stay hydrated. Try to drink enough water every day so that your urine is a clear yellow; the increase in bathroom time helps flush bacteria out of the urethra.
- Befriend the bathroom. You may feel like you’re waddling to the bathroom every five minutes, but it’s important to never hold in your urine. As soon as you get the urge to go, go. Be sure to completely expel your urine, too (try leaning forward while sitting on the toilet). Before turning in for the night, empty your bladder again.
- Wear cotton-crotch underwear. This will help keep that area dry, as bacteria thrive in moisture. Skip the undies when you sleep, at least sometimes if you can, to let the area air out.
- Wipe from front to back. This goes for every bathroom visit.
- Avoid feminine hygiene products. Douches, powders, and perfumed products (shower gels, soaps, sprays, detergents and toilet paper) can cause irritation to an already vulnerable area.
- Eat well. Keep your resistance high by eating a healthy pregnancy diet and staying active. Research data does not support benefits of either probiotics or cranberry products in prevention of UTIs. However, both of these treatments have minimal to no risk, so if you have used them before or want to try them, talk to your doctor.[5]
- Practice good hygiene. Keep your perineum meticulously clean and irritation-free by rinsing externally every time you shower (showers, by the way, are better than baths). It's also a good idea to wash the area and empty your bladder before and after sex.
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