Feeling like you need to pee all the time is par for the course when you're pregnant. But you can't always brush off that constant urge to go as no big deal.
There's a chance that it's caused by a urinary tract infection (UTI), which happens when some unwelcome bacteria travel up your urethra and set up shop in your bladder or somewhere else in your system. That can lead to telltale symptoms, like a constant need to rush to the bathroom along with a burning sensation when you pee.
More than half of all women come down with a UTI at some point in their life, says the federal Office on Women's Health. And they're common in pregnancy, so it can be helpful to understand what to expect and how to deal.
Here's what you need to know about UTIs in pregnancy, according to doctors.
UTI in pregnancy , Pregnant woman at toilet , MD, Ob-gyn at UCHealth Highlands Ranch Hospital in Colorado, tells Health.
The exact rates of UTIs in pregnancy vary depending on who you ask, but in a study cited by the US Centers for Disease Control and Prevention, one in 10 women were diagnosed with a UTI during their pregnancy, or just before it.
Many more pregnant people may have the bacteria that causes UTIs without even realizing it, though. According to a 2019 review, up to 15% of all pregnancies involve "asymptomatic bacteriuria," meaning that the bacteria behind these infections are present but not causing any symptoms.
"We do screen patients at least once, if not a few times, during pregnancy to make sure they don't have an infection," says Dr. Wynn.
She estimates that about 30% of women who have this bacteria in their urinary tract will ultimately develop signs of a UTI.
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What causes UTIs in pregnancy?
Bacteria cause UTIs in pregnancy, as well as all other times in a person's life.
More specifically, Escherichia coli (aka E. coli) is to blame for up to 90% of UTIs, per the National Kidney Foundation (NKF). These germs can be found in your intestines and around your anus, where they usually don't cause any trouble. But if they get into the urethra, such as on a piece of toilet paper or accidentally during sex, they can create a colony in your urinary tract, resulting in a full-blown infection. UTIs usually occur in the bladder, says NKF, but they can also affect your urethra, ureters, and (in severe cases) your kidneys.
While the culprit behind them is the same, UTIs in pregnancy have a few key differences than other UTIs. For one, hormonal changes may make the body more vulnerable to bacteria, says Felice Gersh, MD, OB-GYN, founder and director of the Integrative Medical Group of Irvine in Irvine, California, and author of PCOS SOS Fertility Fast Track.
"When a woman is pregnant, she has high levels of the hormone progesterone. It will somewhat relax the sphincters around the base of the bladder and urethra, so the urethra and urethra opening will enlarge, and that facilitates the bacteria coming up more," Dr. Gersh tells Health.
Meaning it could be even easier for bacteria to get into your system and cause a UTI.
What's more, "pregnancy is a time when the immune system is modified," says Dr. Gersh. "It's modified in a way that doesn't kill the fetus, which is good, but because it's modified, the white blood cells that make up your body's first line of defense against a pathogen may not be quite as capable of fending off invading bacteria."
That, combined with the fact that the bacteria don't always cause symptoms right away, help to explain why UTIs in pregnancy, per the NKF, may be more likely to involve the kidneys. As the US National Library of Medicine points out, this severe type of infection can cause long-term damage or even be fatal if not treated.
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What are the symptoms of a UTI in pregnancy?
If you're pregnant, you may already be experiencing one of the most common symptoms of a UTI: a frequent need to pee. However, that's far from the only red flag of this common infection. The Mayo Clinic describes these other UTI symptoms:
- an urgent need to urinate
- a burning sensation when you pee
- you can only pass small amounts of urine
- your pee is cloudy, pink, red, or brownish
- foul-smelling pee
- pelvic pain
Remember: Many people who are pregnant may have the bacteria that causes UTIs but no symptoms. That's why the US Preventative Services Task Force recommends that doctors give pregnant people a urine test at their first prenatal visit, or sometime between 12 and 16 weeks gestation.
Catching a UTI in pregnancy as early as possible can give you the chance to get medication (if necessary) and wipe out the bacteria before it causes a more severe infection.
If the UTI does become more serious and reach your kidneys, you may experience additional symptoms, per Mayo Clinic, like:
- pain in your groin, back, or side
These are signs you should get medical care right away.
"If a UTI stays in your bladder, it's not as dangerous, but once it goes to the kidneys, it's dangerous for both the woman and the fetus," says Dr. Wynn.
RELATED: 9 Causes of Smelly Urine and What to Do About Them
Treating a UTI in pregnancy
A short course of antibiotics is usually enough to wipe out a UTI in the bladder, explains the National Institute of Diabetes and Digestive and Kidney Diseases. But treatment for UTI is a little more complicated during pregnancy, as certain medications might not be safe for the fetus.
"Different antibiotics may pose different risks at different times during pregnancy," says Dr. Wynn.
The US Centers for Disease Control and Prevention describes a 2016 study in which pregnant women who received trimethoprim-sulfamethoxazole, cephalosporins, or nitrofurantoin to treat a UTI before or during their first trimester were at a higher risk for major birth defects, compared with those who used penicillin.
Your doctor can advise on which antibiotics are safe for you at any point during your pregnancy, factoring in other considerations such as allergies. Generally, you don't need to take antibiotics for more than a week, but sometimes treatment may last 14 days, says the American Urological Association (AUA). The good news is that you should feel better within a couple of days of starting treatment, the Urology Care Foundation reports.
If your UTI has reached your kidneys, treatment is more involved, says AUA. You will likely need to spend a couple of days in the hospital and receive antibiotics through an IV, followed by a course of oral antibiotics.
RELATED: How Long Does a UTI Last? We Asked Urologists
Tips for preventing UTIs during pregnancy
Between the complexity of treating UTIs in pregnancy and the unpleasant symptoms they can cause, it's worth taking steps to avoid getting one of these infections to begin with. Here are some doctor-approved tips for preventing a UTI in pregnancy:
- Pee frequently and empty your bladder fully. OK, you probably have the first part down, but making sure you pass everything that's in your bladder can be an effective way to prevent a UTI, as well. That helps flush out any bacteria that might be hanging out in your urinary tract. Dr. Gersh recommends shifting your position on the toilet to help get all the urine out. "Some women may need to lean forward a little it or change the angle or stand up a little bit," she says.
- Stay hydrated. A 2018 JAMA Internal Medicine study shows that increasing the amount of water you drink may help reduce the risk of UTIs. Aim for six to eight glasses of fluid per day, per the Office on Women's Health.
- Pee before and after sex. When you're getting hot and heavy, you or your partner may accidentally push bacteria from your anus into the urethra area. Peeing just before and after sex helps flush those germs out, preventing them from creating an infectious colony.
- Don't use irritating products. Certain self-care products, like heavily scented bubble bath or soap, can cause an imbalance of good bacteria in your vagina. That, in turn, makes it easier for the bad guys to thrive and create a UTI. Opt for gentle, unscented products, instead.
- Try cranberry supplements. While doctors still aren't quite sure if cranberry supplements actually prevent UTIs, some research (including this 2018 clinical trial in JAMA Internal Medicine) shows that these products may help. Dr. Wynn says they're safe to use during pregnancy, and even if they end up not working, they aren't known to cause any side effects, so the worst case is that you're out a few bucks.
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