UTI During Pregnancy: Why You Shouldn't Wait

When you're pregnant, running to the bathroom every hour feels like part of the deal, right alongside the tiredness and the morning queasiness. So plenty of moms-to-be shrug off a mild sting and blame it on "the baby sitting on my bladder." Sometimes that's all it is. Other times it's a bladder infection that, during these nine months, has an easier path up to the kidneys than at almost any other point in life. In this guide the clinic's medical team walks through what changes in your body, why waiting can cost you, and how a visit to the clinic fits with the care you already get from your OB.

Peeing often is normal; burning is not

This is the single most useful line for a pregnant woman to draw. Frequency goes up naturally in the first trimester and again near the end, once the baby drops. What is not part of a normal pregnancy:

• A hot, stinging feeling right as the urine comes out.
• Urine that suddenly smells different or looks pink.
• Pressure or cramping just above the pubic bone that doesn't feel like your usual aches.
• Needing to go again the moment you walk out of the bathroom, without having drunk anything extra.

If any of those sound familiar, don't write it off as "just pregnancy" until it's been checked.

What changes in your body, and why bacteria take advantage

Pregnancy hormones, progesterone above all, relax the body's smooth muscle. That helps the uterus grow, but it also loosens the tubes that carry urine from the kidneys to the bladder (the ureters) and the bladder itself. Urine moves more slowly and sits still for longer, and still urine is an easy place for bacteria to multiply.

Then there's the weight of the uterus. As it grows, it presses on the bladder and ureters, so the bladder doesn't always empty all the way. The amount and makeup of your urine shift too. The practical upshot: an infection that would normally stay in the bladder has, during pregnancy, a shorter road to the kidney.

Bacteria in the urine with no symptoms at all

One thing surprises a lot of patients: you can have bacteria in your urine and feel perfectly fine. It's called asymptomatic bacteriuria. Outside pregnancy it's rarely looked for or treated, but in pregnancy groups such as the American College of Obstetricians and Gynecologists (ACOG) recommend checking for it with a urine culture early in prenatal care and treating it when it shows up, because left alone it can turn into a kidney infection.

So if your OB asked for a urine sample at your first visit and later called to start treatment even though you felt fine, nothing went wrong: that's routine care. And if you haven't started prenatal care yet, this is one more reason not to put it off.

Why "waiting to see if it goes away" is a bad bet

An untreated bladder infection in pregnancy can climb to the kidney and cause pyelonephritis, a more serious infection that often means a hospital stay, IV fluids and monitoring of the baby. Kidney infections during pregnancy have been linked to early contractions and preterm birth, according to information from the CDC and ACOG. Treating it while it's still in the bladder is far simpler for you and for your baby.

Pregnancy can also disguise the warning signs: low back pain gets blamed on the belly, and exhaustion on the third trimester. Waiting until it's "obvious" usually means arriving after the infection has moved on.

What you feel and where to go

Ask your OB now which hospital to use if something goes wrong; in the second half of pregnancy many hospitals would rather you go straight to labor and delivery than to the general emergency room.

What the visit looks like when you're expecting

When you check in, tell the front desk you're pregnant and how many weeks along you are. If you're not sure and your period is late, a pregnancy test comes first, because the answer changes the treatment options. Then comes the urine part: at the urinary infection visit you give a midstream sample, we do the urine test at the clinic, and if there is an infection, you leave with your treatment the same day, chosen by the clinic's medical team from the options that are safe for your pregnancy and for how far along you are.

During pregnancy it usually makes sense to send a urine culture as well, one of the clinic's lab tests. That result takes a few days and confirms the bacteria respond to the treatment chosen; if they don't, you'll get a call to adjust it. Once you finish treatment, a repeat culture to make sure the urine is clear is common, so ask when to come back for it.

Medications prescribed at the visit are handed to you at the clinic, so there's no extra stop to make while you're tired and carrying the extra weight.

Your OB needs to know

The clinic takes care of the urinary problem, but your pregnancy is followed by your own OB or the prenatal clinic where you're seen. To keep everyone on the same page:

1. Bring your prenatal card, your due date and a list of the vitamins and medicines you take.
2. Ask for the urine test result and the name of the treatment in writing.
3. Call your OB today or tomorrow at the latest; they may want to see you or order another check.
4. Bring up the infection at your next prenatal visit, even if you feel fine by then.

For other concerns that aren't urinary, the clinic's women's health and basic gynecology visit can also point you in the right direction.

What not to do

• Take leftover antibiotics from an old infection, or ones a friend or relative hands you. Some aren't recommended in pregnancy, and a partial course leaves resistant bacteria behind.
• Grab a "bladder relief" product off the shelf without asking: some urinary pain relievers only mask the burning and can delay the diagnosis.
• Rely only on juices or home teas. Water helps, but no home remedy cures an infection that's already active.
• Stop the treatment when the burning fades on day two. Finish what was prescribed.

Habits that help over these months

Spread your water through the day, don't hold it, lean forward a little when you pee so the bladder empties better, wear cotton underwear and urinate after sex. If you have gestational diabetes, keeping your glucose in range lowers the risk too.

Close to you in Pasadena

Clínica Hispana Corazón y Vida is at 918 W Southmore Ave, Suite 180, Pasadena, TX 77502, with free parking right by the door, which helps when every step feels heavier. You can walk in or call ahead at (832) 930-5551 to let us know you're pregnant and having urinary symptoms. If what you feel is on the warning list above, skip the clinic: go to labor and delivery or call 911.