If you’ve ever had a Urinary Tract Infection (UTI), you know how uncomfortable they can be. Now imagine dealing with one while pregnant—ouch! Unfortunately, UTIs in pregnancy are quite common affecting up to 8% of expectant mums. But why is this the case, and what can you do about it? We chatted with Lesley Bland, a registered midwife and consultant midwife for My Expert Midwife, to get the lowdown on managing and preventing UTIs during pregnancy.
Why are UTIs more common in pregnancy?
As your body works overtime to grow your little one, it also goes through many changes. Lesley explains, “UTIs are more common during pregnancy because there are so many changes going on in your body that add stress to the kidneys, bladder, and ureters. The hormone progesterone, which increases throughout pregnancy, relaxes muscles—including the smooth muscle of the bladder—causing it to be less reactive and responsive to needing to be emptied. This can lead to urinary stasis (also known as urinary retention).”
On top of that, your growing uterus puts pressure on your bladder, making it harder for urine to flow out. Lesley adds, “Combined with a growing uterus which compresses the bladder and reduces its capacity, this can all lead to a growth of bacteria, which in turn can result in a UTI infection while pregnant. If left untreated, UTIs can track up the ureter from the bladder to the kidney, where the infection can spread rapidly, becoming pyelonephritis.”
Symptoms of UTI in pregnancy
Lesley listed signs and symptoms of UTI in pregnancy that you should be aware of:
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Stinging when passing urine
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An offensive smell to your urine
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Cloudy or darker urine
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Frequent urge to urinate but only passing a few drops
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Lower back or belly ache and a general feeling of being unwell
If you experience any of the following symptoms below, seek urgent medical review as you may have an advanced UTI or kidney infection:
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Fever
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Nausea
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Vomiting
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Blood in your urine
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Upper back pain, often on just one side
What to do if you think you have a UTI?
If you notice any signs of UTI when pregnant, such as stinging when you pee, an offensive smell to your urine, cloudy or darker urine, or a persistent urge to go, talk to your midwife or GP straight away. “They can carry out some tests and organise any relevant treatment,” advises Lesley.
How can pregnant women safely treat a UTI?
Lesley says, "If you are pregnant and have any symptoms of a UTI it is important that you speak with your Midwife or GP so they can carry out some tests and organise any relevant treatment. If your Midwife or GP suspects a UTI they may prescribe you some prophylactic broad-spectrum antibiotics.
If the lab results come back as no bacterial growth the antibiotics will then be stopped. However, if there is a bacterial growth that is sensitive to specific antibiotics you may have your medication switched to one that is likely to be more effective. If you are allergic to penicillin this may also impact on the first-line choice of antibiotic.
Your prescriber should know that you are pregnant but always remind them as there are certain medications that should be avoided and let them know how many weeks gestation you are as some medications should be avoided at different stages of pregnancy.”
Can I take antibiotics for UTI while pregnant?
Different NHS trusts have their own guidelines for treating UTIs during pregnancy, but Lesley explains, “As a rule, Trimethoprim should be avoided during the first trimester, while Nitrofurantoin should be avoided at full term or if labouring. Amoxicillin and Cefalexin may also be prescribed as antibiotics for UTI while pregnant.”
She also recommends staying hydrated and taking paracetamol to help with any pain. “Keep very well hydrated by drinking at least two litres of water a day,” she adds.
Always consult with your local GP to determine the best approach for managing a UTI during pregnancy.
When should you seek urgent help?
While most UTIs are easily treated, some symptoms mean you should seek immediate medical attention. “If you have a fever, nausea, vomiting, blood in your urine, or pain in your upper back (often on just one side), you might have a more advanced UTI or kidney infection,” says Lesley. “You are advised to seek urgent medical review as you may have an advanced UTI or kidney infection.”
What about recurrent UTIs?
Some women find themselves dealing with UTIs more than once during pregnancy. Lesley notes that recurrent UTIs, defined as having two or more infections during pregnancy, can affect up to one in 20 pregnant women. “The main cause of UTI recurrence is mismanagement—incorrect or inadequate treatment of the first infection,” she says. “However, recurrent UTIs can also occur after sexual intercourse, from dehydration, poor genital hygiene, urine stasis, and general physiological and hormonal changes of pregnancy.”
If you’re prone to recurrent UTIs, your GP or midwife might suggest a daily low dose of antibiotics to keep them at bay. But Lesley emphasises that prevention is key, “Pay particular attention to your oral hydration, your genital hygiene, and ensuring you empty your bladder fully each time you pee.
Remember, the progesterone spike associated with pregnancy can reduce the efficiency and effectiveness of your bladder by relaxing the smooth muscle of its lining, so giving it a helping hand will aid emptying and reduce the risk of urine being left to grow bacteria.”
How can you prevent UTI during pregnancy?
The good news is there are plenty of ways to reduce your chances of getting a UTI in pregnancy. Lesley shares some top tips:
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Emptying your bladder regularly, especially before and after having sex
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Strict hand hygiene, washing with soap and water before and after going to the toilet
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Wearing maternity underwear made from breathable, natural materials such as cotton or bamboo.
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Avoiding tight fitting underwear and clothing
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Changing your underwear daily, or more frequently if needed
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Maintaining good hydration by drinking at least two litres of water a day
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Using only gentle unperfumed soaps and cleansing products on the vulval area
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Ensuring you empty your bladder by raising your feet on a small stool or leaning forwards slightly when peeing
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Wiping from front to back when toileting to avoid transferring bacteria from the anus to the vulva
These simple steps can go a long way in keeping UTI at bay during your pregnancy.
UTIs are no fun, especially when you’re expecting. But with the right care and precautions, you can reduce your risk and keep both you and your baby healthy. If you suspect you have a UTI in early pregnancy or at any stage, don’t hesitate to reach out to your healthcare provider—they’re there to help you feel your best.
About the expert
Lesley Bland is a Registered Midwife and Consultant Midwife for My Expert Midwife. She began her Midwifery career working in large teaching hospitals rotating through all clinical areas with particular emphasis on antenatal and intrapartum care. Lesley qualified as a mentor of students and developed a passion for education specialising as a Clinical Educator teaching the maternity multidisciplinary team.
About the author
Anne Lora Scagliusiis a Senior Digital Writer at Mother & Baby. She is a Scotland-based journalist with over a decade of international writing experience, specialising in women’s health, maternal mental health, and wellness. Her work has been featured in Vanity Fair, Marie Claire, and Glamour and has appeared on several Vogue global editions. She is mum to a one-year-old bambino and lives between Italy and the UK.