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How to treat and prevent UTIs during pregnancy

Dr Christine Catling

Dr Christine Catling

Dr Christine Catling, a midwife for over 25 years, is the Director of Midwifery Studies at UTS. She believes research, innovation and good quality midwifery are pivotal to the well-being of mothers and young families. Christine has extensive experience in antenatal education, policy development and research, and has published on workforce issues, homebirth, vaginal birth...
Created on Oct 03, 2023 · 4 mins read

Urinary tract infections (UTIs) are a prevalent condition that can affect women both during pregnancy and outside of pregnancy. However, some women may find themselves more susceptible to UTIs during pregnancy due to the various physiological changes occurring in their bodies. UTIs typically occur when bacteria enter the urinary system, including the urethra, bladder, and, in severe cases, the kidneys. The bacteria responsible for UTIs can originate from sources such as the intestinal tract/bowels, the skin, or the surrounding environment.

Why do UTIs occur?

During pregnancy, hormonal changes and the physical changes in the urinary system can contribute to an increased risk of UTIs. These changes include:

  1. Hormonal shifts: Hormonal changes during pregnancy can affect the urinary tract, making it more susceptible to bacterial colonisation. Hormones like progesterone can relax the muscles of the urinary tract, potentially causing urine to pool and providing a conducive environment for bacterial growth.
  2. Urinary stasis: As the uterus expands during pregnancy, it can exert pressure on the bladder, leading to incomplete emptying of urine. This stagnant urine can create an environment where bacteria can multiply, increasing the risk of infection.
  3. Hormonal changes in the vaginal area: Pregnant women experience shifts in vaginal pH levels due to hormonal fluctuations. These changes can alter the bacterial balance in the vaginal area, potentially increasing the risk of bacteria reaching the urinary tract.

Sex can also increase your chances as bacteria can enter the urethra during or after intercourse.

If you experienced UTIs frequently before becoming pregnant, you’re more likely to experience them during pregnancy too.

What are the symptoms of a UTI?

Some women will experience no symptoms at all, however many of the most common symptoms include:

  1. Pain or discomfort during urination: A common symptom of a UTI is a burning sensation or pain when urinating. This discomfort may be felt in the urethra or lower abdomen.
  2. Frequent urination: If you find yourself needing to urinate more frequently than usual, it could be a sign of a UTI. This includes waking up multiple times during the night to urinate (nocturia).
  3. Urgency: Feeling a strong and sudden urge to urinate even if the volume of urine is small is another symptom of a UTI.
  4. Cloudy or strong-smelling urine: UTIs can cause changes in the appearance and odor of urine. Your urine may appear cloudy or have an unusually strong smell.
  5. Blood in the urine: In some cases, a UTI may lead to the presence of blood in the urine (hematuria). This can give the urine a pink, red, or brown color.
  6. Lower abdominal or back pain: UTIs can cause discomfort or pain in the lower abdomen or back, particularly in the area surrounding the bladder and kidneys.
  7. Fatigue or malaise: Some individuals with UTIs may experience general feelings of fatigue, weakness, or a sense of overall unwellness. Fever, nausea and/or vomiting can also occur.

Can a UTI be harmful to you or the baby?

If left untreated UTIs can lead to kidney disease as well as birth complications such as pre-eclampsia, early labour and low birth weight.

In some cases, untreated UTIs can lead to a neonatal infection, where the baby acquires the infection during birth. This can cause complications for the newborn and may require medical intervention.

It can also cause major complications to your own health if left untreated and the UTI does reach your kidney.

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How to treat a UTI during pregnancy

If you suspect you have a UTI you should speak with your doctor immediately so they can test you (you will have to provide a urine sample) and then they will usually prescribe a course of antibiotics. They will often advise you to drink more water and to take paracetamol for the treatment of any pain.

Your doctor will then likely test you again after you have finished the course of antibiotics to make sure the bacteria has cleared, and they might also want to continue to monitor it for the duration of your pregnancy.

If the infection enters your kidneys while you are pregnant you may be admitted to the hospital for treatment intravenously.

How to prevent a UTI

There are a number of things you can do to help try and prevent a UTI from occurring in the first place:

  • Drinking plenty of fluids – predominantly in the form of water
  • Going to the toilet often – and emptying your bladder completely. As much as it feels like you’re constantly in the bathroom, don’t fight the urge to go
  • Wiping from the front to the back after going to the toilet and always keeping the area clean
  • Using mild cleanser (only ever wash the area externally)
  • Showers are generally recommended over baths
  • Always remember to go to the toilet before and straight after sex
  • Wearing cotton underwear and letting the area breathe without underwear overnight when you can
  • Avoid synthetic fabrics and wearing anything too tight such as jeans or tights

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