What to Do for Painful Urination During Pregnancy

Peeing all the time? For expectant mamas, that’s normal. But experiencing pain when peeing while pregnant is not. Here’s what might be going on.
ByChristin Perry
Updated
Jul 2020
woman standing in front of toilet with roll of toilet paper
Photo: Shutterstock

During pregnancy, it’s totally normal to hit up the restroom many, many times in a day. Almost from the very beginning of your pregnancy, you’ll probably experience frequent urination. But that doesn’t mean it should be painful. Sure, there isn’t much that’s super-comfortable during pregnancy—we can all agree on that! But painful urination during pregnancy can be a signal that there’s a problem going on. Luckily, it’s a pretty easy fix, especially if your pain when peeing during pregnancy points to a urinary tract infection (which up to 7 percent of pregnant women experience).

Here, we’ll discuss everything you need to know about painful urination during pregnancy—why it happens, what the hidden cause is and how to handle it. So at least you can remove one thing from your list of pregnancy aches and pains.

What Causes Painful Urination During Pregnancy?

When it comes to peeing during pregnancy, frequent is fine—but pain is a problem. “Urination should never be painful,” says Sarah Prager, MD, a professor in the department of obstetrics and gynecology at the University of Washington. While there are a number of causes related to pain when peeing while pregnant, the most common by far is a urinary tract infection (UTI). “UTIs are more common during pregnancy due to both hormonal changes causing the urinary tract to relax, as well as mechanical changes caused by the enlarging uterus,” says Alan Fishman, MD, a maternal-fetal medicine specialist with Obstetrix Medical Group of San Jose in California.

If you’re experiencing painful urination during pregnancy, know that the following conditions can lead to a UTI or can be an underlying cause of bladder pain and painful urination during pregnancy.

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Bacterial vaginosis

Bacterial vaginosis is a common condition caused by an imbalance in the normal bacteria that lives in the vagina. It can cause painful urination due to inflammation of the immediate area, or by spilling bacteria into the urinary tract, which can lead to a UTI.

Sexually transmitted infections

Any undiagnosed sexually transmitted infections can cause painful urination during pregnancy as a result of inflammation. “STIs can cause pain, usually pelvic but sometimes vaginal, or even painful urination. This is why pregnant women are screened for STIs at the beginning of pregnancy,” says Fishman.

Genital herpes

Herpes can cause painful urination, whether you’re pregnant or not. But unfortunately, this painful condition can cause extra complications during pregnancy. If you know you have herpes, it’s critical to follow your doctor’s advice in order to keep active infections at bay, especially as you approach your due date.

Mechanical obstruction

As your uterus grows to several times its normal size during pregnancy, it can put the (literal) squeeze on everything else in there. That includes the ureters (aka the ducts from the kidney to the bladder that urine passes through), says Brittany Robles, MD, an ob-gyn who runs PostpartumTrainer.com, a pregnancy and postpartum health and fitness site. When urine gets left behind in the ureters because it’s physically difficult to properly empty them, “this causes a condition known as urostasis,” Robles says. “That can lead to persistent bacterial growth and ultimately a urinary tract infection.”

Is Painful Urination During Pregnancy Ever Dangerous?

Pain when peeing while pregnant may seem harmless, but it’s actually not. That’s why it’s important to see your doctor if you’re experiencing either painful urination or bladder pain during pregnancy. “Untreated urinary tract infections are associated with pregnancy complications such as preterm labor and preterm delivery. They can also cause kidney damage or sepsis in pregnant women,” says Fishman.

If it’s an undiagnosed or untreated STI that’s causing your painful urination, that can also be harmful to both you and baby. According to the CDC, if left untreated, chlamydia can cause preterm labor and low birth weight. It can also be passed onto baby at birth, potentially resulting in eye and lung infections. Untreated gonorrhea has been linked to miscarriage, premature birth and low birth weight, and newborns can also contract it as they’re delivered through the birth canal.

How to Treat Painful Urination During Pregnancy

See your doctor at the first sign of painful urination, Prager says. Your doctor will probably prescribe antibiotics, especially if it turns out you have a UTI. The reason? “UTIs can become kidney infections or worse, so we’re relatively aggressive about treating them during pregnancy,” Prager says.

That’s likely the same course of action your doctor will take if it turns out you have an STI: antibiotics can clear up many infections pretty quickly, so don’t be embarrassed about speaking up.

How to Prevent Painful Urination During Pregnancy

There are so many aches and pains during pregnancy, and we’re guessing you’re not up for adding yet another one. So how can you prevent painful urination during pregnancy? “Adequate hydration is the best thing you can do to help prevent UTIs during pregnancy,” says Fishman. “This has the beneficial effect of increasing urinary production and flow and flushing the kidneys.” Strive to meet or even exceed the recommended eight cups of water daily. Other ways to prevent UTIs include:

  • Don’t hold in your urine
  • Always wipe from front to back to prevent bacteria from entering into the vagina
  • Empty your bladder before and after sex
  • Wear breathable cotton underwear

In order to prevent STIs during pregnancy, simply follow the same rules you normally would: Use condoms during sex and strive to have only one partner.

About the experts:

Sarah Prager, MD, MAS, is a professor in the department of obstetrics and gynecology at the University of Washington and director of the family planning division. She received her medical degree from the University of Texas Southwestern Medical School in 2000 and completed an internship and residency at the University of Vermont.

Alan Fishman, MD, is the medical director for Obstetrix Medical Group of San Jose in Campbell, California, and is double board-certified in obstetrics and gynecology as well as maternal-fetal medicine. He received his medical degree from Jefferson Medical College in Philadelphia, Pennsylvania, and completed his ob-gyn residency and maternal-fetal medicine fellowship program at University of Southern California, School of Medicine in Los Angeles.

Brittany Robles, MD, MPH, CPT, is an ob-gyn and NASM-certified personal trainer who runs PostpartumTrainer.com, a pregnancy and postpartum health and fitness site.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

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