Pregnancy and the Urinary System: What You Should Know

by | Jun 3, 2025 | Urology

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Pregnancy brings remarkable changes to a woman’s body, and the urinary system is no exception. Understanding how pregnancy affects the kidneys, bladder, and urinary tract can help expectant mothers recognize normal changes versus signs that need medical attention.

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How pregnancy affects the urinary system

During pregnancy, the body produces extra blood to support the growing fetus, increasing the workload on the kidneys. This means more waste products and fluids are filtered, leading to more frequent urination, especially in the first and third trimesters. Additionally, hormonal changes, particularly the rise in progesterone, relax the muscles of the ureters and bladder. While this helps prevent uterine contractions early in pregnancy, it can also slow the flow of urine, making pregnant women more prone to urinary tract infections (UTIs).

The expanding uterus also plays a major role. As the uterus grows, it presses on the bladder, reducing its capacity. This explains the frequent and sometimes urgent need to urinate, even when the bladder isn’t full.

Common urinary changes during pregnancy

  • Increased urination: It’s normal to urinate more often. Staying hydrated is important, even if it means more trips to the bathroom.
  • Mild leakage: Sneezing, coughing, or laughing may cause small amounts of urine leakage due to pressure on the bladder and weakened pelvic floor muscles.
  • Urinary tract infections (UTIs): Pregnant women have a higher risk of UTIs, which can lead to more serious infections like pyelonephritis if untreated.

Warning signs to watch for

While many urinary changes are harmless, certain symptoms may indicate a problem:

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  • Burning or pain while urinating
  • Cloudy, foul-smelling, or bloody urine
  • Fever or back pain
  • Strong, persistent urge to urinate even when little comes out

These signs could point to a UTI or kidney infection, both of which need prompt medical care during pregnancy. If left untreated, urine infections can increase the risk of complications like preterm labour.

Protecting your urinary health during pregnancy

Taking a few simple steps can help maintain urinary health:

  • Stay hydrated: Drink plenty of water to flush bacteria from the urinary tract.
  • Empty your bladder often: Don’t hold urine for long periods.
  • Practice good hygiene: Wipe from front to back and wear breathable underwear.
  • Strengthen your pelvic floor: Kegel exercises can help improve bladder control and prepare for delivery.

Your healthcare provider may screen your urine during prenatal visits to catch any early signs of infection or other urinary issues. Always report unusual symptoms, even if they seem minor.

Post-partum urinary changes

After delivery, many women notice further changes in urination. The body gets rid of extra fluid accumulated during pregnancy, leading to frequent urination in the first few days after birth. Some may experience temporary difficulty urinating or stress incontinence, but these usually improve with time and pelvic floor exercises.

Conclusion

Changes in the urinary system are a normal part of pregnancy, but it’s important to distinguish between expected symptoms and those that need medical attention. By staying informed and proactive, pregnant women can protect their urinary health and support a smoother pregnancy journey.

This article has been fact-checked by Dr Chong Kian Tai, urologist at Surgi-TEN Specialists, Farrer Park Hospital, Singapore.

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