Is your bladder feeling the pressures of pregnancy? Are you unsure what’s causing the pain, and worried it might be serious? Hopefully, we can give you a hint of what’s causing the trouble.
Let’s talk about everything bladder and, yes, there will be some references to urine. As you’ve noticed, a lot goes on inside our bodies when we’re pregnant.
Let’s dive into some causes and remedies for one of the more common issues: bladder pain.
Bladder Changes During Pregnancy
The bladder is probably one of the most vulnerable organs during pregnancy. Over the nine months of gestation, it goes through a number of changes.
Suddenly, your kidneys expand due to hormones, causing an overproduction of urine that the bladder must get rid of. Additionally, your baby will continue to grow, putting further pressure on the already stretched organ.
Let’s take a closer look at how these changes occur throughout pregnancy:
1. First Trimester
I don’t know about you, but my bladder was acting up even before the positive test. I had to pee like crazy! This was without a doubt the first indication that led me to buy a pregnancy test, and I know I’m not alone here.
But besides all that, our uterus begins to expand as well, even though the baby is still only the size of a speck. This extra pressure from the uterus on our bladder makes us visit the bathroom more often.
2. Second Trimester
Typically, when we reach the second trimester, everything tends to slow down. Our bellies are, of course, still growing, and the baby is still developing. But it gets less intense — morning sickness will likely subside, and you may begin eating your usual food again without feeling nauseous.
The same goes for your bladder and urine production. During these few weeks, they’re given a well-earned break before the last, and probably most demanding, trimester.
3. Third Trimester
When we reach the third trimester of pregnancy, the discomfort from the first few months greets us again. By now, the frequent urge to go will come calling again.
Additionally, the baby is now much larger, putting even more pressure on the pelvis and bladder. Unfortunately, for some women, this gets worse during the night when they’re lying down.
Fluid is important, and you should increase your intake during pregnancy. While waking up frequently to relieve yourself may be good practice for when the baby arrives, you need your rest. This is why medical providers recommend reducing your intake of fluids a couple of hours before bed.
Possible Causes of Bladder Pain
Some expectant moms may feel more of an actual pain in the bladder, not just pressure. This discomfort is more than just baby using it as a pillow. A few things can cause pain in the bladder during pregnancy.
1. Increased Urine Production
This might be the most straightforward reason why you feel pressure on your bladder. For some women, however, this causes pain, rather than just pressure.
As we’ve established above, during pregnancy our body begins to up the production of hormones. These hormones increase the volume and speed of blood streaming through your body.
Toward the end of the pregnancy, your body is circulating up to 50 percent more blood than before you were pregnant.
Your kidneys have to process the extra fluid from this blood flow, which results in your bladder filling up more quickly, causing a frequent need to urinate (2).
This generally becomes an issue during the last few months, when the uterus is taking up so much space. Before pregnancy, your uterus was the size of an orange. During the nine months of gestation, it grows to be the size of a watermelon!
Imagine the pressure that this, plus a rapidly growing fetus, is putting on your bladder.
How to Minimize Urine Production
Having constant pressure on your bladder can be very irritating and painful, especially when it’s full more often. Luckily there are ways you can minimize this.
Avoid certain beverages such as coffee, soda, and juice. You can have them once in a while if you must (we all get cravings), but keep them to a minimum. Drinks of this type are known as diuretics and will increase the production of urine (3).
However, never reduce your intake of water. Pregnancy makes us susceptible to dehydration, and that can cause an array of issues for you and your baby. Be sure you drink 8 to 10 glasses of water each day.
Make sure that you fully empty your bladder by leaning forward when you pee. Push it all out, mama! And lastly, don’t hold it — when you gotta go, you gotta go.
2. Urinary Tract Infection (UTI)
This is also a common cause of bladder pain during pregnancy. A UTI is the result of a bacterial inflammation in the urinary tract (4).
A UTI can occur anytime, however, it’s most common between the 6th and 24th week of pregnancy. It generally occurs due to the growing uterus putting pressure on the bladder. This causes a blockage of the urine from the bladder to the urinary tract, trapping the urine and causing an infection.
Generally, when a UTI occurs during pregnancy, it’s due to an otherwise benign bacteria called Escherichia coli. However, sometimes the infection can have a more notorious culprit, namely a bacterium called Group B strep (GBS) or a condition called pyelonephritis.
GBS causes a more severe form of a UTI. Those affected require oral and intravenous antibiotics during pregnancy and labor. If left untreated, it could make the baby and mother severely ill (5).
Pyelonephritis is an acute kidney inflammation caused by a UTI. This condition also requires intensive treatment, or else it could lead to sepsis or kidney failure.
Usually, if doctors suspect the possibility of acquiring a UTI during pregnancy, they’ll order some tests to determine which treatment is necessary.
Signs of a UTI
- Burning or pain while urinating.
- Increased need to urinate and a sense of urgency.
- Traces of mucus or blood in the urine.
- Cramps or pain below the belly button.
- Fever symptoms — including chills and sweats.
If you leave the UTI untreated, it could lead to a kidney infection. This will cause back pain, chills, nausea, and fever.
An untreated kidney infection can eventually cause early labor or low birth-weight — it could even be life-threatening for both mother and baby.
UTI Treatment During Pregnancy
Healthcare providers generally treat UTIs with a course of antibiotics. If a bacterium caused your infection, treatment usually works quickly. Your healthcare provider will likely prescribe a three to seven-day course of antibiotics.
The medicine provided is safe for you and your baby as long as you take it as prescribed. Finish the course and consult your doctor if symptoms don’t subside within three to four days.
If you begin to experience fever, chills, sweats, and nausea, contact your physician immediately.
Urinary stasis is a common condition occurring during pregnancy. This ailment hinders the bladder from emptying completely, generally due to a blockage of some kind.
Pregnant women are especially prone to this condition, usually because of the growing uterus blocking the natural flow of urine.
To check for this condition, your doctor may make a urine culture. This will probably become a part of your regular checkups since urinary stasis is also known to cause UTIs and vice versa (6).
Symptoms of Urinary Stasis
- Inability to urinate.
- Feeling an urgent, but painful need to urinate.
- Pain in the lower abdomen.
- Bloating in the lower belly (this may not be noticeable later in pregnancy).
- Increased contractions or cramping (2nd or 3rd trimester).
Doctors usually diagnose urinary stasis with a physical examination and a postvoid residual measurement (PVR). This is where your physician will see how much urine is still in your bladder after attempting to urinate. Doctors generally do this by performing an ultrasound scan (7).
Treatment for Urinary Stasis
Doctors will usually treat it with antibacterial drugs such as cephalexin, nitrofurantoin, or trimethoprim/sulfamethoxazole. Early intervention and treatment are required. If left without treatment, it could cause bladder or kidney damage.
Other Ways to Ease Bladder Pain
Of course, if either a UTI or urinary stasis is causing your bladder pain, you’ll need prescription medication.
But your discomfort could be just another uncomfortable symptom of pregnancy. You may be happy to hear that there is, in fact, a beneficial tool you can use. Look for something called a maternity support belt.
This is an excellent tool to support your growing belly. It will take some of the pressure off your bladder by elevating your bump. It was something magical I discovered in my second pregnancy, and I’m so glad I did.
Bladder health is very important and bacteria will run wild if left unchecked. Wear loose-fitting clothing, cotton underwear, and avoid scented soaps or douches. Urinate after sexual intercourse and change out of wet clothing (i.e. swimming, exercise) as soon as possible.
Editor's Note:Caitlin Goodwin, MSN, RN, CNM
Feeling pressure or pain in or near the bladder is perfectly normal to experience at some point during pregnancy. For some women, it’s merely due to a growing uterus and will subside without the need for further treatment.
Sometimes, however, it occurs due to a urinary infection (UTI) or urinary stasis. These conditions require treatment with a course of antibiotics or antibacterial drugs.
Medication is necessary, since one can lead to the other and eventually cause serious, albeit not life-threatening complications.