Urinary tract infections (UTI) are common in pregnant women. It's estimated around 5-10% will have symptoms of a UTI when they are pregnant. A UTI can also be present with or without symptoms. Once a woman has had one UTI, she is more likely to have another one.
What is a UTI?
A UTI is an infection in the urinary system of the body. A UTI can affect the kidneys, bladder, ureters or urethra. In women, UTIs are more common than in men. This is because women have a shorter urethra positioned closely to their vagina and anus. Bacteria can easily travel up the urethra and cause an infection. Once inside the bladder, the bacteria multiply and create an infection. A UTI can travel upwards and affect some or all of the renal system, including the kidneys.
What causes a UTI?
The most common cause of a UTI is the bacteria E. coli. This is a group of bacteria found in the gut of nearly all people and animals. An infection starts when E. coli is transmitted from the rectum to the urethra. Wiping toilet paper from back to front after weeing or pooing is the most common way for E. coli to spread. Intercourse (sex) is another way to spread E. coli. Group B streptococcus can also cause a UTI, if this is colonised in the vagina or the rectum. An infection with Group B strep can be dangerous to a newborn, which is why testing is done around the due date.
Why are UTIs more common in pregnancy?
Pregnancy predisposes women to UTIs because of physical and hormonal changes. The normal position of the bladder changes and it can be more difficult to completely empty the bladder when going to the toilet. Residual wee in the bladder provides a perfect environment for bacteria to grow and multiply. The growing uterus also puts pressure on the bladder, particularly as the baby gets larger.
The concentration of a pregnant mother's wee changes. Hormones and sugar levels alter, increasing the risk of UTIs occurring. Another reason is that muscle relaxation affects the tone of the bladder and other tissues involved in urine production and storage.
Risk factors for having a UTI during pregnancy
Some women are more likely than others to develop a UTI when they're pregnant. If you are prone to UTIs generally, or you have a history of kidney or renal issues, you're more at risk.
- Dehydration it's important to stay well hydrated and drink plenty of water so your wee is dilute.
- Gestational diabetes.
- Having multiple children.
- Damage to the nerves which control the bladder.
Signs and symptoms of a UTI
Not every woman will have the same UTI symptoms. Some have many symptoms and others may not even be aware they have a UTI, especially in the early stages or before it's diagnosed.
- Burning or pain when weeing
- Urgency and a feeling of needing to frequently wee
- Trouble weeing e.g. starting and stopping
- Cloudy or blood stained wee and/or smelly wee
- Back or lower pelvic pain
- Not feeling well, having an elevated temperature and just feeling off
- Signs of a kidney infection
- High temperature
- Pain in the back on one or both sides of the kidney area
Complications from UTI
- Increased risk of growth restriction in the baby
- Premature labour
- Kidney infection
Diagnosing a UTI
You'll need to provide a clean sample of your wee so it can be examined for a range of bacteria. Some of the wee will also be cultured in a laboratory to find which antibiotic the bacteria are sensitive to.
It's important you shower and wipe yourself carefully before doing a wee into the specimen jar. You may be asked to provide a mid-stream sample. this means you'll need to start weeing into the toilet and then collect some wee midway. When wee is contaminated with bacteria which normally reside in and around the urethra, it can be hard to identify what is causing the infection.
Treatment for a UTI
Antibiotics are very effective in treating UTIs. Sometimes a broad-spectrum antibiotic is prescribed before the culture results are back.
- Drink plenty of water
- Always wipe from front to back
- Go to the toilet when you need to and don t hold on
- Wear cotton underpants and avoid wearing trousers which are too tight and restrictive
- Before and after sex, do a wee
- Have showers instead of baths
- Speak with your doctor and/or pharmacist about medication which can lower the acidity of your wee so it's less likely to burn when you wee.
Written for Huggies by Jane Barry, Midwife and Child Health Nurse, August 2021.
Last Published* December, 2022
*Please note that the published date may not be the same as the date that the content was created and that information above may have changed since.