By Alexis Dieter, Assistant Professor, Urogynecology and Reconstructive Pelvic Surgery
Pregnancy is a time of a lot of physical change for your body, including changes in your bladder health. One of the most frequent symptoms during pregnancy is an increase in the number of trips to the bathroom, which unfortunately, can occur in any trimester. I can speak to this personally as I am 39 weeks pregnant!
So why do I have to go more when I’m pregnant? One reason is because the blood flow to your kidneys is increasing. This ensures a sufficient blood supply is reaching your uterus and helps to prepare your body for potential blood loss when you deliver. Another reason is because as your uterus grows, it places more and more pressure on your bladder, thus making it harder to hold these larger volumes comfortably. Despite the increase in bathroom trips, it is important to stay hydrated, so going frequently is a good way to avoid having to rush suddenly to the bathroom.
What if I get a UTI? When you are pregnant, you are at an increased risk of a UTI spreading to your kidneys, although this is a rare occurrence thank goodness. Both the increased pressure from the growing uterus and progesterone’s effect of decreasing tone in the ureters (kidney tubes) that bring urine from your kidneys down to your bladder increase the chance of bacteria spreading from the bladder to your kidneys. Your OB/GYN provider will check your urine for infection several times during your routine prenatal visits, but if you think you have a UTI (burning with urination, urgency to urinate, etc.) you should call your OB-GYN to get tested and possibly treated.
Why am I leaking when I laugh or cough? It is very common for women to experience urinary leakage at some point during pregnancy. You could be coughing, laughing, sneezing, or just bending over to pick something up. This is especially common in the second and third trimesters when the uterus is larger and there is more pressure on your bladder. It is also common after you deliver as your pelvic floor takes time to heal after childbirth.
What can I do to help prevent bladder leakage? Usually, urinary leakage improves after recovering from giving birth. But to help prevent leakage, go to the bathroom regularly to avoid having a very full bladder. You can also practice Kegel exercises to help strengthen your pelvic floor muscles (this can also help with delivery!). In order to correctly identify which muscles are your Kegel muscles, try to stop your urine flow mid-stream when you are using the bathroom. However, do not do this routinely, just once or twice to get to know what muscles you need to contract when doing a Kegel. Try doing 3 sets of up to 10 contractions throughout the day, while holding each contraction 5-10 seconds. Make sure to also work on relaxing your muscles in between contractions, as well as breathing normally. If you are having trouble you can also ask your OB-GYN provider for help identifying the correct muscles and for handouts on exercises.