Urinary Tract Health | 6 min read
Urinary tract infections (UTIs) are common during pregnancy—and they deserve extra attention. During pregnancy, a UTI is also more likely to develop, more likely to progress to a serious kidney infection, and can even affect the pregnancy itself. Untreated infection can lead to complications for both the pregnant patient and the pregnancy. The good news is that UTIs in pregnancy are very treatable when caught and managed promptly. The most important thing to know up front: if you're pregnant and suspect a UTI, this is not the time for a wait-and-see approach or self-treatment—contact your prenatal provider right away.
Why UTIs are more common—and more serious—in pregnancy
Pregnancy changes the urinary tract in ways that make infections more likely. Rising progesterone relaxes the muscular walls of the ureters (the tubes carrying urine from the kidneys to the bladder), slowing urine flow. As the uterus grows, it presses on the bladder and ureters, making it harder to empty the bladder completely. Both changes leave urine sitting longer, which gives bacteria more time and opportunity to multiply.
These same factors also make it easier for an infection to travel upward to the kidneys. A kidney infection (pyelonephritis) in pregnancy is a serious complication, and untreated UTIs have been linked to preterm labor, low birth weight, and other risks for both parent and baby. That's why UTIs are taken so seriously in prenatal care.
Why even a symptom-free UTI matters in pregnancy
Here's a key difference from UTIs outside of pregnancy. In non-pregnant adults, bacteria in the urine without symptoms (called asymptomatic bacteriuria) usually isn't treated. In pregnancy, it is. Because of the higher risk that a silent infection will climb to the kidneys or affect the pregnancy, guidelines recommend screening pregnant patients for bacteria in the urine early in pregnancy—typically with a urine culture—and treating it with antibiotics even when there are no symptoms at all. This routine screening is one of the quiet but important parts of prenatal care.
Symptoms to watch for
Alongside routine screening, it's worth knowing the signs so you can report them promptly. UTI symptoms in pregnancy are the same as at other times and may include:
- A burning sensation when you urinate, or pain and discomfort while going.
- A frequent, urgent need to urinate (though some increased frequency is normal in pregnancy, so a change or added burning is the clue).
- Cloudy, bloody, or strong-smelling urine.
- Pelvic or lower abdominal discomfort or pressure.
Signs that an infection may have reached the kidneys—fever, chills, nausea, vomiting, and pain in the back or side—require immediate medical attention.
How UTIs are treated in pregnancy
UTIs in pregnancy are treated with antibiotics, and your provider will choose one considered appropriate for pregnancy based on the stage of pregnancy and the bacteria involved. Several antibiotics are commonly used—such as certain cephalosporins (like cephalexin), amoxicillin-clavulanate, fosfomycin, and, in some situations, nitrofurantoin—while others are generally avoided in pregnancy or at particular stages. This is very much a decision for your provider: the right choice depends on your individual circumstances, and it's important to take the full course exactly as prescribed, even once you feel better.
What to be cautious about
Because pregnancy adds special considerations, this isn't a situation for do-it-yourself remedies. Over-the-counter urinary products—including the pain reliever phenazopyridine, urinary antiseptics like methenamine, and supplements such as cranberry or D-mannose—should not be used in pregnancy without your provider's guidance, as safety in pregnancy varies and some are not recommended, especially at certain stages. Rather than self-treating symptoms, call your prenatal provider, who can confirm the infection and prescribe a treatment that's right for you and your baby.
Simple prevention habits
A few everyday habits can help lower your risk during pregnancy: drink plenty of water, don't hold your urine, urinate before and after sex, and wipe front to back. These are gentle, low-risk measuresbut they complement, rather than replace, prenatal screening and prompt medical care.
When to seek care
In pregnancy, err on the side of calling early. Contact your prenatal provider promptly at the first sign of a UTI, and seek urgent care if you develop fever, chills, nausea, vomiting, or back or side pain, which can signal a kidney infection. Catching and treating UTIs early is one of the most effective ways to protect both your health and your baby's.
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. UTIs in pregnancy require evaluation and treatment by a qualified healthcare provider; do not start, stop, or self-select any medication or supplement in pregnancy without professional guidance. Seek care promptly for any UTI symptoms during pregnancy.
References
1. American College of Obstetricians and Gynecologists (ACOG). Urinary Tract Infections in Pregnant Individuals (Clinical Consensus). Obstet Gynecol. 2023. https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2023/08/urinary-tract-infections-in-pregnant-individuals
2. Habak PJ, Griggs RP. Urinary Tract Infection in Pregnancy. StatPearls, 2023. https://www.ncbi.nlm.nih.gov/books/NBK537047/
3. U.S. Preventive Services Task Force. Asymptomatic Bacteriuria in Adults: Screening. 2019. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/asymptomatic-bacteriuria-in-adults-screening
4. Mayo Clinic. Urinary tract infection (UTI)—Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
From the desk of
Dr. Sonia Bahlani
Pelvic pain specialist/ gynecologist
https://www.pelvicpaindoc.com/
