When does excessive peeing start in pregnancy

For many women, frequent urination is one of the first signs of pregnancy. Hormones stimulate your kidneys to expand and produce more urine, which helps your body get rid of extra waste more quickly. And as your baby gets bigger, his weight may press on your bladder, so you'll need to go more frequently. Read on to learn more about this common pregnancy symptom.

What Causes Frequent Urination in Pregnancy?

If you experience frequent urination in early pregnancy, you can thank hormonal changes that increase urine production. Your uterus, which is normally the size of a fist, also grows and stretches to accommodate your baby. The enlarged uterus puts pressure on your bladder and contributes to the urge to pee, explains Richard H. Schwarz, M.D., obstetrical consultant to the March of Dimes

Most women get temporary relief from frequent urination in the second trimester. That's because your uterus will rise higher in the abdomen and away from your bladder. But don't expect this relief to last long, since this symptom will probably make a comeback in the third trimester. The baby drops lower in your pelvis in preparation for delivery, which puts pressure on your bladder yet again.

How to Manage Frequent Urination

If frequent urination at night disturbs your sleep too much, try cutting back on fluids after 4 p.m. (make sure you drink the necessary six to eight glasses of water a day before then). Also avoid coffee, tea, cola, and any other caffeinated beverages. Caffeine can increase urination.

Keep a soft night light in the bathroom so you don't have to blind yourself in the middle of the night with bright overheads—and for safety's sake, light your path from bed to toilet with nightlights as well.

Dealing with Persistent Urine Leakage

During pregnancy, especially in the last trimester, you may also leak urine whenever you laugh, cough, sneeze, lift something, or exercise. This is called stress incontinence and it's partly caused by the pressure of your uterus on your bladder.

You may be able to prevent leakage by doing Kegel exercises that strengthen the pelvic floor muscles surrounding the urethra (the tube that carries urine from your bladder out of your body). To do a Kegel, tighten and then relax those muscles as if you're trying to stop your urine stream. Try keeping the muscles contracted for about 10 seconds, 10 to 20 times in a row, at least three times a day.

If you're leaking urine, panty liners may keep you a little happier until the problem goes away. Report any persistent leakage to your practitioner, just in case it's amniotic fluid instead of urine.

Frequent Urination and Urinary Tract Infections

Although the never-ending urge to pee is annoying, you should never ignore it. Holding your urine can lead to a urinary tract infection (UTI). Pools of urine in the bladder are breeding grounds for bacteria that normally inhabit the intestines, such as E. coli. Less commonly, a UTI may be caused by a bacterium called Group B strep (GBS), which is a more serious condition that can make your baby very sick. It requires oral antibiotics during pregnancy and intravenous antibiotics during labor and delivery to keep your baby safe.

Typical symptoms of a UTI include:

• Frequent urination
• Burning and pain during urination
• Bloody urine
• A tender lower abdomen

Contact your healthcare provider if you develop any of these symptoms. Additionally, your healthcare provider will probably recommend a urine culture early in pregnancy, and again during the third trimester. That's because about 5 to 10 percent of pregnant women have symptomless UTIs. Without treatment, these can result in health problems for you and your baby, such as a kidney infection, low birth weight, or a premature baby. Your doctor may also check your urine for bacteria at each prenatal visit using a dipstick, which works the same way as a home pregnancy test.

UTIs will be treated with a pregnancy-safe antibiotic. Because these infections sometimes recur, your provider may also do a monthly urine culture. If the infection returns, you may need to take antibiotics for the rest of your pregnancy.

Pregnancy can come with a lot of annoying symptoms, but the need to constantly pee is an extra frustrating one. 

Jasmine Frank* hadn’t told her co-workers she was expecting yet—but she feared one pregnancy symptom was giving away her secret. “In meetings that went on for up to two hours, I was having to get up and go pee sometimes three or four times,” she says. As well as worrying about being disruptive or missing important information, she found her frequent trips to the bathroom embarrassing. “What if colleagues thought I had some type of gastro or bladder issue?”

Unfortunately, her frequent need to pee only got worse. By the seventh month of her pregnancy, she had go to the bathroom every 20 minutes. “It wasn’t like I could pop to the loo at work—it was far,” Frank says. She tried to book meetings in rooms close to the washroom. “Or I would sit as close to the door as possible, so I could sneak out as quietly or quickly as I could,” she says. The first-time mom also worried her frequent urination could be a sign of a problem. “Is this because somebody’s sitting on my bladder, or do I have a bladder infection?”

While it can be an inconvenience, the increased need to pee is typical for many women during pregnancy. Here’s what you need to know.

Is frequent urination a sign of pregnancy?

Like morning sickness and fatigue, Batya Grundland, a family doctor who specializes in obstetrics and maternity care at Women’s College Hospital in Toronto, says frequent urination is a very common symptom of pregnancy, even early on. “But, it would be an unusual only sign of pregnancy,” she adds. “It often comes along with other signs such as a missed period, fatigue and breast tenderness.”

Why do I pee so much when I’m pregnant?

In the early parts of pregnancy—around six to 20 weeks—frequent urination has to do with some of the hormonal shifts that are happening in the body, explains Grundland. The hormones stimulate the kidneys to produce more urine. Pregnant women also experience a physical compression of the bladder from the baby as it grows. “So there’s less ability to hold urine,” she says.

How much should I pee when I’m pregnant?

When it comes to how often you should pee during pregnancy, there is no right or wrong amount. However, Navdeep Grewal, a registered pelvic physiotherapist, says as a guideline, non-pregnant women and men usually go anywhere from four to 10 times per day, and this can be slightly increased during pregnancy. Some women will experience this pregnancy symptom more than others, explains Grundland. “But I think the bigger point is that it’s also not a worrisome symptom if it’s simply just urinary frequency,” she says. “It’s actually a normal symptom of pregnancy.”

Is there a way I can stop peeing so much when I’m pregnant?

“You can’t,” says Grundland with a chuckle. “To try to avoid it is futile.” She does recommend reducing your caffeine intake—it’s a diuretic, which means it makes you pee. Health Canada advises pregnant women to drink no more than 300 mg of caffeine daily. However, it is important to stay hydrated and drink water. So if you think cutting down how much water you drink is a solution, Grundland warns that it’s not medically recommended.

Frequent urination is a symptom you need to manage rather than avoid. Make sure bathrooms are nearby, so you can urinate frequently to reduce the risk of incontinence, Grundland says. Grewal recommends you don’t rush to the bathroom, as this can make symptoms worse. “Walk slowly while taking long belly breaths as you make your way to the bathroom,” she says. Rushing to the washroom can set off our fight or flight system in our body, causing the brain to think this is a normal response. This can make you feel like you will pee your pants, as the fight or flight response includes elimination of the bladder. Over time, it creates a pattern and can worsen to the point where a pregnant woman may experience leakage before reaching the bathroom.

When it’s time to pee, Grewal suggests leaning forward and gently resting your forearms on your knees to help empty the bladder (and bowel) more. And try not to strain, as it can cause the muscles to tighten and can lead to further difficulty in peeing, and may cause hemorrhoids as well. 

I am peeing a bit when I sneeze or laugh. Is this normal during pregnancy?

“Very normal,” says Grundland. Along with having more pressure on your bladder during pregnancy, she explains our bodies also secrete a hormone called relaxin, which makes our ligaments and muscles relax—including our pelvic floor muscles. “Stress incontinence under these circumstances is very common,” she explains. You can wear a small pad or make sure to visit the bathroom frequently so when you cough and laugh there isn’t an inconvenient leak.

Grundland recommends women do Kegel exercises to strengthen their pelvic floor muscles. Start doing Kegels early in pregnancy—if not before. “It can also reduce incontinence both before and after delivery,” she adds.

Is frequent urination during pregnancy ever a cause for concern?

“If frequent urination is accompanied with pain, any blood in the urine, fever or chills, that would be a cause for concern,” says Grundland.  These symptoms could be a sign of a urinary tract infection, which is common in pregnancy. You should see your family doctor to get tested and treated.

“If all you can think about is where the next bathroom will be, there may be a dysfunction in the way your pelvic muscles are working,” says Grewal. The muscles supporting the bladder can weaken during pregnancy, and a pelvic physiotherapist is trained to treat the muscles so you feel more comfortable.

While frequent urination during pregnancy may be a little bit embarrassing, it’s generally not a sign of a problem. “The big message is: it’s not worrisome, just annoying, but relatively easy to manage,” says Grundland.

*Name has been changed

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