While increased urinary frequency is common during pregnancy, pain or a burning sensation when urinating is not. This symptom indicates an underlying issue requiring medical attention. Distinguishing between mild discomfort from uterine pressure and actual pain or burning is important.
Common Causes of Painful Urination During Pregnancy
The most frequent cause of painful urination during pregnancy is a urinary tract infection (UTI). Pregnant individuals are more susceptible to UTIs due to a combination of hormonal and mechanical changes. Hormonal shifts can cause the urinary tract to relax, while the expanding uterus can put pressure on the bladder and ureters, making it harder to completely empty the bladder and allowing urine to pool, which creates an environment conducive to bacterial growth. Bacteria, most commonly Escherichia coli (E. coli), can then ascend the urethra and cause an infection.
Beyond a burning sensation during urination, other symptoms of a UTI can include a frequent and urgent need to urinate, even immediately after emptying the bladder, or passing only small amounts of urine. Urine might appear cloudy, have a strong odor, or contain visible blood. Some individuals may also experience pelvic pain or lower back discomfort. Less common causes of painful urination include yeast infections, sexually transmitted infections (STIs) that cause inflammation, or vaginitis, an imbalance of vaginal bacteria. Kidney stones, though rare, can also present with severe pain.
When to Seek Medical Attention
Any instance of painful urination during pregnancy warrants a prompt call to a healthcare provider. Ignoring such symptoms can lead to more serious complications for both the pregnant individual and the developing fetus. Immediate medical evaluation is necessary if pain is accompanied by fever, chills, nausea, vomiting, or pain in the upper back or flank, as these may indicate a kidney infection (pyelonephritis).
If left untreated, UTIs can ascend to the kidneys, potentially leading to complications such as preterm labor, low birth weight, or maternal sepsis. Even without severe symptoms, seeking care identifies and addresses the underlying cause before it escalates. Early intervention helps maintain the health of both the pregnant individual and the baby.
Diagnosis and Treatment
When a pregnant individual experiences painful urination, healthcare providers begin diagnosis with a urine test. Tests include a urinalysis, which checks for white blood cells, red blood cells, and bacteria, and a urine culture to identify the specific bacteria. Routine prenatal care may also include a urine culture to detect asymptomatic bacteriuria, which requires treatment.
Treatment for UTIs during pregnancy involves antibiotics safe for both the pregnant individual and the fetus. Common choices include certain penicillins, cephalosporins, or nitrofurantoin, usually prescribed for three to seven days. Complete the entire course of antibiotics, even if symptoms improve quickly, to ensure the infection is fully eradicated. If painful urination stems from other causes, such as a yeast infection or STI, the healthcare provider will prescribe appropriate and safe medications specific to that condition.
Preventing Urinary Discomfort
Certain practices can help reduce the risk of urinary discomfort during pregnancy. Staying well-hydrated helps flush bacteria from the urinary system, promoting regular and complete bladder emptying. Urinating frequently and whenever the urge arises is beneficial, as holding urine can allow bacteria to multiply.
Good hygiene, such as wiping from front to back after using the toilet, prevents bacteria from the rectal area from entering the urethra. Urinating before and after sexual activity helps clear any bacteria that might have entered the urethra. Wearing breathable cotton underwear and avoiding tight-fitting clothing helps keep the genital area dry and reduce bacterial growth. Avoiding irritants like douches or harsh feminine hygiene sprays is recommended.