UTIs during Pregnancy

What to do when they keep coming back


A reader who is 24 weeks along wrote that she’s already had five urinary tract infections (UTI) with this pregnancy. Geez! Poor lady. I hate those things; the burning feeling like you have to pee and then nothing comes out. It’s miserable. I actually drove myself to the ER once in the middle of the night because I couldn’t stand the pain, and I wasn’t even pregnant. Add a growing baby to the mix, honey you’ve got all my sympathies.

I assume she’s treated every UTI with antibiotics (and taken every single pill). She’s drinking lots of water and cranberry juice, quit having sex and wears only cotton underwear. It sounds like she’s doing everything right, so why so many infections and can they affect her baby?

Urinary tract infections (also called bladder infections) are really common in pregnancy though most women won’t get five. What causes UTIs? Think about how we’re built. The urethra (the tube that empties the bladder) has its exit point right near the vagina and rectum - a short distance from where poop happens. No matter how good your hygiene is, bacteria are ambitious and happy to travel. It’s also a short distance from the urethra’s external opening to the bladder. It’s warm, wet, and the perfect environment for those traveling bacteria to incubate and grow. Before you know it, a little colony of those guys have called your bladder home and you’ve got an infection. It makes your bladder walls spasm and hurt, inflames the urethra, makes it difficult to pass urine and causes a burning sensation.

Now, stick a big ol’ uterus and baby on top of that bladder and push it down even closer to the urethra. It’s more difficult to empty and an even better bacterial breeding ground. Add sex, which easily pushes bacteria up where it doesn’t belong and you’ve got the perfect recipe for a bladder infection.

Usually, antibiotics kill those suckers and plenty of water keeps the pipes clean to avoid future infections. Cranberry juice has been proven particularly effective for preventing UTIs. It changes the way the bacteria attaches to the bladder and makes it tough for them to set up shop. Cotton underwear lets more air flow “down there.” All of these usually solve the UTI problem. They’re not doing the trick for this reader though.

She needs to find out if the antibiotics she’s taken are the right ones for the bacteria causing her UTI. Doctors diagnose UTIs by sending a urine sample to the lab and performing a urinalysis with culture and sensitivity. A quick examination (urinalysis) checks for white and red blood cells (signs of infection). Next, they set a sample aside to see what bacteria grows over a few days (culture). Then, they kill those nasty bacteria with various antibiotics (sensitivity) to see what’s most effective. If the doctor sees signs of infection on the quick check, he’ll usually prescribe antibiotics right away. If the culture and sensitivity (which takes three days for results) confirms that, yes indeed, the prescribed antibiotic is the right one, great…continue taking them. If he finds the bacteria is resistant to the prescribed antibiotic, he/she’ll prescribe a different one. Antibiotics are usually effective. Symptoms are usually gone within 24 hours and the UTI is gone within a week.

At this point, our reader has probably been tested for diabetes and is either being treated or done a total diet overhaul to eliminate sugary foods. Women with any type of diabetes (type 1, type 2 or gestational) have more sugar in their urine. Bacteria loves sugar. Even without diabetes, lots of women successfully eliminate UTIs by cleaning up their diet and tossing out all processed and high-sugar content foods.

Finally, our reader needs to have a serious chat with her doctor about these recurring infections. If he/she can’t cure them, it’s time to see a urologist (a doctor who specializes in the urinary tract system). While recurring UTIs are unlikely to damage the baby, they can infect the kidneys and make mom seriously ill. Let’s avoid that from happening. Get assertive with your doctor and make this a priority in your prenatal care. Pregnancy’s tough enough without burning pee.

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.