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How to beat bladder blues during pregnancy

By Dr Anagha Karkhanis
February 03, 2020 13:20 IST
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The growing fetus in the uterus keeps pressing on the bladder. The external pressure irritates the bladder muscle, thereby giving the feeling of urination, says Dr Anagha Karkhanis.

How to beat bladder blues during pregnancy

Image published for representational purposes only. Photograph: Courtesy Ashley Graham/Instagram

It is a joyous moment for to-be mothers when they first notice a pink line on the pee stick, the biggest sign that they are expecting.

However soon this excitement becomes clouded, courtesy the bladder blues that cause frequent trips to the bathroom thus interfering with your sleep patterns.

If you are a to-be mother you might wonder why you feel the urge to urinate so often. This is nothing but the urge to visit the restroom more than you usually do in a day, so it's diverse for each person.

The normal pattern for urine can be anywhere close to 4 to 10 times a day, with an average of about 6. However, some females may experience mild fluctuations and may use the bathroom at the same rate or just marginally more often than they did prior to getting pregnant.

Other women witness much more perceptible changes as they end up unceasingly running to the bathroom all through the day and throughout the night. Beating bladder blues can especially pose a problem if you are a working mother.

Imagine you have to get up to pee every now and then when you are seated in an hour-long board meeting.

Along with worrying about being troublesome or missing out on some vital information, your numerous trips to the bathroom can be quite embarrassing for you too.

Why do I pee so much when I'm expecting?

In the initial parts of pregnancy -- around weeks 6 to 20 -- repeated urination has to do with some of the hormonal changes that are taking place in the women’s body.

During pregnancy, the circulating blood volume increases so as to support the blood supply to the growing pregnancy. Therefore, more blood passes through the kidneys every minute as opposed to when a woman is not pregnant.

So, during pregnancy, the kidney is increased plus the pregnancy hormones cause the vessels to be a little more dilated that also is responsible to increase the blood flow to the kidney. Therefore, the filtration rate increases and hence people have got more urine.

It is also very common for pregnant women to experience a physical compression of the bladder from the baby as it continues to develop. Hence there is very little scope to hold urine.

During your first trimester, one may have to visit the bathroom more often than normal.

Hormone changes that happen during the start of pregnancy result in a rise in the flowing blood and fluid in the body.

To top it all, your kidneys also kick into high gear and work very efficiently to flush the unwanted toxins out of your body.

The first trimester also witnesses the uterus that starts to mature and presses against the bladder. When your diet comprises more fluid coupled with more operative kidneys, it automatically means more urine.

Variations in urination patterns by trimester

Frequent urination is an extremely common symptom in early pregnancy. It at times eases during mid-pregnancy only to return back later in the final trimesters.

First trimester

As mentioned above increase blood flow to the kidney, increased work by the kidney and hormonal changes, all three contribute towards increasing the urine output.

The growing fetus in the uterus keeps pressing on the bladder. The external pressure irritates the bladder muscle, thereby giving the feeling of urination.

However, if an expectant mother does not perceive a rise in urination in the starting weeks, it doesn’t imply that there is some problem.

You don’t have to worry at all. Recurrent urination will most likely catch up with you later on in your pregnancy.

Second trimester

As your pregnancy progresses, your body starts to familiarise itself with the novel changes.

At the same time, your developing uterus rises up into the abdominal cavity, taking out some of the pressure off of your bladders. Hence, the second trimester is often known to bring a welcome break to the regular bathroom rounds.

Third trimester

Urinary frequency typically returns back in the third trimester as your growing baby starts to descend or come down into the pelvis in preparation for delivery later.

When the head starts coming down it directly presses on the bladder once again giving rise to an increased need to go and empty the bladder. 

Postpartum

The arrival of your baby releases all the added pressure from your bladder along with the frequent urge to pee. But your body still requires time to recuperate.

It characteristically takes about 8 to 12 weeks for your urinary system to return back to normalcy, just the way it was prior to your pregnancy.

WHEN is frequent urination a problem?

While it is very common and normal to experience increased urination while you are pregnant and is not really a cause for concern.

Nevertheless, frequent urination can be a signal of various health issues too. While you are pregnant, frequent urination can imply the following.

1. Bladder infection

Urinary tract infection (UTI) most commonly presents as urinary frequency. The other signs that can point towards a urinary infection are extreme discomfort, urge to go again and again immediately after you have emptied your bladder, burning sensation while you pee, sometimes blood present in the urine and when an infection is severe one might also get the fever.

Sometimes there can be a mild infection where bacteria or micro-organisms may be picked up in the urine and yet the patient may not have any symptoms.

This is called asymptomatic bacteria which also needs treatment.

2. Gestational diabetes

This is a form of diabetes that comes on during pregnancy and goes away on its way post-delivery.

It typically occurs when there is excessive much sugar present in the blood.

An increase in urination is one of the indications of gestational diabetes. Other symptoms include feeling tired very often and excessive thirst.

Since these symptoms are the same as that of pregnancy, it can sometimes lead to confusion. Hence it is advisable to get yourself checked in case you suspect that you may have this condition.

3. Leaking of urine

Along with bladder blues, some women could also have urinary incontinence which can be a part and parcel of the pregnancy because of the growing baby pushing on the bladder.

Most of this will go back to normalcy once the delivery has happened as once the body has gone back to the non-pregnant state.

Sometimes a difficult delivery or in women who have had multiple babies before or very large babies, the pressure on the pelvic floor can cause pelvic floor trauma and therefore the incontinence that starts during the pregnancy might actually continue even after delivery.

In such women, we strongly recommend that they see a doctor quicker rather than later. This is because the earlier we pick it up and the earlier we start treating it, the better the outcome these women will have.

Most women will respond to exercise and sometimes some mild medication. When this incontinence is severe, a few women may also need surgery.

4. Not peeing very often

Some women do not witness an obvious increase in urinary frequency during pregnancy. This happens when you fail to intake enough fluids all through the day. This makes you dehydrated and can also cause an infection. Also, if you have been holding your urine in can lead to urinary retention and a UTI.

How you can beat bladder blues during pregnancy

  • Although this is an inescapable part of pregnancy, you can make note of certain tips to help you deal effectively with urine frequency.
  • Your healthcare expert may recommend firming your bladder muscles through workouts such as Kegel exercises. These help to strengthen your pelvic floor. Exercises facilitate you in gaining an enhanced control over your urine flow, particularly post giving birth. Performing Kegel workouts on a daily basis about four to six times in a day will surely help in fortifying your bladder muscles.
  • Mothers-to-be should lessen the intake of caffeinated beverages, which act as natural diuretics. Hence avoid these to avert any further pregnancy complications.


Dr Anagha Karkhanis is senior gynaecologist and infertility specialist and director of Cocoon Fertility. She can be contacted on ga@rediff-inc.com.


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