Pregnancy and Bladder Changes

If pregnancy has you mapping every public toilet in town, you're in good company. Bladder changes are one of the most common – and least talked about – aspects of pregnancy. Understanding what's happening to your body can help you manage symptoms and know when something needs attention.

Why Pregnancy Affects Your Bladder

Your bladder is getting a workout from multiple directions:

• Physical pressure – your growing uterus sits right on top of your bladder
• Hormonal changes – pregnancy hormones relax smooth muscle, including in your bladder
• Increased blood flow – your kidneys filter more blood, producing more wee
• Fluid shifts – especially in later pregnancy, fluid retention affects how much you wee and when

First Trimester: The Frequent Wee Phase

Many women notice increased weeing frequency before they even know they're pregnant. In the first trimester:

• Hormonal changes signal your kidneys to work harder
• Your uterus is still in your pelvis, pressing on your bladder
• You might be drinking more water due to thirst or morning sickness management

What helps: Don't reduce fluids – you need them. Just avoid large amounts right before bed if night-time trips are disrupting sleep. Lean forward when you wee to help empty your bladder more completely.

Second Trimester: A Brief Reprieve

Good news – many women find bladder symptoms improve in the middle months. Your uterus rises out of your pelvis, reducing direct pressure on your bladder. Enjoy this phase!

This is a good time to establish pelvic floor exercise habits that will help later.

Third Trimester: The Return of Urgency

As your baby grows and drops lower in preparation for birth, bladder pressure returns with a vengeance:

• Reduced bladder capacity – there's simply less room
• Increased urgency – you may need to go right now
• Stress incontinence – leaking when you cough, sneeze, or laugh
• Difficulty emptying fully – the baby's position can make it harder to wee completely

Managing Third Trimester Symptoms

• Continue pelvic floor exercises – they really do help
• Wear a light pad if leaking is bothering you
• Don't reduce fluids – dehydration can trigger contractions
• Try different positions on the toilet – leaning forward or rocking can help empty your bladder
• Go regularly rather than waiting until desperate

Pelvic Floor Exercises During Pregnancy

These exercises strengthen the muscles that support your bladder, uterus, and bowel. Starting during pregnancy makes recovery easier.

How to find the muscles: Imagine you're trying to stop yourself weeing mid-stream, or stopping yourself passing wind. Those are your pelvic floor muscles.

Basic exercise: Squeeze and lift these muscles, hold for a few seconds, then release fully. Aim for 10 squeezes, three times a day. You can do them anywhere – no one can tell!

If you're not sure you're doing them correctly, a women's health physiotherapist can help.

Postpartum Recovery

Your bladder doesn't bounce back immediately after birth. This is completely normal:

• Swelling and bruising affect bladder sensation
• Pelvic floor muscles have been stretched
• Nerve function may take time to return to normal
• Hormonal changes continue, especially if breastfeeding

What to Expect

• First few days – you may not feel the urge to wee, but try every 2-3 hours anyway
• First few weeks – some leaking is common, especially with coughing or lifting
• First few months – symptoms should gradually improve
• Six months onwards – most women have returned to normal, but seek help if not

Helping Recovery

• Start gentle pelvic floor exercises as soon as you feel able (usually within days)
• Don't strain – let wee flow naturally
• Stay hydrated
• Avoid heavy lifting where possible in the early weeks

When Changes Are Concerning

Some bladder symptoms during or after pregnancy need medical attention:

• Pain or burning when you wee – could indicate infection
• Blood in your wee
• Fever alongside bladder symptoms
• Complete inability to wee (especially after birth)
• Severe or worsening incontinence
• Symptoms that aren't improving 3-6 months after birth

Your GP or midwife can arrange referral to a women's health physiotherapist or specialist if needed. Don't put up with symptoms that affect your daily life – help is available.

Important: This guide is for general information only and isn't a substitute for professional medical advice. If you're experiencing symptoms that concern you, please speak to your GP or a healthcare professional. In an emergency, call 999 or go to A&E.