How Does Your Urine Change When You’re Pregnant?
During pregnancy, many of the body’s functions change, including urination. Changes in urine can tell you whether you’re pregnant and alert you to health issues during pregnancy.
Monitoring changes in your urine, reporting these changes to your doctor, and getting appropriate urinalysis tests can help keep you and your baby healthy during pregnancy.
Many women will discover they are pregnant when they take a urine-based home pregnancy test.
About 12 to 15 days after conception, a urine test should be able to detect levels of the hormone human chorionic gonadotropin (hCG), according to Mount Sinai. HCG is a hormone made by the placenta when you are pregnant, and it appears after the embryo attaches to the wall of the uterus. HCG levels increase quickly and peak within the first trimester, after which they will declining slightly.
The U.S. Food and Drug Administration (FDA) recommends testing one to two weeks after you miss your period, and with your first urination of the day, for the most dependable results. Your healthcare professional can also test for hCG using a blood test to confirm pregnancy status.
HCG levels are measured in milli-international units per milliliter (mIU/ml), which increase as pregnancy progresses. If you’re not pregnant, the HCG reading will be less than 5 mIU/ml. The expected HCG level is based on the length of the pregnancy. At three weeks, hCG will be between 5 and 72 mIU/mL and will likely result in a positive test, per Mount Sinai.
Low levels of hCG, the hospital notes, may suggest a miscarriage or an ectopic pregnancy, while extremely high levels of hCG may suggest that there is more than one fetus (twins or triplets), a molar pregnancy (in which there’s a genetic error during the fertilization process), or, more rarely, ovarian cancer. After a pregnancy loss, it takes roughly four to six weeks for hCG levels to return to normal.
Pregnancy kit manufacturers say that at-home pregnancy tests are 97 to 99 percent accurate when used as directed on the package, according to the Cleveland Clinic. Positive results can be trusted, but you can get a false negative result very early in pregnancy.
The Cleveland Clinic recommends taking a pregnancy test in the morning as soon as you wake up, because this is when urine is the most concentrated with hCG.
Many pregnant women will experience changes in their urine throughout their pregnancy, and many may notice that they are urinating more frequently than normal even before they have missed their first period or taken a pregnancy test, per the Cleveland Clinic. This happens because the body begins producing the pregnancy hormone hCG after implantation of the embryo in the uterus, and this hormone can cause frequent urination.
As the fetus grows, the uterus begins to press on the bladder, making it smaller in size. This makes it fill with urine more quickly, and you’ll will feel the urge to urinate more often and more urgently, according to Merck Manual. As the pregnancy continues, the uterus pushes down on the bladder, urethra, and pelvic floor muscles, and this pressure also leads to the urge to urinate more frequently.
It’s also normal for some urine to leak when you sneeze, cough, or laugh. It may help to take frequent bathroom breaks, and to practice Kegel exercises to strengthen the pelvic floor muscles, according to the Office on Women’s Health.
The color and smell of your urine can change when you’re pregnant.
If your urine looks darker and more concentrated, it could be a sign that you are dehydrated, per the Cleveland Clinic. Pregnant women need to drink more water than normal, and your urine color can help you determine whether you’re getting enough fluids. Morning sickness, and especially hyperemesis gravidarum (severe morning sickness) — which can cause vomiting — can also lead to dehydration, according to the American College of Obstetricians and Gynecologists (ACOG).
When you become pregnant, your hormones may cause urine odor to change. But a strong urine odor may also indicate a urinary tract infection, per the ACOG. Interestingly, some women may be more aware of the naturally occurring ammonia-like smell of urine during pregnancy because of their heightened sense of smell, research suggests.
Blood may show up in your urine due to vaginal bleeding. If you notice this at any time during your pregnancy, contact your doctor, per the ACOG. Some women may experience light implantation bleeding at the very beginning of their pregnancy, which is not necessarily a sign of a problem. Women may also experience light bleeding after sex, an internal exam, or a pap smear. Vaginal bleeding can also be a sign of an infection of the vagina or cervix, according to the ACOG.
Pregnant women are at a higher risk of urinary tract infections; up to 10 percent of women will develop at least one UTI throughout the course of their pregnancy, according to previous research. UTIs happen when bacteria enter the urethra and infect the bladder, ureters, or the kidneys. Because muscle-relaxing hormones increase during pregnancy, bacteria have an easier time entering the urinary tract.
According to the ACOG, symptoms of UTIs tend to come on quickly and may include strong urge to urinate, known as urinary urgency, which may be accompanied by a sharp pain or burning in the urethra. Another common symptom is feeling the need to urinate again soon after the last bathroom trip.
If you notice that your urine has a strong odor, looks cloudy or is tinged with blood, these may also be signs of a UTI per the ACOG. Call your healthcare provider if you see blood in your urine. While it may be caused by a UTI, it also may be caused by other conditions.
In pregnancy, UTIs can be serious because they can affect your health and your baby’s health and put you at risk for preterm delivery, per the ACOG. To diagnose a UTI, your doctor may perform a urinalysis to detect the presence of bacteria, as well as test for white and red blood cells. UTIs are typically treated with a round of antibiotics, and sometimes more serious kidney infections must be treated with intravenous medication at a hospital, according to an article published in July 2021 in StatPearls.
As Mayo Clinic notes, pregnant women can prevent UTIs or speed their recovery by drinking plenty of fluids, emptying the bladder before and after sex, keeping the vaginal area clean, and emptying their bladder thoroughly while urinating. Wearing cotton underwear, avoiding tight pants or leggings, avoiding bubble baths, and wiping front to back after bowel movements can also prevent UTIs.
Group B streptococcus (GBS), a bacterium that often lives in the intestines or lower genital tract, is a potential cause of a UTI, per Mayo Clinic. Yet in pregnancy, GBS may simply be part of a woman’s vaginal flora, rather than the cause of a UTI. Pregnant women are tested for GBS in late pregnancy, typically between weeks 35 and 37, via a vaginal and rectal swab. If a woman tests positive, the antibiotic penicillin is given to her during labor to prevent early-onset GBS infection in newborns, per the ACOG.
Untreated, GBS can spread to infants during delivery and cause group B strep disease in newborns.
Sometimes GBS has an early onset, with newborns experiencing symptoms like fever, lethargy, and difficulty feeding within a week after birth. Or the newborn can develop late-onset symptoms of group B strep disease within a few weeks or months after birth, per the Mayo Clinic.
Your healthcare provider will conduct a urinalysis at your first prenatal appointment and then several times throughout your pregnancy. According to the ACOG, testing may be done to see if you have a urinary tract disease, UTI or early signs of diabetes.
Urine tests also measure protein content. The ACOG says that High levels of protein in urine may signal preeclampsia, a condition marked by high blood pressure that can cause a range of health issues for mothers and growing fetuses. Other potential signs of preeclampsia may include headache, edema, nausea, and vomiting.
High protein levels in urine may also indicate that you have a urinary tract infection or more serious kidney disease, per the ACOG. Your healthcare provider will flag these findings for you.
Large amounts of sugar in the urine may signify gestational diabetes, which typically develops in the second trimester. According to Mayo Clinic, women with gestational diabetes are usually asymptomatic.
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