You're more likely get a UTI (urinary tract infection) when you're pregnant. In case the always-needing-a-wee feeling wasn't strong enough due to your changing hormones and squashed bladder! UTIs are more prevalent in pregnancy because the flow of urine downwards from your bladder is slowed so bacteria can more easily travel upwards and multiply.
There are a few things you can do to help to avoid getting a UTI in the first place, and the same things will lessen the effects once you have one. If you’re pregnant and showing signs of a UTI, you should go and see your GP as soon as possible. Always consult your GP or midwife for the latest safety advice if you intend to self-medicate with any foods beyond the normal occurrence of them in your standard diet.
Foods that prevent and relieve UTIs
Cranberry juice is a traditional go-to treatment and preventative measure for UTIs. The theory is that certain phytochemicals (a compound found in plants that can has biological effects) in cranberries, called proanthocyanidins, stop bacteria from being able to latch onto the uroepithelial cells in the bladder wall, so they're more easily washed away.
Recently, though, a 2013 meta-analysis of randomised controlled trials (i.e. a review of previous studies) showed that the results of the previous studies are conflicting. Some trials showed that cranberry can be effective, while others showed that it wasn't. Taking all the evidence as a whole, there isn't a strong case to say that cranberry juice really works for the general population. There's also uncertainty as to how much of the active agent is contained in any particular cranberry product.
However, for women with recurrent UTIs, there was sufficient evidence to say that drinking cranberry juice regularly did lead to fewer subsequent UTIs if they drank a 150ml glass twice a day. Some women found this hard to do as they didn't like the taste, or didn't want to consume the levels of sugar naturally found in fruit drinks. Any risks associated with drinking cranberry juice regularly are very small, so you may decide it's worth it for you.
While trials haven't been able to prove the efficacy of cranberries in treating existing UTIs, anecdotally, many women feel that drinking the juice has relieved their symptoms.
Because the amount of active compounds will vary between products, I recommend using Biona Organic Cranberry Superjuice, which is 100% pure cranberry. You might find it too intense so you can dilute it with other fruit juices or water to taste if necessary, or have it over yoghurt or in a smoothie.
Biotta Wild Mountain Cranberry Organic Juice is a premium premixed juice which contains 31% cranberry juice with birch infusion and agave syrup for sweetness.
If you prefer something easier and instant, with 10% cranberry juice, Stute Superior Cranberry Juice Drink is another option that's also free from all artificial additives, and available in bulk so you can stock up and save.
Blueberry juice is traditionally thought to have similar effects to cranberry juice. There hasn't been much scientific research done into the effectiveness of blueberries on UTIs. A 2007 review of the studies that have been done determined that there hadn't been any studies rigorous enough to draw any sound conclusions from.
Women may choose blueberry juice over cranberry because of a taste preference. Blueberries are less tart.
Taking probiotics helps to replace pathogenic (bad) bacteria in our gut with good bacteria. Scientists believe that he good bacteria are either better at using up available food than the bad bacteria, which then starve and die. Or the good bacteria produce substances that kill off the bad bacteria.
How does that help areas outside of our gut? It's not fully understood yet, but there are a few theories.
- Bacteria don't necessarily stay in your gut. That's often how you get a UTI in the first place. If some good bacteria migrate along with the bad bacteria, they could help fight the infection.
- The good bacteria produce different by-products to bad bacteria and these have different effects on the rest of your system.
- The good bacteria may trigger a different immune response, which helps you to fight bad bacteria more effectively elsewhere in your body.
So far, there hasn't been enough research to conclude that probiotics definitely help, but there also isn't yet an indication that they don't. A review of nine previous studies noted in particular that there is a chance that they may be effective especially for women with recurrent UTIs and that more research is needed.
If you're going to try probiotics, they are generally considered safe in pregnancy, so the risk is low, but you should always check particular strains with your GP or midwife. One of the most common probiotic bacteria is Lactobacillus, and a small review of studies did find this to tentatively be effective in both preventive and treating UTIs.
Tests were done with a mix probiotic strains, so the Bio-Kult Advanced Multi-Strain Formula is a good choice as it's broad spectrum, containing 14 different strains including multiple Lactobacillus and Bifidobacterium. For something that's specially developed to prevent UTIs, choose Bio-Kult Pro-Cyan Anti-UTI Advanced Triple Action Formula, which contains two select Lactobacillus strains and cranberry extract for combined protection.
Caffeine is thought to irritate the bladder, making avoiding caffeine during a UTI a good idea. This has been backed up by a 5 year study on 4000 people, which found that those who consume more caffeine when they have a UTI are more likely to suffer more severe symptoms, including increased urgency to wee. Switch to decaffeinated beverages for some relief!
Apple Cider Vinegar
In theory, apple cider vinegar makes the urine acidic and inhibits the growth of bacteria. Though once you have a UTI, it's said that more acidic urine can cause more pain. I've not been able to find any hard scientific evidence - trials or otherwise - that support the use of apple cider vinegar for the prevention of UTIs.
That said, if you want to give it a go, it should be safe to take during pregnancy. Some sites recommend that you only use the pasteurised form in order to avoid bacteria, but manufacturer Bragg explains that the vinegar is too acidic for a strain of E. coli to live in it anyway.
One study found that garlic can function as a powerful antioxidant, anti-inflammatory, and immune system booster, which could help you fight off a UTI.
A review of alternative UTI treatments for women has concluded that there is limited scientific evidence to support garlic in treating UTIs, and that was only for non-E. coli UTIs specifically.
Vitamin C (Ascorbic Acid)
When you take vitamin C, any excess that your body doesn't need is excreted in your urine. When it's present in your urine, it is thought (from in vitro tests) to stop bacteria from reproducing. There isn't strong evidence of a link between vitamin C and fewer UTIs.
But there has been a trial in pregnant women who were prone to getting recurring UTIs, and for them, a cocktail of supplements that included vitamin C amongst other things (ferrous sulphate and folic acid) was more effective at preventing new UTIs that one without, more than halving the incidence of UTIs over a three month trial period.
The American Pregnancy Association recommends taking 250-500mg vitamin C with 25,000 to 50,000 IU beta-carotene and 30-50 mg zinc daily to reduce the chances of developing a UTI.
Chinese Herbal Medicine
There have been several small-scale trials done in an attempt to understand whether CHM is beneficial alongside antibiotics in treating UTIs and in preventing recurrence. A 2015 review of these studies concluded that there wasn't a sufficient body of evidence yet to conclude that CHM was beneficial.
Lifestyle factors that prevent & improve UTIs
Follow these tips to avoid getting UTIs, and also to help lessen the severity of symptoms and length of time you have an infection if you've already got one.
Drink lots of water
This gets lots of fluids into your system that will do two things. First, there'll be a steady flow of excess water being pumped away by your kidneys so that bacteria are washed back down towards your bladder and kept away from your kidneys. The last thing you need is a UTI turning into a kidney infection. Then secondly, all that water ends up n your bladder so that you can go to the toilet frequently.
Go to the toilet frequently
Don't hold it in. If you need to wee, wee. The water flushing through your bladder and urinary tract helps to wash away bacteria and stop them from multiplying where you don't want them too.
Wipe from front to back
You don't want to be moving bacteria from the back towards the front where your urethra is. I think that's enough said, right? You get the picture? Enough said.
Go to the toilet after sex
To wash away any bacteria that have been forced up into the urethra.
Wear cotton underwear and loose clothing
Keeping the area cool and dry means that you're not harbouring a warm, damp environment that bacteria love to thrive in.
Use unperfumed soaps
Some harsher and perfumed soaps can kill off some of your good bacteria. This can lead to problems like thrush, where the balance of bacteria and fungi around your vagina and genitals is thrown off and the undesirable elements can thrive. Presumably, keeping those good bacteria around can also help fight off some of the UTI-causing organisms.
Shower rather than bath
Having a bath may allow bacteria to travel up into your urethra.
The NHS advocates the use of localised heat applied around your pelvis and taking paracetamol to relieve any pain associated with your UTI.
Do I have a UTI? Signs & symptoms when you're pregnant
If you have a frequent need to wee anyway, it can be hard to tell if you have a UTI. Luckily, your midwife or GP will test your urine every time you visit them and will let you know straight away if they're seeing anything they shouldn't. They'll also ask you if you have any of these symptoms, which is the NHS's official list of signs of a UTI:
- needing to pee suddenly or more often than usual
- pain or a burning sensation when peeing
- smelly or cloudy pee
- blood in your pee
- pain in your lower tummy
- feeling tired and unwell
It can be harder to detect when you're pregnant. You might also notice the following signs given by the American Pregnancy Association, which can be easily confused with other pregnancy side effects:
- a feeling of urgency when you urinate
- mucus in your urine
- cramps in the lower abdomen
- pain during sexual intercourse
- chills, fever, sweats, leaking of urine
- waking up from sleep to urinate
- change in amount of urine, either more or less
- urine that looks cloudy, smells foul or unusually strong
- pain, pressure, or tenderness in the area of the bladder
- when bacteria spreads to the kidneys you may experience: back pain, chills, fever, nausea, and vomiting
Why do pregnant women get more UTIs?
It's all to do with how well the downwards flow of urine from kidneys to bladder to the outside is working. When you're pregnant, the flow slows down for two reasons.
- The muscles that push urine down the ureter (the tubes from the kidneys to bladder) are relaxed and are less effective.
- Your uterus sits on top of these tubes and squashes them as it gets bigger and heavier. Slow downwards flow means bacteria (which is usually E. coli from your gut) are more likely to be able to travel upwards and stay long enough to colonise and grow into an infection.