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How to manage frequent peeing during pregnancy

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Jojo Bierlein-Lodewyk
Pelvic health physical therapist

It’s no secret that pregnant women often feel like they need to pee every five minutes, all day (and all night!) long. This is usually completely normal and expected, but there are things you can do to help… and no, going on a one-woman water strike is not a good option.

First of all, why do we have to pee all the time during pregnancy? Well, during pregnancy, your uterus is approximately the size of a peach and is situated behind and slightly above the blasser. During pregnancy, the uterus stretches to about the size of a watermelon and expands upwards towards the abdomen. Guess what’s resting right underneath? Yep, that happy little pouch housing your urine: your bladder. So the cute, tiny baby growing inside you is quite literally on top of your bladder. Go ahead and sit on a water balloon and see how well the water stays inside…

But there’s more going on. Your pelvic floor muscles have the job of helping you hold in your pee, poo and gas until you deem it time to let them out. During pregnancy, these muscles are not only having to do their normal continence job, but they’re also doing so against resistance: the weight of the uterus plus your baby. It’s no wonder they get tired and sometimes leak!

Here’s the good news: I’ve got some tricks that might just help you manage these symptoms throughout your pregnancy.

1. Stay hydrated in small sips

Hydration is so, so important during pregnancy. Your body needs it to support the growth of another human, your gut needs it to reduce constipation and haemorrhoids, and your breasts will need it to make breast milk.

This is just a few of the things you need more water for during pregnancy. But who wants to drink water when it makes them pee more often or even leak more frequently?! The fact is that you need to stay hydrated - no ifs, no buts. So the tip is to drink small sips more frequently. If you chug water to catch up, your body isn’t able to absorb and use it as efficiently and you’ll end up needing to pee sooner.

2. Strengthen your pelvic floor muscles

Your pelvic floor muscles are important to keep active throughout your pregnancy, because research has shown that you’re more likely to have a smoother labour, fewer tears to your perineum, and a quicker recovery when the pelvic floor is healthy.

When you’re already feeling like your pelvic floor is fatigued from supporting you and the baby all day, you don’t want to over-fatigue with pelvic floor muscle contractions - this can lead to tension or compensation patterns in these muscles!

The trick is to just do three short contract-relax exercises when you get the urge to pee. So when you get that all-too-familiar signal from the bladder saying, ‘let’s pee now!’, you respond with contract-relax, contract-relax, contract-relax and the bladder hears, ‘shhh, just a little bit longer.’ Ta-da! Urge suppressed.

Now, this trick will only work so many times before you will have to actually go to the bathroom. But sometimes this urge-suppression strategy can get you just a little bit longer between visits and prevent those bathroom visits that are only a few measly drops.

3. Use leak protection if necessary

There are a lot of companies making period-proof or leak-proof underwear, which can be great options. As a pelvic physiotherapist, I feel it’s necessary for me to point out that when being used for leak protection against urine, they should only be used as temporary tools alongside pelvic floor rehab to address the problems causing the leakage in the first place.

Which brings me to the point of this tip: pregnancy and early postpartum are periods when your body is undergoing changes outside its previous norm. Meaning, your posture is shifted to accommodate a growing baby, your bladder is weighed on by the growing baby, your pelvic floor is under constant and progressive resistance from the weight of the baby… so this is a temporary and appropriate time period to utilise these leak proof underwear!

I personally loved mine during pregnancy for long car rides or times when I felt nervous if there would be a bathroom nearby; if I leaked a little before I got to a toilet, it was no worries! I also loved these underwear for early postpartum days when all sorts of fluids were leaking and flowing, and even now for my monthly periods.

So there you have it - frequent urination during pregnancy is usually completely normal. There are lots of ways to manage your symptoms to reduce that anxious feeling of ‘what if I wet myself’ - don’t worry, we all have them!