Pregnancy bladder leaks and peeing a lot: what helps and when to see a doctor

Pregnancy bladder leaks are common, and so is peeing a lot. KKH says both usually come from your growing pregnancy pressing on your bladder. Pelvic floor exercises help, and so does drinking steadily through the day with fewer caffeinated drinks. Burning, blood in your urine or a fever are reasons to see a doctor, and so is a trickle that could be your waters.

What to do about bladder leaks in pregnancy, step by step

1. Find your pelvic floor muscles first. SGH says to sit, stand or lie with your legs slightly apart, then tighten and pull them up without tightening your tummy or buttocks.
2. Do slow and fast pull-ups every day. SGH's pregnancy routine is 5 slow ones, each held for at least 5 seconds if you can, and 5 fast ones, at least 3 times a day.
3. Squeeze your pelvic floor before you sneeze. NHS Scotland's pregnancy physio leaflet calls this the knack: tighten just before you cough, sneeze or lift.
4. Keep drinking water steadily through the day. HealthHub says you need more water when you're pregnant or sweating a lot, and pale urine means you're drinking enough.
5. Drink less in the late evening instead. That's KKH's tip if you're getting up at night to pee.
6. Swap some of your coffee and fizzy drinks for water. NHS Scotland says caffeine, fizzy drinks and citrus drinks can irritate your bladder. Our coffee while pregnant guide covers kopi and teh.
7. Sit down and take your time on the toilet. NHS Scotland's leaflet says not to hover, and to skip just-in-case trips.
8. Keep your bowels moving to avoid constipation. NUH lists constipation among the causes of urine leaks, and KKH suggests high-fibre food, plenty of fluids and regular exercise.
9. Ask your gynae about leaks at your next check-up. SGH says it's often better to learn the exercises from a physiotherapist at the start.

Why pregnancy makes you pee more and leak

KKH says frequent urination and leaks affect up to 30% of pregnant women. The usual cause is the pressure of the growing pregnancy on your bladder. NHS Scotland adds that pregnancy hormones make some women need to pee more often.

Your pelvic floor is a hammock of muscle that holds up your womb, bladder and bowel. SGH explains that it tightens when you cough, to stop urine escaping. A sudden push from a cough, sneeze, laugh or lift can get past it, and a little urine comes out. This is called stress incontinence, and NUH names pregnancy as one of its common causes.

Sometimes peeing a lot is a urinary tract infection (UTI) instead. KKH says to suspect one especially if it burns when you pass urine. Back pain in pregnancy can rarely come from a UTI or a kidney stone too, KKH notes.

SGH calls passing urine more often, and getting up at night to do it, quite normal. It nearly always goes after pregnancy, and leaks usually improve after the birth too. NHS Scotland says pelvic floor exercises in pregnancy help prevent leaks that carry on after your baby arrives.

One more toilet tip from KKH: some women feel faint when they stand up quickly or get off the toilet, so get up slowly. Dizzy spells are covered in our guide to breathless during pregnancy.

Normal, or worth a call?

This table pulls together what KKH, SGH, NUH and HealthHub say.

Is it urine or your waters?

A urine leak usually comes with a cough, sneeze, laugh or lift. HealthHub describes leaking waters as a continuous flow or a sudden gush of clear fluid. If you're not sure which it is, HealthHub says to see your doctor immediately, because of the risk of infection and labour. Our guide on how to know if your water broke has a side-by-side check and the pad test.

What your gynae can check and offer

HealthHub asks you to complete the blood pressure and urine assessment at every antenatal appointment. That's a good moment to mention leaks or burning. Urinary incontinence affects 10 to 20% of women in Singapore, NUH says, so your gynae hears about it often. Our prenatal check-up schedule shows when each visit falls.

NUH says women with stress incontinence may benefit from pelvic floor exercises. SGH suggests learning them from a physiotherapist at the start, so you learn to do them properly. Ask your gynae whether a referral makes sense for you.

Give the exercises time. NHS Scotland says it generally takes 3 to 5 months to strengthen these muscles. SGH says to keep them up for at least 4 months after your baby is born. KKH's lying-down version of the squeeze is in our 23 weeks pregnant guide, and safe exercise during pregnancy covers the rest of your workout.

After the birth, our guides on leaking urine after pregnancy and postpartum pelvic floor recovery take over.

When to see a doctor

• It hurts, stings or burns when you pass urine. KKH lists this as a reason to see a doctor.
• Blood in your urine, which KKH also lists.
• A fever. KKH puts it on the same list.
• Back pain with blood in your urine or a fever. KKH says back pain can rarely come from a urinary infection or a kidney stone.
• A gush or a steady trickle of clear fluid. HealthHub says to see your doctor immediately if you're not sure whether your water bag is leaking.
• Urinary symptoms bad enough to affect your daily life. KKH says these need a doctor too.

For burning, blood, a fever or leaks that bother you, see your gynae, a GP or a polyclinic doctor. KKH's Urgent O&G Centre, a 24-hour walk-in centre at Basement 1 of its Women's Tower, sees urgent problems in pregnancy under 22 weeks. From 22 weeks, KKH says to go straight to its Delivery Suite at Level 2 of the Women's Tower if you have bleeding, signs of labour or a water-bag leak. If you're booked at another hospital, call its delivery suite. Our premature labour signs guide lists the routes at NUH and SGH. For an emergency, KKH says to call 995 or go to an emergency room.

Frequently asked questions

Is leaking urine while pregnant normal?

Yes, small leaks when you cough, sneeze or laugh are common. KKH says frequent urination and leaks affect up to 30% of pregnant women, and SGH says leaks usually improve after the birth. Burning, blood or a constant trickle are different, and need a doctor.

Why am I peeing a lot in pregnancy?

Frequent urination in pregnancy usually comes from your womb pressing on your bladder, KKH says. NHS Scotland adds that pregnancy hormones play a part. SGH calls it quite normal, and it nearly always goes after pregnancy. If it burns or you see blood, get checked for a urinary infection.

Is it urine or waters?

A urine leak usually comes with a cough, sneeze or laugh. HealthHub describes waters as a continuous flow or a sudden gush of clear fluid, and says to see your doctor immediately if you can't tell. From 22 weeks, KKH's route is straight to its Delivery Suite.

How do I do pelvic floor exercises in pregnancy?

SGH's routine: tighten and pull up your pelvic floor as hard as you can, without using your tummy or buttocks. Do 5 slow pull-ups, holding each for at least 5 seconds if you can, then 5 fast ones, at least 3 times a day. NHS Scotland says to keep breathing and not clench your buttocks or legs.

Should I drink less water to stop a pregnancy bladder leak?

No. HealthHub says you need more water when you're pregnant, and Singapore's heat keeps you sweating. Aim for pale urine. If night trips are the problem, KKH suggests drinking less in the late evening, not all day. Our pregnancy heat guide has more on staying cool.

Will the leaks stop after the baby is born?

Usually. SGH says leaks in pregnancy usually improve after your baby is born, and asks you to keep up pelvic floor exercises for at least 4 months after the birth. If leaks carry on, our guide to leaking urine after pregnancy covers what helps.