Urge To Pee but Little Comes Out (Pregnant)

This article was medically reviewed by Dr. Navya Mysore and updated on June 18, 2024

Morning sickness, back pain, sudden cravings or revulsion to certain foods or smells…these are all part of the journey of being pregnant.  Along with these symptoms that occur in pregnancy, you can also experience a frequent urge to urinate.

More frequent urination can occur in pregnant women due to:

• Increased pressure on your bladder: Your growing baby puts pressure on all surrounding organs, which may lead to decreased distention space for the bladder during filling, leading to increased and frequent urge to empty the bladder.
• Extra fluids in your body: When you are pregnant, your plasma volume increases by ~50%, so the increase in blood flow combined with filtration of fluid through the kidneys results in increased bladder filling and urination.    
• Hormonal changes: Hormonal changes during pregnancy, like increased progesterone, cause your blood vessels to dilate. This allows for increased plasma volume and cardiac output due to the decrease in resistance to blood flow. Increased cardiac output means blood flow can get to and from organs (like the kidneys) more quickly and frequently, therefore leading to increased urination.

What Happens When You Pee *Normally*?

Most of us don’t think twice about peeing until something goes wrong. When you pee, your brain and bladder work together. 

The bladder stores urine until you are ready to release it and the muscles of your pelvic floor and the urethra (the tube connecting your bladder to the outside of your body) contract and relax to keep the urine in the bladder. When those muscles are able to communicate consistently with the brain, keeping the bladder and the urethra in the correct position, you have control of your urine, and urine does not leak outside the body unintentionally.

When you are ready to pee, your brain lets the bladder know. This causes the pelvic floor muscles, the urethra, and the bladder to either relax or contract, which allows urine to exit the bladder through the urethra.

What Can Cause an Urge to Pee (But Nothing Comes Out)?

Ok, so what about those times when you feel the urge to pee, but no urine comes out?

Increased Blood Pressure on the Bladder

Your growing baby and uterus put pressure on all surrounding organs, which may lead to decreased distention space for the bladder during filling. This can cause an increased and frequent urge to empty the bladder. Sometimes you may feel the urge to void, even if the bladder has only filled up a little bit with urine. This is due to decreased space for the bladder to fill as your baby develops and your uterus grows. 

Urinary Tract Infection UTI

One of the most common causes of an urge, or constant urge, to pee is a UTI (urinary tract infection). UTIs can occur when bacteria have entered the urinary tract. This bacterial infection causes the bladder to become inflamed and irritated, which can trigger increased contraction of the bladder muscle, discomfort with bladder distention, and pain and burning with urination.

Ways to prevent UTIs include the following:

• Drink plenty of water
• Urinate before and after having sex
• Wipe from front to back after you urinate.
• Wear breathable underwear and clothing, changing your underwear daily
• Don’t hold your urine! (i.e., pee when you have to go)

It's very important that if you are experiencing symptoms of a UTI that you see your health care provider to seek treatment. UTIs are treated with antibiotics and especially in pregnancy it's important that you treat your UTI as soon as symptoms come on.

Overactive Bladder

OAB occurs due to abnormalities in the nerves, muscle, and/or the lining of the bladder, which leads to the bladder muscle (detrusor muscle) inappropriately contracting during bladder filling. This causes urinary frequency and urgency and can occur with or without urinary incontinence (involuntary loss of urine).

What Can You Do About Frequent Urination During Pregnancy?

Lean Forward or Try Double Voiding

The urge to pee will be exacerbated if your bladder doesn’t fully empty when you use the bathroom. So, make sure you empty your bladder when you pee—leaning forward while on the toilet may help with this. 

Another option is to pee, then wait 10 minutes and pee again. This is known as double voiding. Double voiding might be especially helpful before bedtime if you’re experiencing nocturia (waking up to urinate in the middle of the night).

Maintain a Healthy (Pregnancy) Weight

Some weight gain is a healthy part of pregnancy. You should work closely with your doctor to determine the healthy amount of weight you should gain for your pregnancy. Gaining excess weight puts additional stress on your organs and pelvic muscles. That increased pressure can further increase your urge to urinate, making you run to the bathroom more frequently.

Do Kegel Exercises to Strengthen Your Pelvic Floor Muscles

These exercises strengthen the muscles that support the uterus, bladder, and urethra. Kegel or pelvic floor exercises can be done any time, either sitting or lying down. Kegels can even be done when you are eating, working at your desk, or when you are resting.

In describing how to perform Kegels, some will describe it as the same sensation as the technique used to stop urine midstream, or trying to prevent gas from escaping the rectum.

You can assess whether or not you are using the correct muscles by either a) holding a hand mirror in front of the vagina and looking for the perineum to lift up when you contract, or by placing one clean finger inside your vagina and feeling that finger squeezed when you contract.

Kegels are typically performed by squeezing for 3 seconds and then relaxing for an equal amount of time (3 seconds). This is repeated as pelvic floor exercises which one should try to do every day.

Seeking evaluation and care from your healthcare provider - especially a pelvic floor physical therapist - is always important and recommended when addressing weak pelvic floor muscles.

Try Wearing Leakproof Underwear

Leakproof underwear will not prevent leaks, but it can help you better manage them. If “leakproof underwear” conjures images of bulky diapers, rest assured, they come in a wide variety of styles and are basically indistinguishable from your regular underwear. Plus, they’re great for managing all kinds of leaks - from light bladder leaks to period blood and even sweat.

When to Seek Medical Advice

If you experience any of the following, check in with your doctor or healthcare provider:

If You Experience Stinging or Burning When Urinating

An increased urge to urinate is one symptom of a urinary tract infection (UTI). Another symptom is a stinging or burning sensation when you pee and a decreased or irregular flow of urine. If you experience this, you should visit your doctor. 

If you have a history of UTIs, you have greater chances of experiencing a UTI during pregnancy. UTIs are typically treated with antibiotics that are safe in pregnancy. However, untreated UTIs can lead to a kidney infection, which can lead to multiple undesired outcomes, including early labor.

Outlook

Some bladder control issues related to pregnancy (e.g. stress urinary incontinence) resolve within the postpartum period. However, some may persist. In the weeks after delivery, pay heed to whether urinary issues begin to subside, increase, or stay the same. Also, vaginal delivery can contribute to bladder control problems, as muscles can be injured during delivery.

Seeking pelvic floor physical therapy both during and after pregnancy is a great way to strengthen those muscles after the normal laxity of pregnancy.

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Written by Jane Flanagan — Updated on January 30, 2023.

We hope you found this post informative—but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.