Help! I’m really pregnant. Why do I need to pee every time I stand up?

Your desperation to pee – all the time – towards the end of your pregnancy – is largely dictated by four things:

1. How much liquid you have in your bladder (that’s the normal cue);

2. How sensitive you are to the hormone relaxin, which can (amongst all the other things it’s responsible for), make you need a wee more.

3. The size of your baby/uterus as it expands and puts pressure on or squeezes your bladder. This is especially true towards the end of your pregnancy, when there is very little room inside you and you have a bony, human pushing at you from all angles – including shoving you in your bladder at unpredictable moments.

4. Your pelvic floor. If it has been weakened by pregnancy, or it wasn’t that strong before, or it too has been affected by relaxin, your pelvic floor can find it harder to hold in pee.

But why when standing up specifically?

When you are sitting down, it’s quite probable that your pelvis is at a very different angle to when you stand up. Obviously I can’t see you all out there, so I don’t know your individual posture types or bump shapes or activity levels – BUT – I can speak from having seen a large number of pregnant women in my years as an expert in this field.

Your constant need to pee towards the end of your pregnancy has a lot to do with the angle of your pelvis. It can also affect your recovery post birth so it’s worth paying attention to now.

When you stand up, your pelvis tilts forwards, which basically shifts all that baby weight right onto your bladder and puts more pressure on your pelvic floor muscles. Specifically on the pelvic floor muscles that control your urethra and urination.

What do you mean by pelvis angle?

If you can imagine that dangling on the end of your spine is a bucket. The bucket is full of water. When the bucket is level, the water stays put. But tip the bucket forwards and the water spills out. That’s essentially what happens when your pregnant body tips your pelvis forwards. It’s also the cause of many a backache, dodgy hip or stiff pelvis.

There’s also a whole lot of pressure bearing down on your lady parts at the end of pregnancy. It’s all very ‘sensitive’ down there so we can get mixed messages. ‘Do I need to pee or has my body just released a lot of blood down to those bits?’ Ever had a naughty dream during pregnancy? That’s your near bursting uterus pressing onto your sensitive areas getting excited all by itself.

Let’s get practical

To try this out for yourself, get down on all fours now. Onto your hands and knees.

1. Lift your pelvic floor muscles. Do this by imagining you are lifting a tissue up into your vagina, you could imagine sucking anything up but it’s the upwards action you need.
2. Now round your back out as if you were a scared cat, and lift your pelvic floor again.
3. Now tip your pelvis the other way, so you are arching or hollowing your lower back and lift your pelvic floor again.

What I hope you notice is that the intensity of your pelvic floor lift is very different dependent on where your pelvis is. Tip it back (scared cat) and you feel more in the anal sphincter (sorry there if you are eating your dinner). Tip it forwards (slinky cat) and you feel more in your urethra. You probably feel it more in the clitoris too because they’re all at the front.

The forwards tip is what happens when you stand.

How to avoid the need to pee when you stand up

I’d love to wave a magic wand but as with all things pregnancy, I can’t categorically state that one fix will fix all. What you can do however when you stand is focus on your alignment. This literally means imagine as you stand that your tailbone hangs a bit heavier. Going back to the bucket analogy this is the equivalent of stabilising your bucket. You could also think about lifting the front of your bucket, in this analogy – what feels like your hips but is actually the top of your pelvis – up towards your rib cage a little more.

Also remember that holding in pee is essentially training one aspect of your pelvic floor and whilst I would never recommend you hold in a wee, holding it in a bit is all good training.

This post is taken from Karen’s forthcoming book: The Pilates Instructor’s Encyclopedic Guide to Pregnancy.

For details on Karen’s ante natal classes visit: Pilates for Pregnancy

For more articles like this check out: Can I run when I’m pregnant? and Why do we get fat when we get pregnant?