I’ll never forget the panic in my friend Sarah’s voice when she called me at seven months pregnant. She’d spotted blood in her urine that morning and was convinced something was terribly wrong with the baby. Turns out, she wasn’t alone in that fear—spotting blood in your urine during pregnancy is more common than you’d think, and whilst it absolutely warrants a call to your midwife, it’s not always the disaster scenario your mind immediately jumps to.
Let’s talk about what’s actually going on when this happens, because understanding the possibilities can help you know when to worry and when to simply get things checked out as a precaution.
Why Does This Happen During Pregnancy?
Your body does some pretty wild things when you’re growing a human. Your kidneys are working overtime—they’re filtering about 50% more blood than usual by the time you hit the third trimester. That’s a lot of extra work for organs that are already being squashed by your expanding uterus.
The most common culprit? Urinary tract infections. According to the NHS, UTIs affect up to one in five women during pregnancy, and they’re more likely to cause visible blood in urine when you’re expecting. The hormonal changes during pregnancy actually make you more susceptible to these infections because progesterone relaxes the muscles in your urinary tract, which can slow the flow of urine.
But here’s where it gets interesting. Sometimes what looks like blood in your urine isn’t actually coming from your urinary system at all. It could be vaginal bleeding that’s mixing with urine as it passes through. During pregnancy, your cervix becomes more sensitive and engorged with blood vessels, so even something as simple as sex or a routine examination can cause a bit of spotting.
Other possibilities include kidney stones (pregnancy increases your risk slightly), kidney infections, or in rarer cases, issues with the kidneys themselves. I think it’s worth noting that researchers at King’s College London found in a 2019 study that pregnant women with untreated UTIs had a higher risk of complications, which is exactly why your midwife will want to check things out promptly.
What Should You Actually Do About It?
Right, so you’ve noticed blood. First things first—don’t spiral into Google’s darkest corners at 2am. I know that’s easier said than done, but genuinely, your best move is to contact your midwife or GP that same day.
They’ll likely ask you to provide a urine sample for testing. This simple test can identify a UTI within minutes and check for other markers that might indicate what’s going on. If it’s an infection, they’ll prescribe pregnancy-safe antibiotics—usually a week’s course should sort it out.
Here’s what medical professionals will be looking for: Are you running a fever? Do you have pain in your back or sides? Is there any burning when you urinate? These accompanying symptoms help build a picture of what’s happening.
The NHS guidance is pretty clear that any bleeding during pregnancy should be investigated, but they’re also reassuring that many causes are treatable and won’t affect your baby.
When It’s Actually Serious (And When It’s Not)
Let’s be honest about the worry factor here. Some situations need urgent attention—like if you’re experiencing severe abdominal pain alongside the blood, if you’re feeling faint or dizzy, or if you develop a high fever. These could indicate a kidney infection that’s progressed, and you’d need to head to hospital rather than waiting for a GP appointment.
But most of the time? It’s something manageable. Perhaps a straightforward UTI that clears up with antibiotics. Maybe some irritation from increased vaginal discharge (pregnancy does delightful things to your body, doesn’t it?). Or even concentrated urine that looks darker than it is—dehydration can make things appear more dramatic than they are.
I spoke to a midwife friend recently who mentioned she sees this concern at least twice a week. She said the vast majority of cases turn out to be simple UTIs or false alarms where the blood was actually vaginal spotting. Still, she checks every single case because occasionally—and it is only occasionally—there’s something that needs closer monitoring.
Looking After Yourself While Waiting for Answers
The gap between noticing blood and getting answers from your healthcare provider can feel eternal. Here’s what you can do in the meantime.
Drink plenty of water. I mean really increase your intake—aim for eight to ten glasses a day. This helps flush your urinary system and can ease the symptoms if it’s an infection. Some women swear by cranberry juice, though the evidence is mixed on whether it actually prevents UTIs. It certainly won’t hurt, as long as you’re choosing unsweetened versions.
Keep an eye on any other symptoms that develop. Jot them down if it helps—your midwife will appreciate having this information. Note the colour of the blood (bright red, pink, or brown?), how much there is, and whether it’s every time you urinate or just occasionally.
Try not to panic about the baby. In most cases of blood in urine during pregnancy, the baby is completely unaffected. The issue is usually isolated to your urinary tract or reproductive system, rather than affecting the pregnancy itself.
And look, I know easier said than done, but stress isn’t helping anyone. If you’re the worrying type (aren’t we all, a bit?), perhaps call your midwife sooner rather than later just for peace of mind.
The bottom line is this: blood in your urine during pregnancy always deserves a proper check-up, but it rarely turns out to be something catastrophic. Your body is doing extraordinary work right now, and sometimes that means things go a bit wonky. Most of the time, it’s nothing that can’t be sorted with a course of antibiotics and some extra water. But getting it checked means you’ll know for certain, and that’s worth far more than sitting at home wondering.
