Pregnancy discharge

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Pregnancy discharge

Pregnancy discharge

All women, whether they’re pregnant or not, have some vaginal discharge starting a year or two before puberty and ending after the menopause. How much discharge you have changes from time to time and it usually gets heavier just before your period.

Almost all women have more vaginal discharge in pregnancy. Normal vaginal discharge during pregnancy is called leukorrhea and is thin, white, milky, and mild smelling. This is quite normal and happens for a few reasons. During pregnancy the cervix (neck of the womb) and vaginal walls get softer and discharge increases to help prevent any infections traveling up from the vagina to the womb. Towards the end of pregnancy, the amount of discharge increases and can be confused with urine.

In the last week or so of pregnancy, your discharge may contain streaks of thick mucus and some blood. This is called a ‘show’ and happens when the mucus that has been present in your cervix during pregnancy comes away. It’s a sign that the body is starting to prepare for birth, and you may have a few small ‘shows’ in the days before you go into labor.

Increased discharge is a normal part of pregnancy, but it’s important to keep an eye on it and tell your doctor or midwife if it changes in any way.

You should notify your health care provider any time there is a change in normal pregnancy discharge. NEVER try to diagnose and treat yourself. Spotting during pregnancy can be normal but should be mentioned to your health care provider.

Notify your doctor immediately if you experience spotting or bleeding that is enough to fill a pad or tampon, lasts longer than a day, and is accompanied by cramping or pain.

During pregnancy DO NOT:

Use tampons-they can introduce new germs into the vagina.
Douche – this can interrupt the normal balance of healthy bacteria in the vagina and lead to infection.
Assume that it is a vaginal infection and treat it yourself.

During pregnancy DO:

Use panty liners if it makes you more comfortable.
Notify your health care provider at your appointment of any changes.

When to see your doctor

You should tell your doctor if your vaginal discharge increases a lot in later pregnancy. If you have any vaginal bleeding in pregnancy, you should contact your doctor urgently, as it can sometimes be a sign of a more serious problem such as a miscarriage or a problem with the placenta.

See your doctor if:

your discharge changes color, smell or texture
the discharge is colored, especially if it is blood colored
the discharge smells unpleasant or strange
the discharge is green or yellow
you feel itchy or sore around your vagina
you have pain when you urinate
you produce more discharge than usual
you get pain in the area between your tummy and thighs (pelvic pain)

Any of these could be symptoms of a vaginal infection. Healthy vaginal discharge should be clear and white and should not smell unpleasant. If the discharge is colored or smells strange, or if you feel itchy or sore, you may have a vaginal infection.

The most common infection is thrush, which your doctor can treat easily. You should not use some thrush medicines in pregnancy. Always talk to your doctor or pharmacist if you think you have thrush. You can help prevent thrush by wearing loose cotton underwear, and some women find it helps to avoid perfumed soap or perfumed bath products.

Is it normal to have vaginal discharge in pregnancy?

Yes. Almost all women have more vaginal discharge in pregnancy. This is normal, and helps prevent any infections traveling up from the vagina to the womb.

Towards the end of pregnancy, the amount of discharge increases further. In the last week or so of pregnancy, it may contain streaks of sticky, jelly-like pink mucus.

This is called a “show”, and happens when the mucus that’s been present in your cervix during pregnancy comes away.

It’s a sign that the body is starting to prepare for birth. You may have a few small “shows” in the days before you go into labor.

What does normal vaginal discharge in pregnancy look like?

The discharge during pregnancy should be clear or milky white. This extra vaginal discharge in pregnancy is nothing to worry about.

Check if your vaginal discharge is normal:

Vaginal discharge doesn’t have a strong or unpleasant smell
Vaginal discharge is clear or white
Vaginal discharge is thick and sticky
Vaginal discharge is slippery and wet

The amount of discharge varies. You usually get heavier discharge during pregnancy, if you’re sexually active or if you’re using birth control. It’s often slippery and wet for a few days between your periods (when you ovulate).

How do I know if it’s normal vaginal discharge or the mucus plug?

The amount of vaginal discharge increases even more towards the end of your pregnancy and during the last week. It might also contain streaks of sticky, jelly-like pink mucus. This is called a ‘show’ and happens when the mucus plug that’s in your cervix during pregnancy comes away.

If you get a ‘show’, your body might be preparing for birth. Don’t get too excited or panicked though. You could have a few shows before you go into labor. If you’re worried about anything, speak to your doctor.

What is abnormal vaginal discharge?

If your vaginal discharge is green or yellowish, has strong-smell and/or accompanied by redness or itching, you may have a vaginal infection. One of the most common vaginal infections during pregnancy is candidiasis, also known as a yeast infection. Another cause of abnormal discharge could also be an sexually transmitted infection (also called STI, sexually transmitted disease or STD). A sexually transmitted infection (STI) is an infection you can get from having unprotected sex or intimate physical contact with someone who is infected. You can get an STI from having unprotected vaginal, anal or oral sex. You can get a sexually transmitted disease even if you’re pregnant—being pregnant doesn’t protect you from getting infected.

Sexually transmitted diseases can be cause by bacteria, viruses or parasites. Many people with sexually transmitted diseases don’t know they’re infected because they often have no signs or symptoms. Nearly 20 million new sexually transmitted infections happen each year in the United States.

Some sexually transmitted infections can spread in ways other than sex. For example, you can get some sexually transmitted infections, like HIV, syphilis and herpes, by having direct contact with body fluids from an infected person. This can happen by genital touching, touching or kissing an infected sore (in the case of syphilis) or by sharing drug needles or other items that come in contact with body fluids from an infected person.

You can pass some sexually transmitted infections to your baby during pregnancy, labor, birth and breastfeeding. Sexually transmitted infections can cause serious problems for babies. Early testing and treatment can help protect your baby from infection.

Bacterial vaginosis also called BV or vaginitis, is an infection caused when there’s too much of certain bacteria in the vagina. It’s not an sexually transmitted infection, but you’re more likely to get it if you have a new sex partner or more than one sex partner. If you have bacterial vaginosis, you’re at increased risk of getting an sexually transmitted infection.

Table 1. Vaginal discharge that can be a sign of an infection

Discharge	Possible cause
Smells fishy	Bacterial vaginosis
Thick and white, like cottage cheese	Thrush (yeast infection)
Green, yellow or frothy	Trichomoniasis
With pelvic pain or bleeding	Chlamydia or gonorrhea
With blisters or sores	Genital herpes

How can you protect yourself and your baby from sexually transmitted infections?

The best way to protect your baby from sexually transmitted infections is to protect yourself from sexually transmitted infections. If you have an sexually transmitted infection, the best way to protect your baby is to get early and regular treatment during pregnancy.

Here’s what you can do to reduce your risk and your baby’s risk for infection:

Don’t have sex. Sex includes vaginal, oral and anal sex.
Limit the number of sex partners you have. Have sex with only one person who doesn’t have other sex partners.
Use a condom every time you have sex. Condoms are barrier methods of birth control. Barrier methods help prevent pregnancy and sexually transmitted infections by blocking or killing your partner’s sperm. Male latex condoms work best to prevent sexually transmitted infections; other kinds of condoms don’t work as well. Other kinds of birth control, like the pill and implants, don’t protect you from sexually transmitted infections.
Don’t share needles, syringes, razors or other things that may come in contact with another person’s blood or body fluid.
Get tested and treated. Early testing and treatment can help reduce the risk of passing an sexually transmitted infection to your baby. Ask your partner to get tested and treated, too. Even if you get treated for an sexually transmitted infection, you can get re-infected (get the infection again) if your partner is infected.
Go to all your prenatal care checkups, even if you’re feeling fine. You may have an sexually transmitted infection and not know it. If you think you may have an sexually transmitted infection, tell your provider so you can get tested and treated right away.
Get vaccinated. Vaccinations can help protect you from some sexually transmitted infections, like hepatitis B and some types of human papillomavirus (also called HPV). Vaccinations are shots that contain a vaccine that helps make you immune to certain diseases. If you’re immune to a disease, you can’t get the disease.

What problems can sexually transmitted infections cause during pregnancy?

Having an sexually transmitted infection during pregnancy can cause serious problems for you and your baby, including:

Premature birth. This is birth that happens too soon, before 37 weeks of pregnancy. Premature babies can have serious health problems at birth and later in life.
Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.
Premature rupture of the membranes also called PROM. This is when the sac around your baby breaks (your water breaks) before you go into labor.
Pelvic inflammatory disease also called PID. Pelvic inflammatory disease is an infection of a woman’s reproductive organs, including the uterus (also called womb), fallopian tubes, ovaries and cervix. These organs all play a part in pregnancy. PID can make it hard for you to get pregnant. During pregnancy, it can lead to problems like ectopic pregnancy. An ectopic pregnancy can cause serious problems for you and always ends in pregnancy loss. Reproductive organs include the uterus (also called womb), ovaries, fallopian tubes and cervix. All of these organs play a part in a woman’s getting pregnant.
Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.

Having an sexually transmitted infection can cause problems for your baby after birth, too, like problems with the eyes, lungs and liver. Some of these problems can affect your baby’s entire life, and some can even cause death. This is why it’s important to get tested and treated for sexually transmitted infections. Treatment before and during pregnancy can help protect your baby from infection.

How do I know if you have an sexually transmitted infection?

Sexually transmitted infections often have no signs or symptoms, so you may not know you’re infected. Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy.

Common signs and symptoms of sexually transmitted infections include:

Flu-like symptoms, including headache and fatigue (feeling very tired)
Vaginal discharge or burning, itching, redness or swelling in the vaginal area
Pain, itching or burning when you go to the bathroom; pain, discharge or bleeding in the rectum (where bowel movements leave the body); or painful bowel movements
Belly pain
Pain during sex or bleeding after sex or between periods
Eye infections
Sores on the mouth or the vaginal, genital or anal areas

As part of your prenatal care (medical care you get during pregnancy), your health care provider tests you for certain sexually transmitted infections, including:

Chlamydia and gonorrhea. These sexually transmitted infections are most common in women younger than 25. Most infected women have no signs or symptoms. You’re tested for these sexually transmitted infections with a Pap test (when your provider collects cells from your cervix).
Genital herpes. You can get genital herpes from unprotected sex or through direct contact with an infected person’s herpes sore or fluid from a herpes sore. Having genital herpes during pregnancy can cause serious health problems for your baby, including brain infection (also called herpes encephalitis); eye diseases; infection of the liver, lungs, kidneys, skin and mouth; and even death. You’re most likely to pass herpes to your baby if you have genital herpes sores and blisters (called an outbreak) for the first time late in pregnancy. You get tested for genital herpes with a blood test.
Hepatitis B also called hep B. You can get hep B from unprotected sex or through direct contact with infected body fluids, like blood, saliva, semen and vaginal fluid. It spreads easily through breaks in the skin or in soft body tissues in the nose, mouth and eyes. If untreated, hep B can damage your liver. Many infected women have no signs or symptoms, but some may have jaundice. This is when your liver isn’t working properly so your eyes and skin look yellow. The Centers for Disease Control and Prevention (also called CDC) recommends that all pregnant women get a blood test for hep B and that any adult, including pregnant women, at risk for hep B gets vaccinated. You can get vaccinated even if you’re not at risk for hep B. If you’re pregnant and you test positive for hep B, you get another test that can help your provider know if your baby’s at risk for infection. Babies with hep B can have life-long health problems, including liver problems. CDC recommends that all babies get vaccinated for hep B at birth and later as part of their regular vaccination schedule, and that all babies born to women with hep B get vaccinated and treated for hep B at birth.
Human papillomavirus (HPV). HPV is the most common sexually transmitted infection in the United States. In most cases, HPV goes away on its own. But if it doesn’t, it can cause genital warts (small bumps in the genital area) and cancer of the cervix (also called cervical cancer). The Centers for Disease Control and Prevention (also called CDC) recommends women up to age 26 get the HPV vaccination to protect them from HPV. If you’re pregnant and have an HPV infection with genital warts, you may get more warts during pregnancy. They may grow large enough to block the vagina. If this happens, you may need to have a cesarean birth (also called c-section). A c-section is surgery in which your baby is born through a cut your doctor makes in your belly and uterus (womb). It’s rare for HPV to pass from mother to baby during pregnancy. If it does happen, it can cause warts to grow on the baby’s voice box (also called larynx). You get tested for HPV with a Pap test.
Human immunodeficiency virus (HIV). HIV is a virus that attacks the body’s immune system. The immune system protects the body from infections, cancers and some diseases. If untreated, HIV can lead to AIDS. In the United States, HIV is most commonly spread through unprotected sex with or by sharing drug needles with an infected person. Having HIV can make it easier for you to get infected with other sexually transmitted infections. If you have HIV, early and regular treatment during pregnancy can help protect your baby from infection. You get tested for HIV with a blood test.
Syphilis. You can get syphilis from unprotected sex or through direct contact with (touching or kissing) an infected person’s syphilis sore. If not treated, syphilis can damage your eyes, heart, brain and spinal cord. If you have syphilis, early and regular treatment during pregnancy can help protect your baby from infection. When a baby is born with syphilis, it’s called congenital syphilis. Congenital syphilis is completely preventable, but many babies born to moms with untreated syphilis die from the infection. The best way to protect your baby from congenital syphilis is to prevent infection before and during pregnancy. You get tested for syphilis with a blood test.
Zika. Your provider may test you for Zika if you have signs or symptoms of infection or if you or your partner has been in an area where Zika is spreading. Zika is a virus that spreads mainly through mosquito bites and unprotected sex with an infected person. Zika often has no signs or symptoms so you may not know you’re infected. If you have Zika during pregnancy, it causes a birth defect called microcephaly (a condition where the head is smaller than normal) that’s part of a condition called congenital Zika syndrome. If you’re pregnant and you think you’ve been exposed to Zika before or during pregnancy, tell your doctor right away.

Ask your doctor about getting tested for sexually transmitted infections during pregnancy. Find out which tests you get and when you get them. If you think you may have an sexually transmitted infection, tell your doctor. Early testing and treatment can help protect your baby.

How are sexually transmitted infections treated?

Early testing and treatment can help protect you and your baby from most sexually transmitted infections.

If you have an sexually transmitted infection that’s caused by bacteria, your doctor prescribes antibiotics to treat it. Bacteria are tiny organisms that live in and around your body. Some bacteria are good for your body, and others can make you sick. Antibiotics are medicines that kill infections caused by bacteria.

Sexually transmitted infections that are caused by a virus (like HIV, HPV, herpes or hepatitis) can’t be cured with treatment. But treatment can help you manage signs and symptoms.

Should vaginal discharge smell different in pregnancy?

Talk to your doctor if your discharge has an unpleasant smell, you feel itchy or sore, or you have pain when you urinate. If your discharge changes, for example in smell, color or texture, it might be a sign of infection.

Do I have normal pregnancy discharge or a yeast infection?

Yeast infections, which are also known as thrush, are more common than any other time in a woman’s life, especially during the second trimester of pregnancy. Thrush makes vaginal discharge thick, white and cottage cheese like. This is common and a normal symptom in the second trimester.

A fungus called candida, which is normally harmless, causes thrush. It tends to grow in warm, moist conditions. Thrush develops if the normal balance of bacteria in the vagina changes, which happens in pregnancy. Yeast infection occurs when the normal levels of acid and yeast in the vagina are out of balance, which allows the yeast to overgrow causing an uncomfortable, but not serious a condition.

Higher levels of estrogen are another part of pregnancy that can make thrush more likely. Thrush during pregnancy can be treated easily, so speak to your doctor or midwife to find out what help is available.

If you have never been diagnosed or treated by a doctor for a yeast infection and have some of the symptoms, you should see your doctor first for accurate diagnosis and treatment. Other infections have similar symptoms, so you want to make sure that you are treating the infection correctly. There are also treatments that are not appropriate during pregnancy.

Furthermore, if you are experiencing symptoms similar to a yeast infection, but a doctor has not made the diagnosis, you may have one of the following:

Sexually Transmitted Diseases (STDs) like Chlamydia, Gonorrhea and Trichomoniasis
A vaginal infection called bacterial vaginosis

What causes yeast infections during pregnancy?

A yeast infection can be caused by one or more of the following:

Hormonal changes that come with pregnancy or before your period
Taking hormones or birth control pills
Taking antibiotics or steroids
High blood sugar, as in diabetes
Vaginal intercourse
Douching
Blood or semen.

What are the symptoms of yeast infections?

The symptoms of a yeast infection may include one or more of the following:

Vaginal discharge that is usually white/tan in color, similar to cottage cheese and may smell like yeast/bread
Other discharge may be greenish or yellowish, also similar to cottage cheese and may smell like yeast/bread
An increase in discharge
Redness, itching, or irritation of the lips of the vagina
Burning sensation during urination or intercourse.

How do I know for sure if I have a yeast infection?

At your doctor’s office or medical clinic, a clinician will use a simple, painless swab to remove the discharge or vaginal secretions and examine it through a microscope. Usually, upon a simple examination of the vagina, a physician can diagnose a yeast infection. In rare cases, the culture may be sent to a lab.

How are yeast infections treated during pregnancy?

During pregnancy, doctors recommend vaginal creams and suppositories only. The oral medication, Diflucan (a single-dose medication), has not been proven safe during pregnancy and lactation. Not all vaginal creams and suppositories are okay to use during pregnancy, so it is best to consult your doctor or pharmacist to get the right one. If left untreated, yeast infections can pass to your baby’s mouth during delivery. This is called “thrush” and is effectively treated with Nystatin.

It may take 10-14 days to find relief or completely clear up the infection while you are pregnant. After the infection has cleared up and any sores have healed, it may be helpful to use a starch-free drying powder, or Nystatin powder to prevent a recurring infection.

How can I stop my yeast infection coming back?

Thrush can keep coming back but most yeast infections can usually be avoided by doing the following:

Avoid washing down there with soap or shower gels, wipes or feminine hygiene products.
Use a soap substitute for washing and just wash once a day.
After regular, thorough washing (using unscented, hypoallergenic or gentle soap), use your blow dryer on a low, cool setting to help dry the outside of your genital area.
Avoid vaginal douching, which is when people flush water up inside the vagina to wash it.
Avoid wearing tight-fitting clothes.
Wear loose, breathable cotton clothing and cotton underwear.
Always wipe from front to back after using the restroom.
Shower immediately after you swim. Change out of your swimsuit, workout clothes, or other damp clothes as soon as possible.
Include yogurt with “lactobacillus acidophilus” in your diet.
Consider using probiotics like live yogurts directly where you’re feeling the symptoms of thrush. You can also eat and drink probiotics.
Limit sugar intake, as sugar promotes the growth of yeast.
Get plenty of rest to make it easier for your body to fight infections.

DO NOT:

use feminine hygiene sprays
use sanitary pads and tampons that contain deodorant
take a bubble bath/use scented soaps
use colored or perfumed toilet paper.