Vaginal discharge in pregnancy

Why do I have so much vaginal discharge in pregnancy?

It's common to have more vaginal discharge in pregnancy (Bharj and Daniels 2017, NHS 2018a). It's usually harmless, and not that different from the discharge you had before you were pregnant. There's just more of it.

Normal vaginal discharge is called leucorrhoea. It's a mild or musky-smelling, milky fluid that keeps your vagina clean and helps prevent infection (Murray and Hassall 2014, NHS 2018a).

Vaginal discharge comes from your cervix, which is the neck of your uterus (womb). You probably get more when you're pregnant because more blood is flowing to the area.

This discharge tends to increase as you approach labour, and it can be quite heavy (Murray and Hassall 2014). At this stage, you may also notice a bloody, mucus-streaked discharge. This is called a “show”, and is the plug that seals your cervix during pregnancy (RANZCOG 2016).

When this mucus plug loosens and comes out, it's one of the signs that labour may start soon (RANZCOG 2016).

How can I deal with excess pregnancy discharge?

Increased discharge is just one of the normal, temporary changes that pregnancy brings. You don't need to do anything about it. If you’re finding it a real nuisance, you could try unscented panty liners or change your underwear more often.

Other than that, try these tips:

• Keep your outer genital area (vulva) and the area between your vagina and anus (perineum) clean.
• Use unscented soap and water when washing.
• Don't use scented wipes, perfumed bubble bath or vaginal deodorants.
  (NHS 2018b)

Don't rinse out your vagina (douching). This is likely to irritate the lining of your vagina and upset the natural bacterial balance (NHS 2018b).

Vaginal discharge is normally quite acidic, so that good bacteria can keep harmful bacteria at bay (NHS 2018b). If you alter this natural balance, it could cause inflammation, or even an infection.

Is vaginal discharge ever a sign that something's wrong in pregnancy?

Healthy vaginal discharge is clear and white, and doesn't smell strongly. If it isn’t, it may be a sign that you have an infection, which will need treating.

Get advice from your doctor or midwife if you have unusual vaginal discharge. She can prescribe you the correct treatment, or refer you to a specialist clinic for treatment (NICE 2013).

The following are common vaginal infections:

Thrush
Thrush isn't harmful to you or your pregnancy, but it can be unpleasant while it lasts. The signs and symptoms are:

• Thick, white discharge that looks like cottage cheese. It may smell yeasty.
• Itching in or around your vagina.
• The area around your vagina is red and sore. Sex may make you sore.
• Stinging when you wee.

Read more about thrush in pregnancy.

Bacterial vaginosis
Bacterial vaginosis (BV) is a common vaginal infection (BASHH 2012, NHS 2018c). The signs and symptoms are:

• Discharge that has a fishy smell, especially after you’ve had sex.
• Discharge that’s thin and watery, and white or grey in colour.
  (NHS 2018c)

You'll need treatment for bacterial vaginosis because it can cause complications during pregnancy (BASHH 2012).

If BV goes untreated, you may be more likely to go into premature labour. A small number of women who've had complicated pregnancies in the past may be more at risk of late miscarriage (BASHH 2012, NHS 2018c).

Trichomoniasis
Trichomoniasis is a common sexually transmitted infection, caused by a tiny parasite (NHS 2015). The signs and symptoms are:

• Heavier discharge than normal, which may be thick, thin or frothy and yellow-green.
• Discharge that has an unpleasant fishy smell.
• Soreness, swelling and itching around your vagina and possibly your inner thighs.
• Pain when you wee or have sex.
  (NHS 2015)

You'll need treatment with antibiotics if you have trichomoniasis. If left untreated, it may lead to premature birth, or mean your baby is more likely to be born with a low birth weight (NHS 2015).

Aside from common vaginal infections, see your doctor or midwife if your discharge is brownish. It may mean you’re having some light spotting or bleeding. This is fairly common early in pregnancy, but tell your doctor or midwife so she can rule out other problems.

How can I prevent vaginal infections?

There's no sure way to completely prevent vaginal infections. Just being pregnant makes you more likely to have thrush (UK FPA 2018), which may come and go, even with treatment (NICE 2017).

Besides washing your hands before and after touching your genitals, though, following these tips may help reduce your chances of getting infections:

• Don't use vaginal washing products or vaginal deodorants. These may disrupt your vagina’s natural balance of healthy bacteria. Use unscented gentle cleansers for the area around your vagina.
• Don't use scented soaps, perfumed bubble baths or antiseptic liquid in the bath.
• Use non-biological detergents to wash your underwear. Add an extra rinse cycle at the end of the wash, in case the detergent is irritating your skin.
• Use condoms and dental dams if your sexual partner is at risk of a sexually transmitted infection. Keep sex toys clean.
• Make sure your vagina is well-lubricated before foreplay and sex.
• Wear loose clothing and cotton underwear.
• Wipe from front to back after going to the loo.
• If you have diabetes, try to manage your blood sugar levels. You’re more likely to get thrush if your diabetes isn’t managed well.
• If you smoke, try to quit. Smoking makes you more prone to bacterial vaginal infection. It's also harmful to your unborn baby.
  (UK FPA 2018)

Try eating a pot of live yoghurt daily (NICE 2017). It contains the probiotic lactobacillus acidophilus, which may help keep a healthy balance of bacteria in your vagina. There's no real evidence that probiotics will help, but they're safe to try (NICE 2017).

Read about natural remedies for thrush in pregnancy.