When to call your midwife about vaginal discharge during pregnancy.
Your body is changing all the time when you’re pregnant and it’s often hard to know what is normal and what is not. Vaginal discharge can vary in amount, colour and consistency throughout pregnancy and while it’s usually nothing to worry about, sometimes you do need to take action. If you find yourself regularly scanning your knickers and worrying about the health of your baby, our guide to vaginal discharge in pregnancy will help you.
Dr Juliet McGrattan looks at vaginal discharge during pregnancy including what it looks like, how much is normal and when to call your midwife:
What is vaginal discharge?
Tiny glands in the wall of the vagina produce mucous to keep the vagina clean, moist and to prevent infection. Discharge also helps in fertility, becoming wetter during intercourse and more slippery around the middle of the menstrual cycle which helps sperm reach and fertilise an egg.
Discharge amount varies from woman to woman and from day to day. It’s a well-designed system which aims to keep the vagina healthy, at a balanced pH and full of good bacteria to prevent overgrowth of the bad ones.
What is normal pregnancy discharge?
Normal vaginal discharge is white, cream or sometimes a light yellow colour. It may slightly stain your undies but it shouldn’t smell strongly, be itchy, blood-stained, uncomfortable or give you any burning when you pass urine. The amount, colour and consistency will vary throughout your pregnancy.
- Early pregnancy discharge
The rapidly rising hormone levels in early pregnancy mean that you will probably notice an increase in the amount of your discharge. This might actually be the first sign that you are pregnant. The discharge should still be white or milky and have very little smell.
- Late pregnancy discharge
Vaginal discharge can increase noticeably in the last three months of pregnancy. In the few days before going into labour, you might have some thick jelly-like mucous which comes from the cervix as it softens and prepares to dilate. It is often blood-stained. This is called ‘a show’ and it might happen once or in intermittent small amounts in the lead up to labour.
Colours of discharge in pregnancy
It’s worth keeping an eye on your discharge during pregnancy and taking action early if you notice any significant changes. The colour of vaginal discharge is a good indicator as to whether all is well:
- White discharge in pregnancy
It’s normal to have a thin, white discharge all through your pregnancy. However, if the discharge becomes thick and lumpy, resembling cottage cheese, then you might have thrush (candida albicans). Thrush is a yeast infection which is common in all women, especially during pregnancy. Along with the thrush discharge which often smells, you may experience, vaginal or vulval itching or burning when you wee. There’s no need to panic but you need to get some treatment so speak to your pharmacist, midwife or GP who will advise you.
⚠️ Do not treat yourself with over-the-counter thrush medications before you have spoken to a healthcare professional as some of them are not suitable for use when you are pregnant.
- Yellow discharge in pregnancy
A pale yellow discharge can be normal in pregnancy but if it smells strongly or you feel itchy or uncomfortable, then it could be a sign of a vaginal infection. Sometimes thrush can be a little yellow in colour but it’s best not to guess and see your doctor or midwife who will probably want to take a swab of the discharge. It will be sent to the laboratory to see whether infection is present and the correct treatment can then be given.
- Green discharge in pregnancy
Green discharge is not normal and usually means that infection is present. Infections causing a green discharge are generally sexually-transmitted infections including chlamydia and trichomoniasis. It is very important to get tested and treated promptly as they can have an impact on the health of your baby after it is born. You may notice itching, discomfort and an unpleasant smell but these may not be present.
- Brown discharge in pregnancy
When a discharge has a brown colour it usually contains stale blood. A small amount in very early pregnancy, as the embryo implants into the lining of the womb, is not uncommon. However, if it is associated with abdominal pain, it is very important to see your doctor. It might indicate an ectopic pregnancy.
An ectopic pregnancy is a pregnancy that has implanted outside of the uterus and emergency assessment and treatment is needed as these pregnancies cannot survive and may be life-threatening for the mother.
Brown discharge in early pregnancy can also sometimes indicate a miscarriage but the bleeding usually gets heavier and turns more red in colour. Brown discharge later in pregnancy could be a sign of infection or bleeding so always get checked by your midwife.
- Blood-stained discharge in pregnancy
Having pink or red streaks of blood in your discharge are a sign of bleeding. The cause of this will vary according to what stage of pregnancy you are in. There may be nothing to worry about and many women have light bleeding on and off through normal pregnancies. It might however indicate a problem with the pregnancy.
In early pregnancy blood in your discharge can be a sign of an ectopic pregnancy or miscarriage (see the brown discharge advice). In later pregnancy it could indicate bleeding coming from the placenta. Blood stained discharge can also be caused by vaginal infections or from blood coming from delicate areas on the cervix. In the few days prior to labour it’s normal to have a blood stained, thick, mucous discharge called a ‘show’ as the cervix prepares for labour.
❗ Always speak to your midwife or doctor if you have blood-stained discharge or vaginal bleeding.
- Watery discharge in pregnancy
You might find that your discharge is generally waterier in pregnancy than your normal discharge but if it starts to smell strongly (it’s often a fishy smell) or your vagina or vulva feel uncomfortable, then it could be a sign of bacterial vaginosis (BV). BV is a common condition where unhealthy bacteria overgrow in the vagina. The discharge is watery and often grey in colour. While BV doesn’t usually cause any problems in pregnancy it has been linked to cases of miscarriage or premature births so you need to see your midwife or doctor to get tested and treated.
9 ways to manage pregnancy discharge
Having a heavier discharge than normal is common when you are pregnant. It’s important to help keep your vagina healthy and maintain the right balance of good bacteria and pH. Here are 9 simple steps you can take:
- Wear a panty liner to absorb the normal discharge and keep you comfortable.
- Don’t use tampons during pregnancy.
- Change your underwear frequently.
- Use a mild washing detergent and an extra rinse cycle when you wash your pants.
- Avoid tight fitting clothes and tights.
- Wipe from front to back when you visit the toilet to prevent bowel bacteria entering the vagina.
- Don’t over wash; stripping away healthy bacteria will make infection more likely.
- Avoid perfumed soaps, bubble baths and wipes and take a shower rather than a bath.
- Keep an eye on your discharge and speak to your midwife or doctor if you notice any colour changes, strong odours or you have any itching or discomfort in your vagina or vulva.
Treatments for pregnancy discharge
When you see your midwife or doctor about an abnormal pregnancy discharge they will usually want to take a swab of the discharge. Depending on your circumstances, they might take a swab from the low vagina or use a speculum inserted into the vagina so the swab can be taken from higher up. The results of the swab will indicate what infection is present and the right treatment can be given.
The doctor will make sure that the medication you are prescribed is safe for use in pregnancy. It might be given as an oral tablet or a pessary (tablet to insert into the vagina).
If there is any concern about the pregnancy itself such as an ectopic pregnancy or bleeding from the placenta, then an emergency assessment will be arranged and emergency treatment given by the obstetrics and gynaecology team at the hospital.