Everything to Know About Vaginal Infections During Pregnancy

Thanks to a surge in hormones, pregnant people are more susceptible to vaginal infections than others. Here are the common culprits, along with how they're treated during pregnancy.

Relaxed Pregnant Woman with Hands on Bare Belly
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Your body transforms in many ways when you're pregnant, and an increase in vaginal discharge just happens to be one of those (not-so-fun) changes. If the discharge is clear or white and odor-free, it's most likely caused by pregnancy hormones, and it's a sign that the vagina is healthy. But sometimes excess discharge signals an infection, which occurs when the natural balance of bacteria that lives in the vagina is disrupted.

During pregnancy, your OB-GYN will probably look out for these four organisms—bacterial vaginosis (BV), yeast infections, group B strep (GBS), and trichomoniasis—that can impact vaginal health. The good news is that when vaginal infections are diagnosed early, they're generally easy to treat. The tricky part is differentiating between normal discharge and discharge that signals an actual infection. Here, we break down the causes of each infection, the symptoms, the treatments, and preventative tips.

Bacterial Vaginosis (BV)

Approximately 1 in 5 pregnant people will develop this malodorous, irritating infection, according to the National Institutes of Health. Bacterial vaginosis, or BV, occurs when there is an overgrowth of bacteria that naturally lives in the vagina which, during pregnancy, can be influenced by shifting hormones.

If left untreated, BV symptoms can persist, causing discomfort and increasing the risk for other vaginal infections since the health of the vagina is compromised. These increased infections can then increase the risk of preterm birth. The good news is BV can be diagnosed with a simple vaginal test; the healthcare provider inserts a swab, collects a sample of your discharge, and looks at it under a microscope.

The symptoms

  • Thin grayish-white discharge
  • Fishy odor
  • Itching or burning sensation

How it's treated

BV sometimes goes away on its own and is not considered an STD since you do not have to have sex to acquire it. A course of antibiotics, usually metronidazole or clindamycin, generally does the trick.

How to prevent it

  • Use warm water without soap to cleanse the outside of your vagina. Soap can irritate your vagina. 
  • Wear comfortable, cotton underwear that will allow air to circulate. Avoid tight pantyhose or pants, which can cause bacteria-inducing sweat.
  • Sleep without underwear to reduce your risk of infections.
  • Wipe front to back when you go to the bathroom; this will keep bacteria spreading from your anus to your vagina.
  • Avoid douching as it upsets the balance of good and harmful bacteria in your vagina.
  • Refrain from having sex and limit sexual partners. Even though you can get BV without having sex, it is more common in people who are sexually active.

Yeast Infection

The itching and burning brought on by a yeast infection is usually caused by an overgrowth of Candida, a fungus that naturally lives in the vagina. During pregnancy, increased levels of estrogen and progesterone help create the kind of environment in which yeast can thrive.

Other factors that can increase your risk of getting a yeast infection include recent use of antibiotics, insulin resistance or diabetes, vaginal dryness, or douching—all of which can disrupt the natural pH in your vagina. A health care provider can diagnose a yeast infection with a simple vaginal test; they insert a cotton swab, collect a sample of your discharge, and look at it under a microscope.

The symptoms

  • Pain and itching in the vagina (the area can sometimes feel "raw")
  • Redness and swelling of the vagina and labia
  • Thick, curdled whitish-yellow discharge, which may or may not have an odor that smells like bread baking
  • Pain or discomfort during sex
  • Burning while urinating

How it's treated

Vaginal yeast infections are treated with a cream or ovule that you insert into your vagina, or an oral antifungal medicine such as Diflucan (fluconazole).

How to prevent it

  • Wear breathable (or no) underwear to reduce excess moisture, which invites yeast to breed
  • Stay well hydrated (aim for your urine to be a light yellow color)
  • Aim to eat more complex carbohydrates and whole grains over refined sugar to help decrease the environmental factors for infections.
  • Consume yogurt often. (Lactobacillus, a probiotic that is naturally found in yogurt, promotes proper digestion and is known to help prevent vaginal infections.)
Relaxed Pregnant Woman with Hands on Bare Belly
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Group B Strep (GBS)

According to Myra Wick, M.D., an OB-GYN at the Mayo Clinic in Rochester, Minnesota, 20% to 25% of people have colonized GBS bacteria living in their system, usually in the intestinal tract, rectum, or vagina. Your doctor will automatically test you for GBS between weeks 35 and 37 of your pregnancy.

GBS is not considered a true infection, though it can occasionally cause UTI symptoms if a lot is growing in your urine. The primary reason it is important to know if you have GBS colonization prior to delivery is that babies passing through the birth canal can get sick from GBS. Therefore, GBS positive pregnant people are encouraged to use antibiotics during delivery to reduce risk to the baby.

The symptoms

GBS is a normal bacteria found in the genital tract and does not typically cause symptoms. However, it is important to know if you are colonized with GBS prior to delivery because you may need antibiotics prior to delivery to prevent your baby from getting sick from GBS exposure.

How it's treated

If you test positive for GBS, you'll receive antibiotics through your IV during your delivery so that you don't pass the infection to your baby. Without antibiotics, your baby is at risk for early-onset GBS disease, which can cause sepsis, meningitis, and in rare cases, even death.

How to prevent it

Some believe that a nutritious diet low in processed sugars and high in foods that promote gut health like garlic and fermented foods can decrease your chances of GBS colonization.

Trichomoniasis

With an estimated 2+ million new cases each year, trichomoniasis—or "trich"—is one of the most common and most curable sexually transmitted infections (STIs), according to the Centers for Disease Control and Prevention (CDC).

The symptoms

  • Greenish-yellow, frothy, foul-smelling discharge
  • Itching, burning, and possible irritation during sexual intercourse
  • Bleeding after intercourse
  • Over 70% of people have no symptoms at all

How it's treated

A health care provider will most likely treat you with oral antibiotics, such as metronidazole and tinidazole.

How to prevent it

  • Get tested so that if you or your partner has trich you can get it treated before the other one catches it.
  • Use a condom to help prevent spreading this infection should you or your partner have it.
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Sources
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  1. U.S. Department of Health and Human Services, Office on Women's Health. Bacterial vaginosis.

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