Everything to Know About Vaginal Infections During Pregnancy

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.

Four vaginal infections, ranging from common to more rare, can affect pregnant people: bacterial vaginosis (BV), yeast infections, group B strep (GBS), and trichomoniasis. 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 itchy, 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 will persist and the baby may be born early or have a low birthweight. (In those who are not pregnant, BV can lead to pelvic inflammatory disease, which can cause infertility or damage the fallopian tubes.) The good news is BV can be diagnosed with a simple vaginal culture; the health care provider inserts a swab, collects a sample of your discharge, and looks at it under a microscope.

The symptoms

• Thin grayish-white discharge
• Pain during urination
• Itching around the vagina

How it's treated

BV sometimes goes away on its own. If you are in your first trimester, your health care provider may wait to treat it until your second trimester. A course of antibiotics, usually metronidazole or clindamycin, generally does the trick.

How to prevent it

• Never sit around in a wet bathing suit or sweaty panties; always put on a clean pair of cotton underwear after you're finished swimming or working out.
• 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.
• Skip bath oils—they can trap bacteria.

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 causes of yeast infections include taking antibiotics and having penetrative sex, both of which can disrupt the natural pH in your vagina. A health care provider can diagnose a yeast infection with a simple vaginal culture; 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 cotton underwear, which will allow air to circulate and absorb any discharge.
• Sleep without underwear to reduce your risk of infections.
• Stay well hydrated to help flush out toxins (aim for your urine to be a light yellow color)
• Urinate regularly to help eliminate infection-causing bacteria.
• 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.)

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 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.

Because many healthy people have GBS living in their bodies with no symptoms, it's unclear why some individuals develop more serious infections from GBS while others do not. However, if you have the bacteria, it can be dangerous and even life-threatening to your baby if it passes to them during delivery, so it is very important to know if you are GBS positive before giving birth.

The symptoms

GBS may cause a urinary tract infection (UTI) in some people, but most often, it causes no symptoms at all. Symptoms of a UTI include pain or burning during urination, cloudy urine, and a sudden urge to urinate.

How it's treated

If you test positive for GBS, you'll receive at least two doses of antibiotics (if possible) 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 causes fever, difficulty feeding, lethargy, and in rare cases, even death.

How to prevent it

There is no way to prevent GBS and for most adults, it's not dangerous.

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
• Discomfort when peeing
• 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.