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​​Most women would notice an increase in vaginal discharge during pregnancy. This is quite normal and is caused by a combination of factors — increased blood supply, softening of the cervix and vaginal walls, and later, stimulation from the baby’s head, as he or she presses against the cervix ready for labou​​r

Normal vaginal discharge is clear, white or creamy, and fairly runny. It may have a distinctive odour, but not an unpleasant smell. Signs of infection include thick, curd-like or greenish discharge, a nasty smell, itchy and soreness, low abdominal pain or pain during sex. 

When you are about to go into labour, your discharge may contain streaks of thick mucus and a little fresh blood, as the cervical mucus plug is dislodged from the cervix. This is known as the show. 

Having a show does not necessarily mean that labour is about to start, but it is a reasonable indication that the cervix is beginning to ripen or to prepare for labour. Some women have shows off-and-on for several days before the actual labour. 

What Can I Do About It? 

An increase in vaginal discharge is a normal part of pregnancy. Remind yourself that this discharge plays a part in protecting your uterus from infection ascending up the vagina. 

However, be aware of changes to your discharge, ​​and highlight this to your doctor if you think things may not be quite right. Your doctor may take a vaginal swab to check for an infection such as Candidiasis, Group B streptococcus (GBS) or Gardnerella. The result of this should be known within one week. Most vaginal infections can be effectively treated during pregnancy. 

Proper hygiene and, if necessary, the use of panty liners should keep you feeling fresh. Avoid excessive vaginal douches and scented hygiene wipes — as they may cause irritation and may upset the delicate acid/alkali balance of the vagina. 

Common Vaginal Infections in Pregnancy 

1. Vaginal candidiasis (moniliasis or thrush) 

This is a common and frequently distressing fungal infection for many women during pregnancy. It does not harm the baby during pregnancy or childbirth. Having vaginal thrush can cause extreme itch and clumps of white discharge. Because of the hormonal changes, pregnant women often get thrush, especially during the third trimester of pregnancy. Fortunately, it does not cause the baby any harm and can be easily treated by vaginal pessaries and cream. It may recur throughout pregnancy but usually has no long standing effects on the pregnancy. 

2. Group B streptococcal infection (GBS) 

Group B streptococcus is a type of bacteria found in the vagina and rectum in about 30–40% of women (read the article on Pregnancy Complications​​). 

Late in yo​ur third trimester you may be tested for GBS. Testing involves inserting a cotton swab into the vagina. The swab is then sent to the laboratory to see if this particular bacteria is present. 

If it is present, you will require intravenous antibiotics during labour to reduce the risk of infection in the baby. 

3. Gardnerella infection (bacterial vaginosis) 

This is a type of bacteria that is usually found in the vagina but is kept under control by the presence of other types of harmless bacteria that produce chemicals to keep the vagina slightly acidic. Bacterial vaginosis, caused by the overgrowth of these bacteria, can cause abnormal vaginal odor and discharge. It is common in pregnancy and has been found to be associated with a higher risk of preterm delivery and rupture of the membranes. This can be easily treated with antibiotics, either orally or inserted into the vagina.​ 

​4. Vaginal bleeding 

If you have bleeding from your vagina, put on a sanitary pad and observe its amount. Many women lose a small amount of blood at some point in their pregnancy and, often, this is of little significance. 

However, occasionally, vaginal bleeding may indicate a serious problem — a threatened miscarriage, a low-lying placenta or a polyp in the cervix — so it is always best to get advice from a doctor. 

It is wise to note the following: 

  • The color of the blood (dark or bright red). 
  • The quantity (just a smear, a teaspoon, a tablespoon, or soaking through pads and clothing). 
  • The presence or absence of pain (continual, cramping, contractions and so on). 
  • Whether you had sex recently. 
  • The frequency of your baby's movements (often a useful clue to his or her wellbeing). 
  • Your pregnancy details so far (including the results of any ultrasound scans​). 

How to Differentiate between Vaginal Discharge, Urine or Bleeding? 

It may be difficult at times to differentiate these symptoms. If you are unsure whether you have a heavy vaginal discharge, stress urinary incontinence, or are leaking amniotic fluid, put on a sanitary pad to check on the discharge. Consult your doctor as soon as you can.​ ​