By Sheila Kaufman, MSN, CNM, WHNP-BC, Certified Nurse Midwife, Virtua Midwifery

During pregnancy, you may notice changes in your vaginal discharge due to hormonal shifts. Even before pregnancy, vaginal discharge can vary from day to day or week to week. However, certain types of vaginal discharge shouldn’t be ignored, especially during pregnancy.

If you have pregnancy discharge concerns, knowing what’s typical versus what may need medical attention can help put your mind at ease. Here’s what you need to know about vaginal discharge changes that may require evaluation or treatment from your midwife or OB.

Understand pregnancy discharge color changes and causes

White or off-white

White or off-white, thin, mostly odorless discharge during pregnancy is called leukorrhea. Leukorrhea is especially common in pregnancy for several reasons, including:

• The high estrogen levels women experience during pregnancy
• The cervix creating more mucus to protect the pregnancy
• An increased blood flow to the vaginal walls

Nearly every pregnant woman experiences this, but it’s not dangerous or harmful. Here are some helpful tips:

• Avoid using a panty liner or pad, as this can cause irritation and increase the chance of infection.
• Avoid douching or using feminine hygiene cleansers, as they can disrupt the natural flora that protects the vagina from infection.
• Wear cotton underwear and change it more frequently if the discharge is bothersome.
• Wash your vulva with warm water—there's no need for harsh soap or cleansers.

Clumpy and white or off-white

If you experience thick or clumpy discharge, it may be because yeast is present. About 1 in 4 women have vaginal yeast overgrowth during pregnancy. This is usually accompanied by internal and/or external itching of the vulva and vagina.

Yeast or a yeast infection won’t hurt the baby, so there’s no need to hit the panic button. However, you’ll want to talk to your OB provider to determine if you need treatment. Call if you experience burning or itching along with increased discharge.

Most providers prefer to treat yeast infections in pregnancy locally using a vaginal cream for seven nights, instead of using an oral medication that can cross the placenta. Talk with your OB provider about what's safest for you and your baby.

Yellow or green

If you experience darker yellow or green discharge with a strong or fishy odor, burning, or itching, call your OB provider. These can be signs of two vaginal infections: bacterial vaginosis (the overgrowth of common bacteria that causes vaginal inflammation) or trichomoniasis (a sexually transmitted infection caused by the parasite trichomonas vaginalis).

These symptoms may also be a sign of other sexually transmitted infections, such as gonorrhea or chlamydia. You're usually screened for infections at your first visit, but you can be retested at any time during the pregnancy. These infections can cause problems at your baby's birth, but are easily treated with antibiotics. Careful condom use can reduce your risk for these infections.

Brown or red

Generally, red or brown bloody discharge isn’t considered “normal” during pregnancy and is a reason to call your provider. At the same time, many things can cause bloody discharge that aren’t related to a pregnancy complication.

It can be common to experience spotting after intercourse during pregnancy because of the increased estrogen levels. Vaginal infections can also cause spotting in pregnancy.

Still, you shouldn't wait to discuss it until your next prenatal visit if you're experiencing spotting, bleeding, or brown discharge. Don’t panic, but call your provider right away. They will help you determine the appropriate next steps.

Watery and clear or light yellow

If you experience a gush or continuous trickle of watery fluid during pregnancy, it may be either urine or amniotic fluid.

It’s common to experience incontinence (the involuntary loss of urine) during pregnancy, especially in later stages when your growing baby is pressing on your bladder. However, it can be challenging to know whether you’re leaking urine or amniotic fluid. When in doubt, call your OB provider. They can do an exam in the office or hospital to determine if your water has broken.

If you have frequent urinary incontinence or bladder leaks, talk with your provider about exploring pelvic physical therapy and other solutions.

If you’re unsure about a symptom, always call your OB provider instead of worrying that something is wrong.

Virtua experts are here to help you have a healthy pregnancy

• Find a Virtua pregnancy care provider near you and schedule an appointment online.
• Virtua Health offers a variety of in-person and virtual maternity and breastfeeding classes and interactive courses, including childbirth preparation, baby basics, and more. See all the maternity classes.