Discharge in Pregnancy – What It Is, Why It Occurs and What Purpose It Serves

Did you know that an increase in discharge is one of the earliest signs of pregnancy? And as pregnancy progresses, the body continues to produce plenty of vaginal secretion, which can change in consistency and elasticity. Since these changes can be rather unsettling, we'll explain what kind of discharge is normal during pregnancy and when it's wise to see a specialist.

What is vaginal discharge?

Fluor vaginalis, known as vaginal discharge, is that white, whitish or clear fluid made up largely of cells and bacteria that is expelled through the vagina. This fluid is produced by the uterus, cervix and vagina, and serves to moisturise, flush out bacteria and prevent infection.

It's a natural self-cleaning mechanism of the vagina, and all girls notice this discharge roughly 1–2 years before puberty begins. As every woman is unique, it's perfectly normal for the amount, smell and consistency of the secretion to vary from person to person. However, if the colour, consistency or smell of the discharge changes, this may indicate an infection or another condition.

Why is vaginal discharge heavier during pregnancy?

You'll be familiar with this: discharge changes throughout the menstrual cycle as a natural response to hormonal fluctuations. It usually becomes heavier shortly before your period starts.

Exactly the same thing happens during pregnancy. As the baby grows, hormone levels change constantly and continue to influence the consistency, colour and amount of vaginal secretion. So not only is it normal to have discharge during pregnancy – it's equally normal for the amount to increase due to high oestrogen production and increased blood circulation in the vaginal area.

Changes to the cervix can also lead to heavier discharge during pregnancy. The cervix and vaginal walls become softer and more sensitive, which is why the body produces more secretion to prevent infection. And towards the end of the final trimester, pressure from the baby's head on the cervix can also cause a greater volume of discharge.

What role does vaginal discharge play during pregnancy?

Besides its basic function – moisturising and cleaning the vagina – discharge has an additional role during pregnancy. It becomes more abundant precisely in order to prevent possible vaginal or uterine infections. At the same time, it can point to an infection or an abnormality – so do speak to your doctor promptly if you notice worrying symptoms typical of infection.

And of course: if your pregnancy hasn't been confirmed yet, increased discharge could be exactly the sign you've been waiting for. Brownish discharge between periods can also be one of the earliest signs of pregnancy.

Types of vaginal discharge during pregnancy  

As your baby grows, your body adapts to keep pace with all the changes. Numerous hormonal fluctuations occur, and vaginal discharge changes markedly from the first to the last day of pregnancy. Depending on how your baby's development in each trimester affects you, you may notice various types of discharge – from clear and whitish to pink and red.

Discharge in the 1st trimester of pregnancy

In the 1st trimester the pregnancy implants, the embryo begins to grow and develop, and hormone levels start to change. The body adjusts to the new circumstances, and it's normal for the following to occur:

• Light bleeding in the 1st trimester: About one in four women notices light, short-lived bleeding around 10–14 days after conception, when the fertilised embryo implants in the lining of the womb (implantation bleeding). As a rule, this light bleeding during pregnancy is normal and requires no medical treatment – however, do speak to a specialist if the bleeding becomes heavy, has an unpleasant smell or is accompanied by severe pain.
• Whitish and clear discharge in the 1st trimester: This discharge tends to be watery and odourless, but just as normal as before pregnancy; as long as the consistency, colour and smell don't change, there's no cause for concern.

• Brownish discharge in the 1st trimester: It can be an early sign of pregnancy if it appears around week 7 as old blood that the body is expelling; however, it can also indicate a vaginal infection – which is why a specialist examination is advisable.

  

Discharge in the 2nd trimester of pregnancy 

In the 2nd trimester your baby continues to grow and vaginal discharge becomes ever heavier. You may lose about a teaspoon of whitish secretion each day – and that's perfectly normal. It's a mildly acidic secretion whose job is to keep the vaginal pH balanced and protect the uterus from bacterial or fungal infections.

There's cause for concern if this discharge changes consistency or is accompanied by itching and an unpleasant smell – usually a sign of a candida infection or a sexually transmitted disease. In this case a medical examination is needed to determine suitable treatment.

If brownish discharge with clots and abdominal pain occurs in the 2nd trimester, you should see a doctor immediately, as this may indicate a miscarriage or an ectopic pregnancy.

Discharge in the 3rd trimester of pregnancy 

In the third trimester you'll notice that discharge is at its heaviest. This is entirely natural, as major physiological changes are taking place in the body to prepare it for labour and birth. The following types of discharge may occur:

• Clear, gel-like discharge in the 3rd trimester: As the birth approaches and the cervix opens, a clear, gel-like discharge resembling egg white may appear – sometimes streaked with pink. It usually shows up in the final week of pregnancy and is a sign that the body is preparing for labour.
• Greenish discharge in the 3rd trimester: Greenish secretion in the final trimester may indicate a leak of amniotic fluid, which needs urgent medical assessment – particularly if traces of blood are also present. Although such secretion can be caused by things like stress, too much fat or too little fibre in the diet, or raised progesterone levels, the general rule is this: any yellowish or greenish discharge with an unpleasant smell is a sign of infection – in any trimester.

Vaginal discharge in pregnancy – when is a medical examination necessary? 

As a rule, healthy vaginal discharge – regardless of the stage of pregnancy – should be whitish or clear and shouldn't have an unpleasant smell.

However, it's extremely important to stay alert and speak to your doctor if you notice any unusual change: yellowish or greenish discharge, with or without itching and an unusual smell (which may indicate a bacterial or fungal infection), or discomfort when passing urine (which may be a sign of a urinary tract infection).

A medical examination is also recommended if the following occur:

• Grey or greyish discharge with an unpleasant smell: This may indicate bacterial vaginosis (for example following frequent intercourse or excessive douching) or urogenital trichomoniasis; a medical examination is needed for the correct diagnosis and treatment.
• Red discharge towards the end of the 2nd trimester or in the 3rd trimester lasting longer than 24 hours: In the final months of pregnancy, any vaginal bleeding that doesn't stop within a few hours is a medical emergency and must be assessed by a doctor; it may be a sign of infection, an ectopic pregnancy or even a miscarriage, and immediate treatment is necessary to protect the mother's health and indeed her life.
• Brownish discharge: In the first trimester it's harmless – it's simply old blood that the body is expelling; however, if dark brown discharge occurs during pregnancy, particularly in the later stages, you must contact your doctor straight away.

Intimate hygiene during pregnancy – tips and recommendations  

Intimate hygiene is crucial to every woman's reproductive health at every stage of life. This is all the more true during pregnancy: pay particular attention to your intimate care routine to protect your vaginal health and avoid disruption to the vaginal flora as well as infections that could harm your baby. With that in mind, it's advisable to:

• Wear cotton underwear, so the skin can breathe and bacteria don't build up.
• Avoid tight trousers and close-fitting clothing made from synthetic materials that don't let the skin breathe.
• Avoid hot tubs or very hot baths, as they can raise your body temperature to a level that's dangerous for your baby's development.
• Use a pH-neutral antibacterial intimate gel, such as the Enroush intimate gel, which is made with 95% natural ingredients and without parabens or other chemicals that can throw the vaginal flora off balance.

• Use Enroush pads made from 100% organic cotton, which contain no fragrance or other questionable chemicals and offer you gentle, hypoallergenic protection against vaginal discharge.

  

Vaginal bleeding during pregnancy – causes and possible complications

Light bleeding is normal during pregnancy, but heavy vaginal bleeding can have more serious causes that require specialist examination and treatment. The most common and most dangerous causes of bleeding in pregnancy include:

• Miscarriage: Losing a pregnancy within the first 20 weeks may involve heavy bleeding, the passing of tissue from the uterus and severe abdominal pain. Medical help is essential in these situations to prevent a possible infection.
• Ectopic pregnancy: This cannot be carried to term, as the embryo implants outside the uterus; it may be accompanied by lower abdominal pain, abdominal cramps, dizziness and weakness. Rapid diagnosis and medical intervention are crucial to prevent serious complications such as internal bleeding and haemorrhagic shock.
• Placenta praevia: Here the placenta lies in an unfavourable position, partly or completely covering the cervix; it can cause bleeding in the 2nd and 3rd trimesters, with increasing pain as pregnancy progresses. The condition raises the risk of premature birth and may make an emergency caesarean necessary to protect the lives of both baby and mother.
• Placental abruption: If the placenta partly or completely separates from the uterine wall before birth, this can cause heavy bleeding, pain and uterine contractions. Possible consequences include premature birth, the death of the baby, shock from blood loss or even the death of the mother – medical intervention is therefore vital.
• Premature labour: Labour that begins before the 37th week of pregnancy may show itself through vaginal bleeding, regular contractions, back pain and pelvic pressure.
• Infections of the cervix or vagina: Bleeding, unusual discharge with an unpleasant smell and discomfort when passing urine may indicate an infection such as bacterial vaginitis, cervicitis or certain sexually transmitted infections; left untreated, these can lead to premature birth and further complications.
• Cervical polyps: These are usually painless and harmless, but can cause bleeding after intercourse or a gynaecological examination – which is why specialist assessment is important.
• Subchorionic haematoma: This is a collection of blood between the placenta and the uterine wall, which usually resolves on its own; medical monitoring is nonetheless important, as a large haematoma can increase the risk of placental problems or even miscarriage.

How can vaginal bleeding during pregnancy be prevented?

Vaginal bleeding can't always be prevented. But you can do everything within your power to minimise the risk of conditions that cause vaginal bleeding – and with it the associated complications. The most effective preventive measures include:

• Regular check-ups with your gynaecologist to detect complications early
• A healthy lifestyle with a nutrient-rich diet and plenty of exercise
• Avoiding alcohol, tobacco and other harmful substances
• Avoiding excessive physical exertion, particularly in high-risk pregnancies
• Plenty of rest and, in certain cases, bed rest
• Abstaining from intercourse in problematic pregnancies, in line with medical advice
• Treating infections and managing chronic conditions, along with appropriate intimate hygiene

• Monitoring high-risk pregnancies in women who have previously had complicated pregnancies or repeated miscarriages.

  

Frequently asked questions about vaginal discharge during pregnancy

Vaginal discharge can be unsettling: how do you know what's normal and what isn't? If you still have questions, take a look at the section below – there we answer the most common questions about vaginal secretion during pregnancy.

What does vaginal discharge look like during pregnancy? 

Vaginal discharge changes constantly from the first to the last day of pregnancy and becomes heavier than usual.

In the first trimester you may notice light bleeding as part of implantation, as well as white or clear discharge. The closer you get to your due date, the more abundant and gel-like the discharge becomes – a sign that your body is preparing for labour.

How can you tell whether you have normal vaginal discharge or a bacterial infection? 

Healthy vaginal discharge is whitish, white or clear. Depending on the stage of pregnancy it may be more watery or more gel-like, sometimes with brownish streaks or brief traces of blood.

However, if bleeding lasts more than 24 hours, if discharge has an unusual consistency or smell, or if the secretion is greenish, yellowish, grey or greyish, these may be signs of a bacterial or fungal infection or of other complications – and an immediate medical examination is required.

What should you do if vaginal discharge changes colour and smell during pregnancy? 

If you notice changes in vaginal discharge during pregnancy, it's advisable to see a doctor promptly. Some changes are normal, but changes in smell and colour often indicate an infection or other problems – and these should be treated early to avoid serious complications.

How can you prevent vaginal infections during pregnancy?

To avoid vaginal infections and the associated risks during pregnancy, aim for as healthy a lifestyle as possible and pay particular attention to your intimate care routine.

Eat a nutrient-rich diet, get plenty of rest and avoid douching as well as tight clothing and underwear that doesn't let the skin breathe. Use organic pads made from 100% organic cotton and choose a natural intimate gel free from fragrance and parabens to protect your vaginal microbiome.

Is bloody vaginal discharge a cause for concern? 

Generally speaking, light bleeding without other symptoms is normal during pregnancy. About a quarter of all pregnant women notice light implantation bleeding in the 1st trimester, for example, which is entirely normal.

However, if the bleeding is heavy, lasts longer than 24 hours and is accompanied by severe pain or other unusual symptoms, it may be a sign of an infection, a miscarriage or an ectopic pregnancy – in which case it's very important to speak to your doctor to get the right diagnosis and treatment.

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