Pregnancy vaginal discharge: what's normal, signs of thrush and when to see a doctor

It's normal to have more discharge when you're pregnant. KKH says pregnancy hormones raise it to stop infections travelling up from the vagina to the womb. KKH's doctors describe normal pregnancy vaginal discharge as clear, white or creamy and runny, with no unpleasant smell. See your doctor if it itches, smells bad, turns green or brown or has blood in it. A watery gush or trickle means going to hospital.

What to do about vaginal discharge during pregnancy, step by step

1. Check the colour, smell and texture, and notice any itching or soreness. Families for Life says normal discharge is clear, white or creamy and runny.
2. Wear a panty liner if you like, and change it often. HealthHub says soiled pads and liners can raise the risk of infection.
3. Use a pad, not a tampon, if you think you're leaking fluid. The RCOG (UK) says to note the colour and amount.
4. Wear loose cotton underwear, as KKH advises. Skip tight clothes in hot weather, since HealthHub says trapped heat and moisture help fungus grow.
5. Wash the outside with mild soap and water only, as HealthHub advises. Families for Life says douches and scented wipes can irritate, and KKH says skipping perfumed soap helps prevent infection.
6. Wipe from front to back after the toilet, as HealthHub advises.
7. Don't treat suspected thrush yourself. HealthHub says to see a doctor if you're pregnant, and that oral fluconazole can't be used in pregnancy.
8. Tell your gynae or polyclinic doctor about any change. They may take a vaginal swab, and KKH says most infections are treated with antibiotics or vaginal pessaries.
9. Go straight to hospital if you feel a gush or a steady trickle. SGH says leaking waters can be mistaken for discharge or urine.

Why you have more discharge in pregnancy

KKH doctors writing for Families for Life say you may notice a lot more discharge from around week 12. A bigger blood supply and a softer cervix and vaginal walls both add to it. Near your due date, your baby's head pressing on the cervix adds more. Normal discharge has its own scent, but it shouldn't smell unpleasant.

The NHS says the amount rises again towards the end of pregnancy, and in the last week or so you may see streaks of sticky, jelly-like pink mucus. That's the show, mucus from your cervix coming away, and our guide to signs of labour in Singapore explains what to do when you see it.

Thrush, BV and other infections

Being pregnant is on HealthHub's list of things that raise your chance of thrush. The discharge is thick and creamy white, like cottage cheese, with itching or pain in and around the vagina; SGH notes that it usually has no smell.

Bacterial vaginosis (BV) looks different. SGH describes a thin, off-white discharge with a fishy smell that's more noticeable after unprotected sex. SGH says BV without symptoms often needs no treatment, but pregnancy after a previous preterm birth is an exception. If you've had a baby early before, tell your gynae.

Trichomonas is a sexually transmitted infection. SGH lists a foul-smelling, yellow-green discharge and itching, and says every case needs treating, even without symptoms. Your partner needs testing and treatment too. SGH says chlamydia, gonorrhoea and herpes can also cause discharge. Our guide to CMV and herpes in pregnancy covers herpes.

Group B strep is a separate check. KKH says most women who carry it have no symptoms, so your discharge won't show it. KKH offers a swab between 35 and 37 weeks if you're planning a vaginal birth. Our group B strep guide explains the test.

Treating thrush when you're pregnant

Pharmacies sell thrush treatments, but HealthHub says pregnant women should see a doctor instead. It also says oral fluconazole can't be used in pregnancy. The NHS says some thrush medicines aren't for pregnancy, and that thrush in pregnancy is easily treated. Families for Life says most vaginal infections, thrush included, can be treated with creams or antibiotics.

HealthHub advises no sex until thrush has fully cleared; our guide to sex during pregnancy covers the other times to pause. If you're weighing up any other medicine, our guide to safe medicine during pregnancy walks through how to check it.

What you see and what to do

Use this to decide who to call. It can't tell you what you have, and your doctor may need a swab for that.

Discharge, urine or waters?

These can be hard to tell apart. Families for Life says discharge and urine can look alike, and SGH says leaking waters get mistaken for both. Waters can come as a sudden gush or a continuous trickle. If you're not sure, HealthHub says to see your doctor immediately, because a leak puts you at risk of infection and labour. Put on a pad so the colour and amount can be checked.

Our guide on how to know if your water broke compares them side by side. For urine, see bladder leaks in pregnancy.

When to see a doctor

Call your gynae's clinic or your polyclinic doctor if you notice any of these:

• Itching, soreness, an unpleasant smell or a fever (KKH).
• A lot of discharge, especially if it's green or brown (KKH), or a green or fishy-smelling discharge (HealthHub).
• Thick, curd-like discharge, or pain in your lower tummy or during sex (Families for Life).
• Pain when you pee (NHS, SGH).
• Any blood in your discharge (KKH). Families for Life says to call your doctor straight away. See bleeding in early pregnancy.
• A sudden gush or steady trickle of fluid (SGH). Go to the hospital rather than wait.
• Regular, painful tightening from 25 to 37 weeks, or blood-stained mucus with painful contractions before your due date (HealthHub). Read premature labour signs.

For leaking fluid, bleeding or signs of labour, go to your delivery hospital. KKH asks you to go to its Delivery Suite, Level 2 of the Women's Tower, from 22 weeks. Before 22 weeks, go to its 24-hour Urgent O&G Centre in Basement 1 of the Women's Tower (6294 4050). SGH's Labour Ward 52A, Block 5 Level 2, sees women from 20 weeks; before that, go to its Emergency Department. SCDF lists excessive bleeding as an emergency: call 995.

Frequently asked questions

Is pregnancy vaginal discharge normal?

Yes. KKH says more discharge is normal in pregnancy, because it helps stop infections reaching the womb. Families for Life says you may notice the increase from around week 12. Call your doctor if the colour, smell or texture changes, or it itches.

How much vaginal discharge during pregnancy is too much?

There's no set amount. HealthHub says to tell your doctor if there's an excessively large amount, or if the texture, colour or smell changes. KKH flags heavy discharge that's greenish or brownish.

How do I know if it's thrush in pregnancy?

HealthHub describes thrush as thick, creamy white discharge like cottage cheese, with itching or soreness, and SGH says it usually doesn't smell. Because other infections can look much the same, see your doctor before you use any treatment.

What does smelly discharge in pregnancy mean?

A fishy smell can point to BV, and a foul-smelling yellow-green discharge to trichomonas, SGH says. You can't tell which at home. KKH lists an unpleasant smell as a reason to see your doctor, who may take a swab.

Is it discharge or my waters breaking?

Leaking waters can be a sudden gush or a continuous trickle, SGH says, and are easy to mistake for discharge or urine. If you're not sure, HealthHub says to see your doctor immediately. Wear a pad, not a tampon, as the RCOG advises, so the colour and amount can be checked.

Should I wear pantyliners every day in pregnancy?

Families for Life suggests panty liners, changed through the day, to stay fresh. SGH's gynaecology team, writing for all women, advises against wearing them daily. Either way, change them often, and wash with mild soap and water rather than a douche or scented wipe.