Bacterial Vaginosis During Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, CDC, NIH guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with bacterial vaginosis during pregnancy, here is what you need to know.
The short answer
Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance in the natural bacteria of the vagina. It affects up to 30% of pregnant people. BV during pregnancy has been associated with increased risk of preterm birth and premature rupture of membranes, so it is important to be treated if diagnosed.
Key takeaways
- Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance in the natural bacteria of the vagina. It affects up to 30% of pregnant people. BV during pregnancy has been associated with increased risk of preterm birth and premature rupture of membranes, so it is important to be treated if diagnosed.
- Usually normal when: Increased clear or white vaginal discharge without strong odor is normal in pregnancy
- Call your doctor if: Discharge accompanied by pelvic pain, fever, or contractions
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to ACOG, CDC, NIH guidelines, bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance in the natural bacteria of the vagina. It affects up to 30% of pregnant people. BV during pregnancy has been associated with increased risk of preterm birth and premature rupture of membranes, so it is important to be treated if diagnosed. At First trimester, bV can occur at any time during pregnancy. Symptoms include thin, grayish-white vaginal discharge with a strong fishy odor, especially after intercourse. Some people have no symptoms at all. If you notice unusual discharge, tell your provider. Treatment with pregnancy-safe antibiotics (oral or topical metronidazole or clindamycin) is recommended. It is generally considered normal when increased clear or white vaginal discharge without strong odor is normal in pregnancy. However, you should contact your pediatrician promptly if discharge accompanied by pelvic pain, fever, or contractions.
Normal vs. Concerning
By Age
What to expect by age
First trimester
BV can occur at any time during pregnancy. Symptoms include thin, grayish-white vaginal discharge with a strong fishy odor, especially after intercourse. Some people have no symptoms at all. If you notice unusual discharge, tell your provider. Treatment with pregnancy-safe antibiotics (oral or topical metronidazole or clindamycin) is recommended.
Second trimester
BV that is detected and treated reduces the risk of associated complications. Avoid douching, use only water to clean the vulvar area, wear cotton underwear, and avoid scented products in the vaginal area. BV is not considered a sexually transmitted infection but can be triggered by changes in vaginal flora.
Third trimester
Untreated BV in the third trimester may increase the risk of preterm premature rupture of membranes and preterm labor. If you develop symptoms, report them promptly. Treatment is safe and effective at this stage. BV can recur, so tell your provider if symptoms return.
What to Tell Your Pediatrician
- Describe when you first noticed bacterial vaginosis during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if thin, grayish-white discharge with a noticeable fishy smell.
- Mention if vaginal burning or itching with unusual discharge.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Increased clear or white vaginal discharge without strong odor is normal in pregnancy
- Mild changes in discharge consistency are expected during pregnancy
- Thin, grayish-white discharge with a noticeable fishy smell
- Vaginal burning or itching with unusual discharge
- Any change in discharge color, consistency, or odor
- Discharge accompanied by pelvic pain, fever, or contractions
- Heavy watery discharge that could be amniotic fluid rather than vaginal discharge
What You Can Do at Home
- Keep track of when you notice bacterial vaginosis during pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that increased clear or white vaginal discharge without strong odor is normal in pregnancy — this is generally within the range of normal.
- At First trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if discharge accompanied by pelvic pain, fever, or contractions.
Related Conditions
Yeast Infections During Pregnancy
Yeast infections are more common during pregnancy due to higher estrogen levels and changes in vaginal pH that promote Candida overgrowth. They affect about 1 in 4 pregnant people. While uncomfortable, yeast infections do not harm the baby during pregnancy. Topical antifungal treatments are safe and effective during pregnancy.
Normal Vaginal Discharge Changes in Pregnancy
Increased vaginal discharge (leukorrhea) is a normal and expected change during pregnancy. It is typically thin, white or clear, and mild-smelling. This increased discharge helps protect the birth canal from infection and maintains a healthy balance of bacteria. Changes in color, odor, or consistency may indicate an infection and should be evaluated.
Preterm Labor Signs
Preterm labor is labor that begins before 37 weeks of pregnancy and affects about 10% of pregnancies. Recognizing the signs early is critical because treatment can often delay delivery, giving the baby more time to develop. Signs include regular contractions, lower back pain, pelvic pressure, vaginal discharge changes, and fluid leaking. Contact your provider immediately if you suspect preterm labor.
Related Resources
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is bacterial vaginosis during pregnancy normal?
When should I call the doctor about bacterial vaginosis during pregnancy?
When is bacterial vaginosis during pregnancy normal?
What causes bacterial vaginosis during pregnancy?
What should I mention to my pediatrician about bacterial vaginosis during pregnancy?
Is bacterial vaginosis during pregnancy normal at First trimester?
Is bacterial vaginosis during pregnancy normal at Second trimester?
Should I go to the ER for bacterial vaginosis during pregnancy?
Does bacterial vaginosis during pregnancy go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Bacterial Vaginosis During Pregnancy.
Things to mention
- Describe when you first noticed bacterial vaginosis during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if thin, grayish-white discharge with a noticeable fishy smell.
- Mention if vaginal burning or itching with unusual discharge.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Thin, grayish-white discharge with a noticeable fishy smell
- Vaginal burning or itching with unusual discharge
- Any change in discharge color, consistency, or odor
Urgent signs to report immediately
- Discharge accompanied by pelvic pain, fever, or contractions
- Heavy watery discharge that could be amniotic fluid rather than vaginal discharge
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of bacterial vaginosis during pregnancy are normal. Talk to your pediatrician if discharge accompanied by pelvic pain, fever, or contractions.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Maternal Concerns
Yeast Infections During Pregnancy
Yeast infections are more common during pregnancy due to higher estrogen levels and changes in vaginal pH that promote Candida overgrowth. They affect about 1 in 4 pregnant people. While uncomfortable, yeast infections do not harm the baby during pregnancy. Topical antifungal treatments are safe and effective during pregnancy.
Normal Vaginal Discharge Changes in Pregnancy
Increased vaginal discharge (leukorrhea) is a normal and expected change during pregnancy. It is typically thin, white or clear, and mild-smelling. This increased discharge helps protect the birth canal from infection and maintains a healthy balance of bacteria. Changes in color, odor, or consistency may indicate an infection and should be evaluated.
Preterm Labor Signs
Preterm labor is labor that begins before 37 weeks of pregnancy and affects about 10% of pregnancies. Recognizing the signs early is critical because treatment can often delay delivery, giving the baby more time to develop. Signs include regular contractions, lower back pain, pelvic pressure, vaginal discharge changes, and fluid leaking. Contact your provider immediately if you suspect preterm labor.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.