Discharge and bleeding in pregnancy: what is usual and when to call

You noticed more moisture in your underwear, or a drop of blood, and your stomach dropped. That is a very understandable reaction. Discharge and light spotting are common in pregnancy, but some signs do need to be shared with your doctor. This article is here to help you tell the difference calmly.

What does usual discharge look like?

In pregnancy, oestrogen rises and more blood flows to the vagina. As a result, most people notice clearly more discharge. Usual discharge tends to be:

• Milky white or clear,
• Thin or slightly thick in texture,
• Without a strong smell (there may be a mild, slightly sweet scent),
• Free of itching and burning.

The amount may grow as pregnancy goes on. A panty liner can feel comfortable, but tampons and vaginal douches are not recommended. Cotton underwear and gentle washing of the outer genital area are enough.

Changes in discharge to watch for

The following can be signs of an infection and need a doctor's assessment:

• Green, yellow or grey colour
• A fishy or unpleasant smell
• Thick white, cottage-cheese-like discharge with strong itching
• Burning, redness in the vagina, or burning when passing urine
• Pain in the lower abdomen

Yeast and bacterial infections can occur in pregnancy and can usually be treated. It is important not to leave them untreated, but please do not use any medicine or cream on your own; check with your doctor first.

Watery discharge: could it be amniotic fluid?

A thin, watery, odourless discharge, or a sudden gush of fluid, can be confused with leaking urine. Especially before week 37, it raises the possibility that the membranes have broken early. Do not wait in that case; call your doctor or go to the maternity hospital.

Bleeding: not all bleeding is the same

Light spotting is fairly common in early pregnancy. The reasons can include the embryo settling into the uterus, a sensitive cervix, or a small leak after intercourse. Often nothing is wrong, but reporting every bleed to your doctor is the safest path. Light bleeding can also happen near the end of pregnancy, such as a pink or bloody mucus plug showing that the cervix is starting to open.

At any stage, if one of these features is present, the situation should be assessed more seriously:

• Bleeding that soaks a pad or includes clots
• Cramp-like or severe pain in the abdomen or back
• Dizziness, weakness, feeling faint
• Fever or chills along with the bleeding

What you can do

• Note when the bleeding started, its colour and amount (for example, number of pads).
• Avoid intercourse and tampons while bleeding.
• Rest; having someone close by can help.
• If you are tracking the baby's movements (kick counter), reduced movements should also be reported.
• If your blood group is Rh negative, tell your doctor about any bleeding; they will assess whether extra steps are needed.

Small tips

• White or yellowish marks can dry on your underwear and turn yellow through contact with air; this alone is not a problem.
• Light spotting after intercourse can come from a sensitive cervix. If it repeats or is heavy, tell your doctor.
• Spotting after an examination can also occur; it is expected to pass within a few hours.
• If something unsettles you, you can call even without a specific symptom or number to point to. Your instincts count.
• Talking with your partner about bleeding or discharge helps share the load; you can also discuss questions about intimacy with your doctor openly.

When to contact your doctor

• Heavy bleeding, bleeding that soaks a pad, or clots: go to the emergency room or call 112 right away
• Bleeding with severe abdominal pain, dizziness or a feeling of fainting: call 112
• Any bleeding in the second half of pregnancy, even light: reach your doctor the same day
• Watery discharge or a leak of fluid
• Discharge that smells bad, changes colour or itches
• Fever, chills or fewer baby movements
• Whenever you are unsure, do not hesitate to ask

Calling is never a waste of time; doctors and midwives answer these questions every day.

This article is for information only; your doctor's or midwife's advice is what counts for your personal situation.