What happens if you have a yeast infection while pregnant

During pregnancy, a woman is at an increased risk of contracting several different types of infections, including urinary tract infections (UTI) and bacterial vaginosis (BV).

A yeast infection is another condition that is very common for expecting mothers, especially during their second and third trimesters. You already may be well aware of yeast infections. An estimated 75% of all women have a yeast infection in their lifetime.

While a yeast infection can be quite annoying and uncomfortable (particularly during the third trimester of pregnancy), it is generally harmless and can be easily treated with antifungal medication. Still, it's important to treat this condition as early as possible. Because you want to avoid transferring the infection to the baby during labor and delivery.

Read below to find out more about this condition, the causes, available treatments, and how to prevent one in the future.

What Is a Yeast Infection?

 A vaginal yeast infection (vaginal candidasis) is a fungal infection that causes irritation and discharge of the vagina.  Under normal circumstances, the vagina keeps a healthy balance of its pH (acid level) and the amount of yeast inside of it. This balance acts as a type of protection and helps kill off bad bacteria. When a yeast infection occurs, the levels of acid and yeast in the vagina become unbalanced and allow the yeast to overgrow, which causes uncomfortable symptoms.

A yeast infection is not a sexually transmitted infection (STI), but women often develop the condition after they first become regularly sexually active. It may also be linked to mouth-to-genital contact (oral-genital sex). This infection affects up to 3 out of 4 women, making it extremely common. Fortunately, yeast infections are not considered serious and can be cured within two weeks with appropriate treatment.

Why Are Yeast Infections Common During Pregnancy?

Yeast infections are much more common in pregnant women because of the hormonal changes happening in their bodies. They are notoriously difficult to treat during pregnancy. 

Pregnancy increases the release of the hormone estrogen, which is known to upset the vagina's chemical balance. Pregnant women also have a higher amount of sugar in their vaginal secretions, making it easier for the yeast to grow.   These factors will also increase the risk of contracting a yeast infection:

• Hormonal changes that come with pregnancy or before your period
• Taking hormone medication
• Taking antibiotics
• Taking steroids
• Having high blood sugar or diabetes
• Vaginal intercourse
• Douching
• The vagina comes into contact with blood or semen
• An impaired immune system

What Are the Symptoms of a Yeast Infection?

The symptoms of a yeast infection during pregnancy can vary by how far the infection has progressed.  It generally includes one or more of the following:

• An increased amount of discharge
• Watery vaginal discharge
• Discharge that looks white/tan in color, or possibly green/yellow
• Discharge that looks similar to cottage cheese (odorless)
  
• Discharge smells like yeast/bread
• Itching or irritation in the vagina and vulva
• Redness or swelling of the vulva
• Burning sensation during urination or intercourse

Pregnant women are more likely to have what's called a "complicated yeast infection." This simply means that you may experience multiple yeast infections throughout your pregnancy, which can create chronic symptoms that take longer to resolve. This is considered normal and is not a cause for concern, especially if you are in your second or third trimester.

How Is a Yeast Infection Diagnosed?

If you suspect that you might have a yeast infection, make an appointment with your doctor right away. Treating yeast infections early can save you from experiencing more uncomfortable symptoms of a yeast infection during pregnancy. 

At the doctor's office, your doctor will provide a pelvic exam and use a small tool to painlessly swab your discharge or vaginal secretions. The sample is put under a microscope, where a physician can identify and diagnose an infection.

How Is a Yeast Infection Treated?

In normal circumstances, doctors usually prescribe a single-dose oral medication called Diflucan that can clear up an infection within a few days. However, this medication has not been proven to be safe to take during pregnancy and should be avoided if possible.

Instead of an oral pill, doctors will recommend you take vaginal creams and suppositories to cure the infection. These are anti-fungal medications that fight off overgrown yeast and restore the vaginal balance. Only certain creams and suppositories are safe to use during pregnancy. Treatments like Terazol or Monistat are generally considered safe for pregnant women, but make sure to consult with your doctor to get their professional opinion.

It may take up to two weeks to fully get rid of a yeast infection, but the uncomfortable symptoms may subside within the first few days. After the infection has cleared, it may be beneficial to use a starch-free drying powder to prevent another infection.

Can a Yeast Infection Harm My Baby?

Yeast infections rarely cause any complications for you or your baby. These common infections, particularly during the second and third trimesters, are easy to treat and tend to stay localized in one area.

But an untreated yeast infection has the possibility of passing to your baby's mouth during labor and delivery. This condition is called "thrush.", You want to avoid thrush. Still, it can be treated with the Nystatin, another anti-fungal medication. So pregnant women need to visit their doctor as soon as they start experiencing symptoms.

That said, if a persistent yeast infection during pregnancy gains steam and travels through the vagina or blood, there is a risk, albeit low, of complications.  It can in rare cases cause chorioamnionitis, prematurity, endometriosis, and neonatal sepsis.

How Can I Prevent a Yeast Infection?

You do not need to be dealing with an untreated yeast infection during the third trimester of your pregnancy.  You have enough to worry about. So an untreated yeast infection during pregnancy is a complication you want to avoid. There are several different steps you can take to prevent a yeast infection from occurring or recurring:

• Wear loose, breathable cotton underwear.
• After showering, use your blow dryer on a low, cool setting to help dry the outside of your genital area.
• Always wipe from front to back when using the restroom.
• Avoid wearing damp, wet clothes. Change your clothes immediately after swimming or working out.
• Include yogurt with the bacteria "lactobacillus acidophilus" in your diet.
• Limit your sugar intake, as sugar promotes the growth of yeast.

Avoid using these:

• Tight-fitting pants or pantyhose
• Douching
• Feminine hygiene sprays
• Sanitary pads and tampons that contain deodorant or scents
• Taking a bubble bath or sitting in a hot tub
• Using scented soaps
• Using colored or perfumed toilet paper

Dealing with a Yeast Infection During Pregnancy

Overall, yeast infections are more of a nuisance than a concern during pregnancy.  But there are enough rare occasions with tragic outcomes not to not only keep an eye on your yeast infection but to also consult with your doctor to make sure it is under control.

But the good news is as awful as yeast infections can be, they are usually easy to treat and only rarely present long-term complications.

If your symptoms are particularly hard to manage, talk to your doctor about other over-the-counter medications that specifically treat burning sensations, itchiness, and swelling. Remember to completely finish the entire course of medication to get rid of the infection completely and prevent it from coming back.

Sources and Additional Literature

Elkady, A., Sinha, P., & Hassan, S. A. Z. (Eds.). (2019). Infections in Pregnancy: An Evidence-Based Approach. Cambridge University Press.

Vieira-Baptista, P., & Bornstein, J. (2019). Candidiasis, Bacterial Vaginosis, Trichomoniasis, and Other Vaginal Conditions Affecting the Vulva. Vulvar Disease (pp. 167-205). Springer, Cham.

Jeanmonod, R., et al. (2019). Vaginal Candidiasis (Vulvovaginal Candidiasis). StatPearls.

Presterl, E., et al. (2019). Medical Mycology: Fungal Infections. Basic Microbiology and Infection Control for Midwives (pp. 155-159). Springer, Cham.

Chatzivasileiou, P., & Vyzantiadis, T. A. (2019). Vaginal yeast colonisation: From a potential harmless condition to clinical implications and management approaches-A literature review. Mycoses: Diagnosis, Therapy, and Prophylaxis of Fungal Diseases.

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