How to Maintain Vaginal Health in Pregnancy
I don't know about you, but my vagina is often a bit of an afterthought. No offense to her specifically, but I don't pay a whole lot of attention to what is going on down there... unless she is screaming at me for attention. (Yes, I am personifying my vagina- would you expect anything less from a homebirth midwife passionate about holistic women's health?) Pregnancy can bring your attention to your vaginal health quite quickly as it goes through an exceptional transformation to accommodate all the changes with sustaining life inside you.
How does a vagina "scream" at you, you may ask? Your vagina is an extremely intricate system influenced by the things you put in and around it: your hygiene and sexual habits, plus your hormone and gut health, just to name a few. Your vagina might "talk" to you with a change in odor, discharge or labia comfort.
It can feel overwhelming to try to decode these symptoms amidst so many other bodily (and emotional, mental, social, everything!) changes. How do you know what's normal and what's not, and when do you need to do something about it? Is there anything that can be done to prevent pesky vaginal issues while you are pregnant? You are in the right place to have all these questions answered, and more! Be sure to read through to the end and you'll be a vagina expert in no time!
Here's the line-up of what we thoughtfully packed into this informational post:
Vaginal Changes in Pregnancy- What to Expect and Tips for Comfort
Care and Keeping of your Vagina- Do's and Don't of Vaginal Hygiene
Urinary and Yeast Infections- Symptoms and Solutions
Gut Health as the Gateway to Vaginal Healing- What's a Microbiome?
Why You Need a Healthy Vagina for Birth- Risks Worth Preventing
Treatment + Solutions- When to Get More Help
Vaginal Changes in Pregnancy
Does your vagina change during pregnancy? It certainly does! Pregnancy changes almost everything about how your body functions and feels- it is meant to be adaptable but vaginal changes aren't always anticipated and can come as a surprise to manage- especially if you never had these symptoms in your non-pregnant past.
Ch-ch-ch-changes Down There:
A (sometimes huge) increase in discharge amount, texture or color. You might notice that it's creamier or thicker or has a new yellowish tint to it.
A different odor than you have had before, usually stronger smelling or more noticeable.
A heightened susceptibility to UTIs and yeast infections.
An increase in skin irritations and inflammation on and around your labia, often near pubic hair follicles.
A new swelling of the tissue, both inside and out, creating a heavier and fuller feeling (especially during/after intercourse).
Thankfully, these vaginal changes can all be relatively normal. Your body is wisely adapting to growing a human by shifting hormones, protecting your womb, increasing blood volume, making physical space and changing nutrient requirements. (Thanks mom bod!)
Tips for Easing the Discomfort:
You may find it necessary to wear a panty-liner (make sure it's organic cotton), or to change your underwear a couple times a day. A change in odor is not necessarily a bad thing, learn all about the different smells, what they mean and when you need to do something about it, in our article Vaginal Odors, HERE.
You may discover that you are more prone to irritation caused by pubic hair grooming and change your habits to include allowing more hair than before (or more simply put, less grooming). To ease general swelling and discomfort be sure to wear loose and breathable clothing, make gentle movement (think walking or stretching) a part of each day and ensure plenty of clear fluids- we recommend at least 3 liters per day.
Care and Keeping of your Vagina
It's easy to recognize a change in your vagina smell or discharge and automatically think, "Something is wrong, I must be dirtier now." Those may not be your exact thoughts, but that is truly the meaning behind this embarrassing revelation. What do we do with "dirty" things? We clean them. But, please, please DON'T!! Applying soaps, wipes, douching or other products to your vagina can take the good bacteria out with the bad, deepening or masking any potential true issues.
Why Your Vagina Doesn't Want to be Washed:
Are you accidentally stripping away everything your vagina is producing to balance itself? These recommendations are going to make a whole lot of ladies uncomfortable, so follow along with us on our reasoning a bit here:
Your vagina is a self-cleansing organ. It works hard and efficiently at keeping your vagina "clean" with a super dynamic pH and good bacteria balance. This is part of what vaginal discharge does for us, moves dead cells and bad bacteria out!
Soaps, cleansers, lotions and douches disturb this balance tremendously. Yes, even those most gentle ones. Yes, even the ones claiming to be pH sensitive.
Vaginas are supposed to smell (again I'll direct you to the info HERE) but if there truly is an odor giving you the signal that something is not quite right- we need to get to the root cause of that issue, not cover it up.
These products are a marketing scam ladies, preying on your embarrassment over normal female body functions. No one wants a stinky or dirty vagina, but this is not the way to address true vaginal hygiene.
Vagina Hygiene Tips:
1. Keep shower soap off of your labia and out of the folds. Rinsing with water in the shower, and spreading the skin to rinse in between the folds is enough of a "wash" for regular upkeep. There may be a transitional period with odor, where it seems like it is getting worse before it gets better, but trust the process and know that once your body discovers it own balance, that is the good bacteria winning out and doing its job for the long haul!
2. Ditch all sprays and deodorizers. It should go without saying that douching is a major no-no, but some women are so tempted to try it when they experience an unfamiliar change in vaginal symptoms.
3. Screen your personal products for harmful materials (bleached or non-organic panty liners, and synthetic cloth underwear can mess with pH big time).
4. Wear breathable clothing, especially underwear- organic cotton or bamboo are great options.
5. Give your vaginal flora the best shot at doing its job to maintain hygiene for you by improving your gut health. (More on this further down in this blog.)
Urinary and Yeast Infections
The two most common vaginal infections for all women, but especially for pregnant mamas, are UTIs and Yeast. Expectant mothers are more prone to vaginal infections for a few different reasons:
Pregnancy naturally lowers immunity in order to protect the "foreign invader" of the developing baby, making you more susceptible to infection and a greater challenge to fight existing infections
Anatomical changes in pregnancy can compress and add physical stress to the bladder and urethra
Massive hormonal shifts can cause imbalances in pH and vaginal flora, which is why some women who have never dealt with yeast before suddenly have problems in pregnancy
Changes to digestive health caused by anatomy, hormones and diet changes can disrupt gut balance which influences bacterial balance in other parts of the body (bladder and vagina).
A urinary tract infection occurs when bad bacteria starts to grow somewhere between the bladder and urethra (small tube that brings urine out of your body when you pee). A yeast infection occurs inside the vagina when the bacterial balance becomes disturbed.
Most women do not know the difference between these two issues, even though they are happening in totally different organ structures in the body. We have some important distinctions below for you to be certain you are recognizing the differences.
Strong urge to urinate
Pain with urination
Pelvic pain, or low back ache
Blood in urine
Alter diet to reduce nutritional items that bacteria feed off of (sweets, carbs, starches)
Increase fluids (to urinate frequently and keep your urethra frequently flushing)
Add immune boosting support (rest, supplements, stress reduction)
Thick, white discharge- sometimes chunky like cottage cheese
Bread-like or sweet (yeasty) odor
Redness + irritation of tissue
Alter diet to reduce nutritional items that yeast feed off of (sweets, carbs, starches)
Add immune boosting support (rest, supplements, stress reduction)
Treat the discomfort (yogurt, coconut oil, suppositories, essential oils, cold packs, probiotics)
Gut Health as the Gateway to Vaginal Balance
How does a vagina stay balanced? A normal vaginal environment is dynamic & constantly changing. It's in minute-by-minute flux of bacteria (good and bad), estrogen, and pH.
What's a Microbiome?
The microbiome refers to the microorganisms in a particular environment. That can be your entire body, or sub systems like your gut, vagina or oral environment. The crazy thing is, they are all connected in some way or another. Imagine a busy city with its own subdivisions and roads that transports (microorganisms) constantly between them. These systems can have their own set of strengths and weaknesses, but to some degree the weaknesses seem to be correlated- especially as we look at the relationship of the gut (microorganism environment of the digestive tract) and reproductive organs (mainly the vagina).
Our gut microbiome is the home to almost 90% of our immune system, so it tracks that anytime we are "fighting off" any type of overgrowth, our gut is a huge part of that support (or lack thereof). We have noticed that women who have frequent or severe vaginal imbalances often have some signs of gut imbalance too. Take a look at a few of the most common signs that your gut needs more support:
Gas, bloating, diarrhea or constipation with intermittent diarrhea
Food allergies, intolerance or sensitivities
Low mood or depression, brain fog, memory loss, headaches
Acne, rosacea, eczema or mystery rashes
Fatigue- emotional, physical, mental (or all 3!)
Many of these symptoms are a part of normal pregnancy changes, or transitions and may not be caused by gut problems alone. However, you can think critically about noticing the persistence of any of these signs before pregnancy. Perhaps you have had many years of suffering with digestive, mood or skin problems. Understanding how all these pieces connect is a huge part of how we get to view the whole-woman with holistic health principles.
Because your vaginal flora (unique set of microorganism) are dynamic, they change according to what is going on in and around the vagina.
The good bacteria of the vagina is primarily composed of the biotic strain, lactobacillus. Adequate amounts of it keep the bad bacteria from taking over and causing the symptoms we are all too familiar with (odor, funky discharge, itching, inflammation and swelling). Bacterial balance is achieved when we "feed" the good bacteria and "starve" the bad.
pH Balancing Act
The pH of the vagina is naturally acidic. The lactobacillus keep the vagina at a healthy pH of around 4. Anytime there is a rise in pH (towards alkalinity) or a fall in lactobacillus, the vagina is vulnerable to an overgrowth of bad bacteria.
Some of the things that can cause the pH and bacterial balance to get messed up are some of the most common items present in our everyday:
Bleached cotton (in underwear and period products)
Chemicals in household and personal products (looking at you, SOAP)
Poor gut health due to processed food or antibiotic overuse
Hormone imbalances caused by stress, illness, endocrine disruptors
Sexual barriers and lubricants (and sometimes semen itself!)
You can see how easily our vaginas can get caught up in some pretty uncomfortable cycles. Nothing in our body happens in a vacuum- our entire system is in communication when one part of it is off.
The good news is, when we recognize our symptoms as our body talking to us, we get to employ some solutions that support our entire selves. Holistic female health for the win!
Why You Need a Healthy Vagina for Birth
When our midwifery clients are dealing with vaginal balance issues in pregnancy, we jump on these quickly. Urinary tract infections left untreated can put women at a higher risk for preterm birth. Ladies who have chronic yeast, odor or other vaginal disruptions are more likely to test positive for GBS. More about GBS and all its implication can be found HERE.
Infections and imbalances of any kind are sources and generators of inflammation. For best outcomes with perineal elasticity, vaginal repair and physical recovery, we want the tissue inside the vagina to be healthy, dynamic, supple and strong.
We especially take yeast seriously in pregnancy, because sometimes it can appear to be under control, yet yeast symptoms that come and go (even mild ones) can be a sign that an underlying infection has never been fully taken care of. A sudden change in stress, diet or environment (all things that happen during birth and postpartum) can leave this area vulnerable. Even a slight yeast overgrowth postpartum can spread to the baby and your nipples, and infection called thrush, and complicate your recovery and breastfeeding relationship considerably.
Treatment and Solutions
The majority of women dealing with common imbalance issues are going to find quick relief and restoration with the suggestions outlined in this post. For mild imbalances that women desire to take care of from home, here is a summary of what we have unpacked today:
Reduce food items that cause bacteria to feed and multiply, like sugar, simple carbs, and processed food. Our Vaginal Health Food Guide is a great place to start
Increase fluids, anti-inflammatory foods and gut supporting foods
Reduce your intake of foods that harm your gut microbiome, like pesticides, antibiotic or hormone raised animal products, and preservatives
With symptoms present, begin an immune boosting protocol
Increase use of probiotics to twice per day, orally and/or vaginally
Decrease stress as much as possible, becoming particularly mindful of it during an acute infection
Avoid toxins in products that come in contact with your pelvic area, especially in soaps and sanitary pads
When More Targeted Help is Needed
Of course it goes without saying, an infection that causes severe pain, fever or doesn't get better within a few days of home treatment should be brought immediately to the attention of your primary care provider for further evaluation.
Maybe you are dealing with these issues for the first time during pregnancy, or maybe this is a reoccurring theme in your lady-life. Maybe you feel like you have done all conventional treatments just to find yourself on a antibiotic carousel. We bet either way, you are interested in the natural and effective protocols to treat these imbalances; Especially if you can confidently do it safely from home, AND avoid the side effects from conventional medical treatments- that might not even work!
In our Vaginal Infections Course we provide you with the natural, alternative and effective approaches to treat UTI and Yeast that we use in our own homebirth midwifery practice. These tools are safe for pregnancy and breastfeeding and produce the type of results that leave your entire body healthier and happier.
This all-online, forever-access, self-paced course offers everything you need to handle these issues from home:
Instructional videos to learn how to diagnose, implement treatment and prevent recurring vaginal infections
A guidebook filled with specific treatment protocols and lifestyle suggestions curated by two licensed midwives with years of experience treating these infections holistically
How to support your support your system when antibiotics are needed
Home suppository how-to for kicking yeast
Vaginal steaming instructions for common infections experienced postpartum
Easy, safe swap guide for choosing products to help create vaginal health balance
Symptom tracking journal to help you follow your journey and record your wins
Find out more by following the link below. Cheers to one healthy pregnancy and one very balanced vagina!