Bacterial Vaginosis and Pregnancy

Pregnant Woman Holding Hands with her HusbandBacterial Vaginosis is a common infection during pregnancy that affects up to 30% of pregnant women every year. This infection occurs when there is too much of a certain bacteria in the woman's vagina. Pregnant women are at an increased risk of contracting this infection due to the fluctuation of hormones happening in their body.

Bacterial vaginosis is not a sexually transmitted infection, contrary to popular belief, but the infection is much more common in sexually active women. In most cases, bacterial vaginosis can be cured with a standard course of antibiotics. However, studies have provided significant evidence that shows untreated bacterial vaginosis can lead to pregnancy complications. Read more below to understand how this infection can affect your baby and how to prevent it from happening.

Bacterial vaginosis was once named Gardnerella vaginitis. This is because of a belief that this was the bacterium that led to BV. The new name there is like many different types of bacteria that are in the vagina. There is nothing wrong with these bacteria typically. But if they quickly multiply, they can cause BV.

What is Bacterial Vaginosis?

Bacterial vaginosis is an infection that causes inflammation of the vagina. Bacteria is not always a bad thing. The vagina is filled with naturally occurring bacteria that helps keep its pH balanced. When there is an overgrowth of the vagina's "bad" bacteria, it upsets the natural balance and starts to cause problems.

The cause of BV is not fully understood yet but is associated with having sex or frequent douching. Women who don't have sex rarely contract this infection. The hormones in a pregnant woman's body can make it easier for bacteria to collect in the vagina. Increased hormone production and its fluctuations make it difficult for the vagina to keep its pH balanced.

Symptoms of BV

Many women with BV do not exhibit any symptoms, which can make it harder for pregnant women to identify if they have an infection. Symptoms of BV include:

  • Thin vaginal discharge
  • Discharge that is gray, white, or green
  • Foul-smelling or "fishy" vagina odor
  • Vaginal itching
  • Pain in the vagina
  • Burning during urination
  • Burning feeling inside the vagina

If you start showing signs of BV, it's important to contact your health provider as soon as possible to prevent any complications.

How Does BV Affect my Pregnancy?

It's estimated that 1 million pregnant women contract BV every year. In the majority of cases, the infection can be successfully treated and there are no adverse effects for the baby. BV that is not detected early or is left untreated increases the risk of premature birth and low birthweight. Some studies have also shown that BV is linked to miscarriage and premature rupture of the membranes. When a baby is born too early or has a low birth weight, it puts them at risk for several different complications, including underdeveloped organs, infections, lower Apgar scores, jaundice, and brain hemorrhaging. The more premature a baby is, the more likely they are to develop problems after birth.

Premature rupture of the membranes (PROM) is when the mother's amniotic sac ruptures before labor begins. PROM increases the risk of chorioamnionitis (infection of the placental tissues), compression of the umbilical cord, and cesarean birth. BV can also lead to pelvic inflammatory disease (PID), which is an infection of the uterus and fallopian tubes. PID is known to cause infertility.

Diagnosis and Treatment for BV

If you suspect you have BV, there are different ways a doctor can diagnose the conditions. First, the doctor may ask questions about your medical history. Previous vaginal infections of STI's can increase the risk of getting BV. A pelvic examination is usually performed to inspect the inside of the vagina for signs of infection. The doctor will insert two fingers into the vagina while pressing on the abdomen with their other hand to check for signs of inflammation or infection in your pelvic organs.

During the pelvic exam, the doctor collects a sample of vaginal secretions. The secretion is tested under a microscope for overgrowth of bacteria. Finally, the doctor may also test your vaginal ph or the acidity of your vagina. This involves placing a small pH test strip inside your vagina. A pH of 4.5 or higher is an indication of infection.

Once the diagnosis is confirmed, antibiotics are prescribed to cure BV. Common antibiotics used during treatment include metronidazole, clindamycin, and tinidazole. You may be given a combination of oral pills and topical creams. The pills are used to get rid of the infection, while topical cream can be used inside and around the vagina to relieve some of the immediate symptoms.

If you have BV, make sure to finish the entire course of antibiotics, even if you're not experiencing any more symptoms. Antibiotics that are stopped early can allow a recurrence of the infection that becomes more resistant to typical treatment. Male partners of women with BV generally do not need to be treated, but the infection can spread between female sexual partners. Avoid having sex until treatment is finished to prevent further irritation.

It's normal for pregnant women to get multiple BV infections throughout gestation. Hormones will continue to rise and fluctuate until after birth, which causes the natural balance of bacteria to be continuously disrupted. This can be frustrating, especially when you're experiencing uncomfortable symptoms, but BV must be treated every time to keep your baby safe.

Risk Factors of BV

Besides being pregnant, other risk factors increase your chances of getting BV. These include:

  • Having multiple sex partners or a new sex partner: Even though the cause of BV is unknown, the infection is linked to sexual activity. BV is more common in women who have sex with other women.
  • Douching: This practice involves rinsing out the inside of the vagina with water or other cleansing liquid, which can upset your vagina's bacterial balance and pH. Douching is known to increase the risk of BV. Women are generally discouraged to use a douche since the vagina is already self-cleaning.
  • Lacking certain bacteria: Some women's bodies do not produce enough of the "good" bacteria in the vagina, making it easier to cause infection.
  • Are African-American: African-American women are twice as likely to contract BV than white women. The cause for this is not fully understood.
Preventing BV Infections

Fortunately for pregnant women, there are ways you can help prevent BV.

  • Avoid having sex often
  • Avoid further irritation of the vagina
  • Limit the number of sexual partners
  • Do not douche
  • Use only warm water to clean the outside of the vagina
  • Use gentle, fragrance-free soaps
  • Use a condom during sex
  • Avoid contracting an STI
  • Get regularly screened for BV

Even if you try all these methods, some pregnant women will still deal with recurrent BV infections. Unfortunately, infections around the pelvic region are extremely common during pregnancy. BV can be frustrating, but is generally is not a cause for concern as long as it's treated properly. Early detection and the use of antibiotics can ensure that there is no harm to your baby. If you start experiencing symptoms of BV, do not wait to contact your doctor.