Yeast Infection During Pregnancy: What You Need to Know

Pregnancy is a time of incredible transformation. Your body is working overtime to support a growing life, and that comes with a variety of physical changes. Some of these changes are expected, like morning sickness or fatigue. Others, like vaginal yeast infections, may come as a surprise.

Yeast infections are common at any stage of life, but they’re particularly prevalent during pregnancy. If you’re pregnant and dealing with unusual discharge, itching, or irritation, you might be experiencing a vaginal yeast infection, also known as vaginal candidiasis. While typically not dangerous if you’re not pregnant, these infections can carry greater risks during pregnancy.

Below, we’ll explore why pregnancy increases your risk, what complications can arise from untreated infections, and how to treat a yeast infection during pregnancy.

What are vaginal yeast infections?

Yeast infections occur when there’s an overgrowth of Candida, a type of fungus that naturally lives in the vagina in small amounts. Under normal conditions, the vaginal microbiome maintains a balance between bacteria and yeast. But when that balance is disrupted — often by hormonal shifts, antibiotics, or immune changes — Candida, particularly Candida albicans, can multiply and cause an infection.

Symptoms can include: 

• Thick, white discharge that’s often described as having a “cottage cheese” texture
• Vaginal itching and burning
• Redness and swelling. 

Though uncomfortable, these infections are usually easily treated. But pregnancy can change that picture significantly.

Why pregnancy increases the risk of yeast infections

Hormonal changes are a hallmark of pregnancy, and one of the main reasons why yeast infections become more common during this time. Two hormones in particular, estrogen and progesterone, play a central role in shaping your body’s susceptibility.

Estrogen levels rise significantly during pregnancy to support fetal growth and the development of the placenta. However, high levels of estrogen also create a more hospitable environment for Candida albicans. Research indicates that estrogen can actually decrease the ability of vaginal epithelial cells to inhibit the growth of Candida, thereby facilitating the fungus's colonization and persistence. Pregnancy also increases glycogen levels in the vaginal mucosa, and while this supports the growth of protective Lactobacillus species, it can also create a favorable environment for yeast.

In other words, estrogen weakens one of your body’s first lines of defense against yeast overgrowth, leaving you more vulnerable to infection.

Progesterone, another hormone that increases during pregnancy, also influences Candida, although to a lesser extent than estrogen. It affects the formation of biofilms, the protective layers that Candida uses to stick to surfaces and resist treatment. Lower biofilm formation might seem like a good thing, but progesterone can also alter the overall balance of microorganisms in the vagina, potentially contributing to colonization and infection.

How common are yeast infections during pregnancy?

Studies estimate that around 30% of pregnant women experience vulvovaginal candidiasis. For some, these infections are isolated and resolve with treatment. For others, they may be recurrent and require more proactive management.

Risks of an untreated yeast infection during pregnancy

A yeast infection might feel like a minor irritation, but during pregnancy, it carries potential risks that go far beyond discomfort. When left untreated, especially if the infection is recurrent, Candida colonization can have serious consequences for both the mother and the baby.

One key concern is the connection between untreated vaginal yeast infections and preterm birth. Some studies have found a correlation between recurring yeast infections in early pregnancy and preterm birth. However, the evidence is mixed, and a 2023 systematic review found no strong evidence that a yeast infection during pregnancy leads to preterm birth or other major complications. 

If a yeast infection goes untreated during pregnancy, it can be passed to the baby during childbirth. This may lead to a rare condition called congenital cutaneous candidiasis, characterized by a fungal skin infection in the newborn. This condition needs medical treatment, highlighting the need to identify and manage yeast infections in pregnant women.

Can a yeast infection cause miscarriage?

There’s currently no proven, direct link between vaginal yeast infections and miscarriage in humans. While yeast infections are common during pregnancy and can be uncomfortable, they are generally not considered a direct cause of pregnancy loss.

Some animal studies have shown that vaginal Candida infections in early pregnancy can interfere with placental development, which leads to increased miscarriage rates in those models. These findings are important for guiding future research, but it’s crucial to understand that animal studies don’t always translate directly to humans.

When it comes to human studies, the evidence is much more limited and less conclusive. The only consistent association seen in human research is not with yeast infections themselves, but rather with certain medications used to treat them. Specifically, oral fluconazole, especially when taken in high doses or during the first trimester, has been linked to a slightly increased risk of spontaneous abortion. That’s why fluconazole and other oral antifungals are generally avoided during pregnancy in favor of topical treatments, which are both effective and much safer.

If you’re pregnant and experiencing a yeast infection, try not to worry. Most yeast infections don't pose a risk to your pregnancy, especially when treated properly, usually with topical antifungal creams like clotrimazole or miconazole. There is no strong evidence in humans that yeast infections alone cause miscarriage.

What matters most is getting diagnosed and treated correctly. Always check with your healthcare provider before starting any medication, even over-the-counter ones, so they can guide you toward the safest and most effective option.

How do you treat a yeast infection while pregnant?

When dealing with yeast infections during pregnancy, it's crucial to address them safely and quickly. The good news is that there are effective treatments that are safe for you and your developing baby.

The go-to yeast infection treatments while pregnant are topical azole antifungals like clotrimazole and miconazole. These medications are simply applied directly inside the vagina, typically for at least seven days.

Oral antifungal medications, especially fluconazole, are best avoided during pregnancy, particularly in the first trimester. Research suggests that high doses can increase the risk of spontaneous abortion and birth defects, especially with long-term use.

Other systemic antifungals like itraconazole, posaconazole, and isavuconazole aren't recommended either, given the limited safety data and potential risks.

Can you prevent yeast infections during pregnancy?

While it’s not always possible to prevent a yeast infection, especially given the hormonal shifts of pregnancy, there are steps you can take to reduce your risk:

• Avoid douching and scented vaginal products, which can disrupt the natural microbiome.
• Wear breathable, cotton underwear and avoid tight-fitting clothing that traps heat and moisture.
• Limit sugar intake if you’re at risk for gestational diabetes. 
• Support your vaginal microbiome by eating probiotic-rich foods or using probiotics (as recommended by your healthcare provider). 
• Talk to your doctor if you’re experiencing symptoms or if you’ve had yeast infections in previous pregnancies. 

If you’re pregnant and think you might have a vaginal infection, talk to your healthcare provider. Being proactive about your vaginal health is one of the best ways to ensure a safer, healthier pregnancy for both you and your baby.

FAQ

What happens if you give birth with a yeast infection? 

Giving birth while you have a yeast infection is generally not dangerous, but it can lead to some discomfort and a few potential complications. The most common concern is that the infection can be passed from mother to baby during vaginal delivery. This can result in oral thrush, a harmless but uncomfortable yeast infection in the baby’s mouth that may cause white patches on the tongue and difficulty feeding. In some cases, the baby might also develop a diaper rash caused by Candida. For the birthing parent, having a yeast infection during labor can make the vaginal area feel more irritated or painful, especially during delivery. Fortunately, these infections are treatable, and healthcare providers can offer safe antifungal treatments during pregnancy. If you suspect you have a yeast infection near your due date, it's a good idea to let your doctor know so they can help you manage it before labor begins.

What can be mistaken for a yeast infection while pregnant?

During pregnancy, several other conditions can cause symptoms that mimic a yeast infection, making it easy to confuse them. This is why it's important not to self-diagnose, especially when you're pregnant. One common culprit is bacterial vaginosis (BV), a condition caused by an imbalance in the vaginal microbiome. Like a yeast infection, BV can cause abnormal vaginal discharge, itching, and irritation, but the discharge usually has a fishy odor and is thinner or grayish-white, which helps distinguish it. Urinary tract infections (UTIs) can also cause itching or burning sensations, especially during urination, which may be confused with yeast infection symptoms. However, UTIs usually come with frequent urination, pelvic pressure, and cloudy or strong-smelling urine. Another possibility is sexually transmitted infections (STIs) such as trichomoniasis, chlamydia, or gonorrhea, which can also cause unusual discharge, discomfort, or itching. Because the hormonal changes of pregnancy can affect vaginal pH and discharge, it's best to see your provider for proper testing and diagnosis if you're experiencing symptoms.

Is it a yeast infection or BV?

Both yeast infections and BV cause discomfort, discharge, and irritation, but there are a few key differences. A yeast infection usually causes intense itching, redness, and a thick, white, cottage cheese-like discharge. It may also cause burning, especially during urination or sex. The discharge typically has no strong odor. On the other hand, BV often leads to a thin, grayish-white discharge with a noticeable fishy smell, especially after sex. It may cause mild irritation or itching, but it's usually less intense than with a yeast infection. Because the symptoms can overlap (and because BV is more closely associated with pregnancy complications like preterm birth), it's important to get tested rather than try to guess. A quick visit to your doctor can help confirm the diagnosis and ensure you get the safest and most effective treatment.