Most women notice an increase in vaginal discharge during pregnancy. This is quite normal and is caused by a combination of factors – increased blood supply, softening of the cervix and vaginal walls, and later, stimulation from the baby’s head, as he or she presses against the cervix ready for labour. Sometimes your vaginal discharge may be so heavy that you feel you have accidentally passed urine. This may happen when your baby's head is low in the pelvis and you have been walking around a lot.

Normal vaginal discharge is clear, white or creamy, and fairly runny. It may have a distinctive odour, but not an unpleasant smell. Signs of infection include thick, curd-like or greenish discharge, a nasty smell, itchy and soreness, low abdominal pain or pain during sex.

In the last week or so of pregnancy, your discharge may contain streaks of thick mucus and a little fresh blood, as the cervical plug is lost. This is known as the 'show'. Having a show does not necessarily mean that labour is about to start, but is a reasonable indication that the cervix is beginning to 'ripen' or prepare for labour. Some women have small shows off-and-on for several days before labour starts properly.

What can I do about it?

• Try to accept an increase in vaginal discharge as a normal part of pregnancy. Remind yourself that this discharge plays a part in protecting your uterus from infection ascending up the vagina. This said, be aware of changes to your discharge, and tell your midwife or doctor if you think things may not be quite right. He or she may take a swab to check for infection. The result of this should be known in a few days; most vaginal infections (for example, thrush) can be effectively treated during pregnancy.

• Normal hygiene and, if necessary, the use of 'panty liners' should keep you feeling fresh. Avoid vaginal douches and scented hygiene wipes – both may cause irritation and may upset the delicate acid/alkali balance of the vagina.

• If you are not sure whether you have a heavy vaginal discharge, stress incontinence, or are leaking amniotic fluid, put a sanitary pad inside your pants to catch your loss and have a word with your midwife. She will help you decide what is happening.

Vaginal bleeding alert

If, you lose any blood from your vagina, put on a sanitary pad and contact your midwife or maternity unit. Many women lose a small amount of blood at some point in their pregnancy and, often, this is of little significance. However, occasionally, vaginal bleeding may indicate a serious problem – a threatened miscarriage, maybe, or a problem with your placenta – so it is always best to ask for advice.

Be ready to answer questions about the following:

• the colour of the blood (dark or bright red),
• the quantity (just a smear, a teaspoon, a tablespoon, or soaking through pads and clothing),
• the presence or absence of pain (continual, cramping, contractions and so on),
• whether you have had sex recently,
• the frequency of your baby's movements (often a useful clue to his or her wellbeing),
• what has happened in your pregnancy so far (including the result of any ultrasound scans).

Revised by babyworld midwife, Hannah Hulme Hunter November 2000.