Yeast infections affect roughly 30% of pregnant women, making them one of the most common vaginal infections during pregnancy. While they're typically uncomfortable rather than dangerous, pregnancy changes how your body handles these infections, and understanding the risks and safe treatment options is crucial for protecting both you and your baby.

Why Does Pregnancy Make Yeast Infections More Likely?

The culprit behind increased yeast infections during pregnancy is hormonal change. Two hormones in particular, estrogen and progesterone, create an environment where Candida albicans, a fungus that naturally lives in the vagina, can thrive. Estrogen levels rise significantly during pregnancy to support fetal growth and placental development, but this same hormone actually weakens your body's natural defenses against yeast overgrowth .

Research shows that high estrogen levels decrease the ability of vaginal cells to inhibit Candida growth, essentially rolling out a welcome mat for the fungus. Additionally, pregnancy increases glycogen levels in the vaginal mucosa, which while supporting protective bacteria, also creates a more favorable environment for yeast to multiply . Progesterone, the other key pregnancy hormone, also plays a role by altering the protective biofilms that normally help your body resist yeast colonization.

What Are the Real Risks of an Untreated Yeast Infection During Pregnancy?

If you're worried that a yeast infection could harm your pregnancy, here's the reassuring news: there is no proven direct link between vaginal yeast infections and miscarriage in humans . While some animal studies have shown that Candida infections in early pregnancy can interfere with placental development, these findings don't necessarily translate to human pregnancies.

The main concern with untreated yeast infections is a rare condition called congenital cutaneous candidiasis, which occurs when a yeast infection is passed to the baby during childbirth. This fungal skin infection in newborns requires medical treatment, which is why identifying and managing yeast infections during pregnancy matters . Some studies have also found a correlation between recurring yeast infections in early pregnancy and preterm birth, though a 2023 systematic review found no strong evidence supporting this connection.

One important caveat: while yeast infections themselves don't cause miscarriage, certain medications used to treat them can. Oral fluconazole, particularly in high doses or during the first trimester, has been linked to a slightly increased risk of spontaneous abortion, which is why doctors recommend topical treatments instead .

How to Safely Treat a Yeast Infection During Pregnancy

• Topical Antifungal Creams: Clotrimazole and miconazole are the safest and most effective treatment options during pregnancy, with no increased miscarriage risk and proven effectiveness in clearing infections.
• Avoid Oral Medications: Oral antifungals like fluconazole should be avoided during pregnancy, especially in the first trimester, due to the potential link to spontaneous abortion.
• Always Consult Your Healthcare Provider: Before starting any medication, even over-the-counter options, check with your doctor to ensure you're using the safest treatment for your specific situation.

The key takeaway is that yeast infections during pregnancy are common and manageable. Most infections don't pose a risk to your pregnancy when treated properly with topical antifungal creams. What matters most is getting diagnosed and treated correctly rather than trying to manage the infection on your own.

"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," noted Dr. Kate McLean, MD, MPH, FACOG.

Dr. Kate McLean, MD, MPH, FACOG

If you're pregnant and experiencing unusual vaginal discharge with a thick, white "cottage cheese" texture, itching, burning, or redness and swelling, these are classic signs of a yeast infection . Don't wait to address these symptoms. Contact your healthcare provider promptly so they can confirm the diagnosis and recommend the safest treatment approach for your pregnancy stage.