Quick take: Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of bacteria, and it's especially important to treat it during pregnancy. While often mild, untreated BV in pregnancy can increase your risk for complications like preterm birth, low birth weight, and miscarriage. Thankfully, it's easily diagnosed and safely treated with antibiotics prescribed by your doctor.
Discovering you have an infection during pregnancy can be unsettling. You're likely trying your best to keep yourself and your baby healthy, and a diagnosis like bacterial vaginosis (BV) might bring up a rush of questions and worries. Perhaps you've noticed a change in your discharge, or your doctor mentioned it during a routine check-up, and now you're wondering what it means for your pregnancy.
You're not alone. BV is the most common vaginal infection among women of reproductive age, and it affects about 10-30% of pregnant women. The good news is that medical professionals understand BV well, particularly its implications during pregnancy. We're here to walk you through what BV is, why it matters when you're expecting, how it's diagnosed, and most importantly, how to treat it safely and effectively to protect both you and your baby.
Our goal is to provide clear, reassuring, and evidence-based information to help ease your concerns and empower you with knowledge. While this article offers comprehensive guidance, remember that it's always essential to discuss your specific health situation with your healthcare provider.
What is Bacterial Vaginosis (BV) and How Does it Affect Pregnancy?
Bacterial vaginosis (BV) is a common vaginal condition that occurs when there's an imbalance in the natural bacteria found in your vagina. Think of your vagina as having its own delicate ecosystem. Normally, "good" bacteria, primarily Lactobacilli, keep the environment slightly acidic, which helps prevent the overgrowth of other, less beneficial bacteria. With BV, these protective Lactobacilli decrease, allowing "bad" bacteria (like Gardnerella vaginalis) to multiply, leading to an infection.
Why is BV More Common in Pregnancy?
Pregnancy brings significant hormonal changes, especially fluctuations in estrogen and progesterone. These hormonal shifts can alter the vaginal environment, making some women more susceptible to developing BV. The vagina's pH levels might change, or the immune system's response could be slightly different, creating conditions where the bacterial balance can be easily disrupted. Many women find they develop BV for the first time during pregnancy, or experience a recurrence.
How BV Affects Pregnancy
While BV can be asymptomatic (meaning you have no noticeable symptoms) or just mildly uncomfortable for many non-pregnant women, its presence during pregnancy carries more significant implications. The primary concern is that BV, if left untreated, can increase the risk of certain pregnancy complications. The bacteria associated with BV can sometimes travel up into the uterus, leading to inflammation and potentially affecting the amniotic sac or the cervix.
This doesn't mean every pregnant woman with BV will experience complications, but it does mean that your healthcare provider will want to diagnose and treat it promptly to minimize any potential risks. Understanding this helps explain why your doctor takes BV seriously when you're pregnant, even if you don't feel particularly unwell.
What are the Symptoms of BV During Pregnancy?
One of the tricky things about bacterial vaginosis, especially during pregnancy, is that it doesn't always come with obvious signs. About half of women with BV experience no symptoms at all. This is why routine screenings or a high index of suspicion from your doctor can be so important during your prenatal care.
Common Symptoms of BV
When symptoms do appear, they can be similar to other vaginal infections, which is why accurate diagnosis is key. The most characteristic symptom is:
- Unusual vaginal discharge: This is often thin, watery, and gray or white in color. It might coat the vaginal walls.
- Fishy odor: This distinctive smell is often stronger after sex or during your period, and you might notice it more after urination. Many women describe it as a "fishy" or "musty" smell.
- Vaginal itching: While not as common or intense as with yeast infections, some women with BV may experience mild itching.
- Burning during urination: This can also be a symptom, though it's less frequent and can also indicate a urinary tract infection (UTI).
BV Symptoms in Early Pregnancy Discharge
In early pregnancy, it can be particularly confusing to distinguish BV symptoms from normal physiological changes. Pregnancy naturally increases vaginal discharge, which is usually thin, milky white, and has a mild odor. This normal discharge is called leukorrhea. If you notice your discharge changing from this normal pattern to something thinner, grayer, or with a strong, fishy smell, especially after intercourse, it's worth mentioning to your doctor.
When to Suspect BV
If you experience any of these symptoms, even if they are mild, it's crucial to contact your healthcare provider. Don't try to self-diagnose or treat BV, especially when pregnant, as the symptoms can mimic other conditions like yeast infections or trichomoniasis, which require different treatments. Your doctor can perform the necessary tests to determine the cause of your symptoms and ensure you get the right care.
Symptoms Checklist for BV During Pregnancy
- ✅ Thin, watery, gray or white vaginal discharge
- ✅ Strong, fishy odor from the vagina, especially after sex or during menstruation
- ✅ Mild vaginal itching
- ✅ Burning sensation during urination (less common)
If you check off one or more of these, it's time for a conversation with your OB/GYN or midwife.
How is Bacterial Vaginosis Diagnosed While Pregnant?
Accurate diagnosis of BV during pregnancy is crucial for effective treatment and preventing potential complications. Your healthcare provider won't rely solely on your symptoms, as BV can mimic other vaginal infections. Instead, they'll use a combination of methods to confirm the diagnosis.
What to Expect at Your Appointment
When you visit your doctor with concerns about BV, they will likely:
- Take a medical history: They'll ask about your symptoms, when they started, and any previous history of vaginal infections.
- Perform a pelvic exam: This involves a visual inspection of your vagina and cervix.
- Collect a vaginal fluid sample: This is the most important step for diagnosis. Your doctor will gently swab your vaginal wall to collect a sample of discharge. This process is quick and generally not painful.
Diagnostic Tests for BV
The vaginal fluid sample will then be analyzed using one or more of the following methods:
- Wet Mount Microscopy: A drop of the vaginal discharge is placed on a slide, mixed with saline, and examined under a microscope. Your doctor will look for specific "clue cells" – vaginal cells coated with bacteria – which are a hallmark of BV. They'll also check for an absence of lactobacilli.
- Vaginal pH Test: A small strip of pH paper is touched to the vaginal wall. A vaginal pH greater than 4.5 is highly suggestive of BV, as healthy vaginal environments are typically more acidic (pH 3.8-4.5).
- Whiff Test: A drop of potassium hydroxide (KOH) is added to a sample of vaginal discharge. If there's a strong, fishy odor (an "amine" odor), it's a positive sign for BV. This test detects the volatile amines produced by the anaerobic bacteria associated with BV.
- Gram Stain (Nugent Score): This is considered the "gold standard" in some labs. A sample is stained and examined under a microscope to count and categorize different types of bacteria, giving a numerical score (Nugent score) to determine the likelihood of BV.
- Molecular Tests: In some cases, your doctor might use highly sensitive molecular tests (like PCR) to detect the specific bacteria associated with BV. These tests are very accurate but may not be routinely used for initial diagnosis.
Can I Test for BV at Home While Pregnant?
While there are over-the-counter vaginal pH test kits available, these are generally not recommended for diagnosing BV during pregnancy. A high vaginal pH can indicate several conditions, not just BV, and a false negative could lead to an untreated infection. Furthermore, these tests don't look for clue cells or other specific markers. It's always best to have a healthcare professional perform a proper diagnosis to ensure you receive the correct treatment, especially when pregnant.
Prompt and accurate diagnosis is key to starting appropriate treatment and protecting your pregnancy. Don't hesitate to reach out to your provider if you have any concerns or symptoms.
What Are the Safe Treatment Options for BV in Pregnancy?
If you're diagnosed with BV during pregnancy, the good news is that it's highly treatable, and there are safe and effective antibiotic options available. The goal of treatment is to restore the normal balance of vaginal bacteria, alleviate symptoms, and reduce the risk of pregnancy complications.
Approved Antibiotics for BV in Pregnancy
The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend specific antibiotics that are safe and effective for pregnant women. These medications have been extensively studied and are not known to harm your developing baby when used as directed.
The most commonly prescribed treatments include:
- Metronidazole: This can be prescribed as an oral pill (taken by mouth) or as a vaginal gel. Oral metronidazole is typically taken twice a day for 7 days. Vaginal metronidazole gel is usually applied once a day for 5 days.
- Clindamycin: This is available as an oral pill or a vaginal cream. Oral clindamycin is often taken twice a day for 7 days, while clindamycin vaginal cream is typically applied once daily for 7 days.
Important Considerations for Treatment
- Complete the Full Course: It is absolutely critical to take all your medication exactly as prescribed, even if your symptoms improve before you finish the course. Stopping early can lead to the infection returning and potentially developing antibiotic resistance.
- Abstinence or Condom Use: While undergoing treatment, your doctor might recommend avoiding sexual intercourse or using condoms. Some vaginal creams or gels can weaken latex condoms, so discuss this with your provider.
- Side Effects: Oral metronidazole can sometimes cause nausea, a metallic taste in your mouth, or an upset stomach. It's also important to avoid alcohol entirely while taking oral metronidazole and for at least 24-72 hours after your last dose, as it can cause a severe reaction (disulfiram-like reaction). Vaginal gels or creams can cause some local irritation. Discuss any side effects with your doctor.
- Recurrence: BV can sometimes recur after treatment, especially during pregnancy. If your symptoms return, contact your doctor for re-evaluation and potential re-treatment.
Treatment Options for BV in Pregnancy
What About Natural Remedies for BV During Pregnancy?
While you might encounter information about natural remedies like boric acid, tea tree oil, or apple cider vinegar for BV, it's very important to exercise extreme caution, especially during pregnancy. The safety and effectiveness of many of these remedies have not been rigorously studied or proven safe for use in pregnant women. Some can even be harmful or cause irritation, and they may not effectively clear the infection, leaving you vulnerable to complications.
For example, while ACOG mentions that boric acid has shown some effectiveness for recurrent BV in non-pregnant women, it is generally not recommended during pregnancy due to potential risks. Always prioritize prescribed, evidence-based treatments from your healthcare provider when you're pregnant. If you're interested in complementary therapies, discuss them thoroughly with your doctor first.
Can BV Cause Complications Like Preterm Labor or Miscarriage?
One of the primary reasons healthcare providers emphasize prompt diagnosis and treatment of BV during pregnancy is its potential link to serious complications. While not every pregnant woman with BV will experience these issues, the risk is elevated, and that's why vigilance is key.
Preterm Labor and Preterm Birth
This is perhaps the most well-known and concerning complication associated with untreated BV. Preterm labor is when labor starts before 37 weeks of pregnancy, and preterm birth is when the baby is born before 37 weeks. Babies born prematurely are at higher risk for health problems, including breathing difficulties, developmental delays, and other serious medical conditions.
The connection between BV and preterm birth is thought to be due to the inflammation caused by the overgrowth of "bad" bacteria. These bacteria can produce substances that weaken the membranes surrounding the baby (the amniotic sac) or stimulate the production of prostaglandins, hormones that can trigger uterine contractions and lead to early labor.
Premature Rupture of Membranes (PROM)
BV can increase the risk of Premature Rupture of Membranes (PROM), which is when your water breaks before labor begins. If this happens before 37 weeks, it's called Preterm Premature Rupture of Membranes (PPROM). When the amniotic sac ruptures, it creates an open pathway for bacteria to enter the uterus, increasing the risk of infection for both mother and baby. It also means the baby is no longer protected by the amniotic fluid, increasing the likelihood of preterm labor and birth.
Low Birth Weight
Babies born to mothers with untreated BV may have a higher chance of being born with a low birth weight (less than 5.5 pounds or 2,500 grams). Low birth weight is often linked to preterm birth, but even full-term babies can be affected if there's chronic inflammation or infection impacting nutrient delivery.
Miscarriage and Late Miscarriage
While research is ongoing, some studies suggest a potential link between BV and an increased risk of miscarriage, particularly in the second trimester. The inflammation and infection caused by BV could potentially compromise the pregnancy, especially if the infection ascends into the uterus. This is a rarer complication, but it underscores the importance of addressing BV promptly.
Chorioamnionitis and Postpartum Endometritis
BV can also increase the risk of infections within the uterus. Chorioamnionitis is an infection of the amniotic fluid and membranes surrounding the baby, which can be very serious for both mother and baby. After delivery, there's also an increased risk of postpartum endometritis, an infection of the uterine lining, especially after a C-section.
Bacterial Vaginosis and C-Section Risk
While BV doesn't directly cause a C-section, having an untreated infection can increase the risk of complications if you do have a C-section. For example, if you have BV at the time of delivery, there's a slightly higher chance of developing a postpartum uterine infection (endometritis). This is why treating BV before delivery, regardless of delivery method, is important for maternal health.
It's important to remember that these are *risks*, not certainties. Most women with BV, especially those who receive timely treatment, will have healthy pregnancies and healthy babies. The key is to be aware, communicate with your doctor, and follow their treatment recommendations.
What Happens If BV is Left Untreated During Pregnancy?
The decision to treat BV during pregnancy isn't taken lightly; it's based on extensive research and clinical experience showing the potential for significant adverse outcomes if the infection is allowed to persist. If bacterial vaginosis is left untreated while you're pregnant, the risk of developing the complications discussed earlier increases considerably.
Increased Risk of Ascending Infection
The primary concern is that the imbalanced bacteria in the vagina can "ascend," meaning they travel upwards through the cervix into the uterus. This can lead to:
- Inflammation and Infection of the Amniotic Sac: Once bacteria enter the uterus, they can infect the amniotic fluid and the membranes surrounding your baby. This condition, called chorioamnionitis, is very serious and can lead to early labor, fetal distress, and severe infections in both mother and baby.
- Cervical Weakening: The inflammation can also affect the cervix, potentially leading to cervical shortening or weakening, which is a risk factor for preterm labor.
Higher Chance of Preterm Birth and Low Birth Weight
As mentioned, untreated BV is a recognized risk factor for preterm birth. The inflammation and bacterial byproducts can irritate the uterus, trigger contractions, and lead to your water breaking prematurely (PPROM). This, in turn, often results in a baby being born too early, increasing their risk of health problems such as:
- Respiratory distress syndrome (difficulty breathing)
- Intraventricular hemorrhage (bleeding in the brain)
- Necrotizing enterocolitis (a severe intestinal condition)
- Sepsis (a life-threatening infection)
- Long-term developmental delays or disabilities
Babies born prematurely are also more likely to have a low birth weight, which can independently increase their vulnerability to health issues in infancy.
Miscarriage and Stillbirth Risk
While less common, some studies suggest that persistent, untreated BV, particularly in early to mid-pregnancy, may be associated with an increased risk of late miscarriage or even stillbirth due to the severe inflammation and infection it can cause within the uterine environment. This highlights why early detection and treatment are so important.
Postpartum Infections
Even if your pregnancy progresses to term, untreated BV at the time of delivery can increase your risk of infections after your baby is born. This includes postpartum endometritis (an infection of the uterine lining) or wound infections if you have a C-section. These infections can cause fever, pain, and require additional antibiotic treatment.
The potential for these complications underscores why healthcare providers strongly recommend treating BV during pregnancy, even if your symptoms are mild or absent. The benefits of treatment far outweigh the minimal risks associated with the prescribed antibiotics. Ignoring BV can create a cascade of risks that are best avoided for a healthy pregnancy outcome.
How Can I Prevent Bacterial Vaginosis While Pregnant?
While it's not always possible to completely prevent BV, especially with the hormonal shifts of pregnancy, there are several practical steps you can take to help maintain a healthy vaginal environment and reduce your risk. These strategies focus on supporting your body's natural balance and avoiding common irritants.
Good Hygiene Practices
- Avoid Douching: Douching disrupts the natural balance of bacteria in the vagina by washing away beneficial Lactobacilli, increasing your risk of BV and other infections. The vagina is self-cleaning and doesn't require douching.
- Wipe Front to Back: After using the toilet, always wipe from front to back to prevent bacteria from the rectum from entering the vagina.
- Gentle Washing: Wash your vulva (the external genital area) with warm water only, or with a mild, unscented soap. Avoid harsh soaps, perfumed products, and bubble baths, which can irritate the delicate skin and disrupt pH.
Clothing and Underwear Choices
- Wear Breathable Fabrics: Opt for cotton underwear, which allows air to circulate and reduces moisture buildup. Avoid synthetic fabrics like nylon or satin, which can trap heat and moisture, creating a breeding ground for bacteria.
- Loose-Fitting Clothing: During pregnancy, wearing loose-fitting clothes can also help with air circulation and prevent excess moisture and heat in the genital area.
- Change Out of Wet Clothing Promptly: If you've been swimming or working out, change out of wet swimsuits or sweaty clothes as soon as possible.
Sexual Health Practices
- Limit Partners: While BV is not considered a sexually transmitted infection (STI) in the traditional sense, having new or multiple sexual partners can increase your risk. Semen also has a higher pH than the vagina, which can temporarily disrupt the vaginal balance.
- Practice Safe Sex: Using condoms can help prevent the exchange of bacteria and reduce the risk of BV, especially if you have a new partner or are prone to recurrent infections.
Diet and Lifestyle
- Probiotics: Some studies suggest that consuming foods rich in probiotics (like yogurt with live and active cultures) or taking probiotic supplements designed for vaginal health might help maintain a healthy bacterial balance. However, evidence for preventing BV is mixed, and you should always discuss any supplements with your doctor during pregnancy. Look for strains like Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14.
- Balanced Diet: A generally healthy and balanced diet supports your overall immune system, which can help your body fight off infections.
- Avoid Smoking: Smoking is associated with an increased risk of BV, among many other health problems. Quitting smoking is one of the best things you can do for your health and your baby's health during pregnancy.
Regular Prenatal Care
Consistent prenatal check-ups allow your doctor to monitor your health, address any symptoms you might have, and perform necessary screenings. Early detection of BV, even if asymptomatic, is a key part of prevention from a complications standpoint.
While these tips can help, if you suspect you have BV or experience symptoms, always prioritize seeing your healthcare provider for diagnosis and treatment. Prevention is about reducing risk, but proper medical care is essential if an infection develops.
Is BV Harmful to My Baby During Pregnancy?
This is a common and understandable worry for any expectant parent. The short answer is that untreated BV *can* be indirectly harmful to your baby during pregnancy, primarily by increasing the risk of complications that affect fetal development and the timing of birth. However, BV itself does not directly infect or damage your baby in the way some other infections might.
Indirect Risks to Your Baby
The harm to your baby is not from the BV bacteria directly attacking the fetus. Instead, it stems from the potential pregnancy complications that BV can trigger:
- Preterm Birth: As discussed, BV is a risk factor for preterm labor and birth. Being born prematurely is the biggest indirect harm to your baby, as it can lead to immature lung development, brain bleeds, feeding difficulties, and a higher risk of infections, developmental delays, and long-term health problems. The earlier a baby is born, the greater these risks.
- Low Birth Weight: This often goes hand-in-hand with preterm birth, but even full-term babies can be affected. Low birth weight babies are more vulnerable to health issues.
- Infection Risk for Baby: If BV leads to chorioamnionitis (infection of the amniotic fluid and membranes), the baby can become infected while still in the womb or during delivery. This can result in neonatal sepsis (a severe bloodstream infection in the newborn), which is life-threatening.
- Preterm Premature Rupture of Membranes (PPROM): If your water breaks too early, your baby loses the protective barrier of the amniotic fluid, increasing their risk of infection and requiring early delivery.
Reassurance for Expectant Parents
It's crucial to balance this information with reassurance:
- BV is Treatable: When diagnosed and treated promptly with appropriate antibiotics, the risks associated with BV are significantly reduced. Most women who receive treatment for BV during pregnancy go on to have healthy pregnancies and healthy babies.
- No Direct Fetal Anomalies: BV is not known to cause birth defects or congenital anomalies in your baby.
- Your Doctor is Vigilant: Your healthcare provider is aware of these risks and incorporates BV screening (either routine or symptom-based) into your prenatal care to catch and treat it early.
A pregnant woman we spoke with shared, "When my OB told me I had BV, I immediately pictured my baby being sick. But she calmly explained that with the right antibiotics, we could manage it and keep everything on track. That reassurance, and seeing the treatment work, made all the difference."
So, while the presence of BV during pregnancy is something to take seriously and requires medical attention, it's not a cause for panic. By working closely with your healthcare provider and following their treatment plan, you can effectively manage BV and significantly reduce any potential harm to your developing baby.
Myth vs. Fact
- Myth: BV is an STI, so I must have gotten it from my partner.
Fact: While sexual activity can sometimes be a trigger for BV, it's not strictly an STI. BV is an imbalance of naturally occurring bacteria in the vagina and can develop in women who are not sexually active. However, it's more common in sexually active women.
- Myth: I can just use an over-the-counter yeast infection cream for BV.
Fact: BV and yeast infections are caused by different organisms and require different treatments. Using a yeast infection cream for BV will not be effective and could potentially worsen the imbalance or delay proper treatment. Always get a diagnosis from your doctor.
- Myth: If I don't have symptoms, BV isn't a problem during pregnancy.
Fact: This is a dangerous misconception. Many women with BV, especially during pregnancy, have no symptoms. However, even asymptomatic BV can increase your risk of pregnancy complications like preterm birth. That's why your doctor may screen for it or treat it if detected, even without symptoms.
Key Takeaways
- BV is a common bacterial imbalance in the vagina, affecting many pregnant women.
- Untreated BV during pregnancy can increase risks for preterm birth, low birth weight, PROM, and miscarriage.
- Symptoms often include thin, gray/white discharge with a strong "fishy" odor, especially after sex.
- Diagnosis involves a pelvic exam and vaginal swab, often looking for "clue cells" and high vaginal pH.
- Safe and effective antibiotic treatments (like metronidazole or clindamycin, oral or vaginal) are available and crucial during pregnancy.
- Always complete the full course of prescribed antibiotics, even if symptoms improve.
- Prevention includes avoiding douching, wearing breathable underwear, and practicing good hygiene.
- BV does not directly harm your baby, but the complications it can cause pose indirect risks.
Frequently Asked Questions
Is BV dangerous during pregnancy, and should I be worried?
While BV itself isn't immediately life-threatening, it can be dangerous during pregnancy because it increases your risk of serious complications like preterm labor, premature rupture of membranes, and low birth weight. It's important to take it seriously and seek prompt treatment, but not to panic. With proper medical care, most pregnant women with BV have healthy outcomes.
What are the risks if BV goes untreated during pregnancy?
If BV is left untreated during pregnancy, the risks include an increased chance of preterm birth (baby born too early), low birth weight, premature rupture of membranes (your water breaking early), and infections of the amniotic fluid (chorioamnionitis) or the uterine lining after delivery (postpartum endometritis). It may also increase the risk of late miscarriage.
Can bacterial vaginosis harm my developing baby?
BV does not directly harm your baby by infecting them or causing birth defects. However, it can indirectly harm your baby by triggering pregnancy complications like preterm birth or PPROM. These complications can lead to health issues for the baby due to prematurity or infection. Treating BV significantly reduces these indirect risks.
What's the best way to treat BV when you're pregnant?
The best way to treat BV during pregnancy is with antibiotics prescribed by your healthcare provider. Common options include oral metronidazole or clindamycin, or vaginal forms of these medications (gels or creams). It's crucial to complete the entire course of antibiotics as prescribed to ensure the infection is fully cleared and to minimize recurrence.
How can I tell if I have BV during pregnancy?
The most common signs of BV during pregnancy include a thin, watery, gray or white vaginal discharge, a strong "fishy" odor (especially after sex), and sometimes mild vaginal itching or burning during urination. However, many women have no symptoms at all. If you notice any of these signs, or have concerns, contact your doctor for proper diagnosis.
Is it true that BV can cause preterm labor?
Yes, it's true. Bacterial vaginosis is a known risk factor for preterm labor and preterm birth. The bacteria associated with BV can cause inflammation and produce substances that may weaken the amniotic membranes or stimulate uterine contractions, leading to labor starting before 37 weeks of pregnancy.
When to See a Doctor or Specialist
If you are pregnant and suspect you have bacterial vaginosis, or if you experience any unusual vaginal symptoms, it's important to contact your healthcare provider promptly. Do not attempt to self-diagnose or self-treat. Your **OB/GYN** or **midwife** is the right specialist to consult.
You should call your doctor if you experience any of the following:
- ⚠️ New or unusual vaginal discharge (thin, gray, white, or with a strong odor).
- ⚠️ Vaginal itching, irritation, or burning during urination.
- ⚠️ Any vaginal bleeding or spotting.
- ⚠️ Symptoms that return after completing treatment for BV.
- ⚠️ Any signs of preterm labor, such as regular contractions, pelvic pressure, backache, or a sudden gush or trickle of fluid from your vagina (which could indicate your water has broken).
This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition, especially during pregnancy.
References
- American College of Obstetricians and Gynecologists (ACOG). Bacterial Vaginosis: FAQ002.
- Centers for Disease Control and Prevention (CDC). Bacterial Vaginosis - CDC Fact Sheet.
- Mayo Clinic. Bacterial vaginosis.
- National Institute of Allergy and Infectious Diseases (NIAID). Bacterial Vaginosis.
- American College of Obstetricians and Gynecologists (ACOG). Premature Rupture of Membranes: FAQ087.
- American College of Obstetricians and Gynecologists (ACOG). Chorioamnionitis: FAQ193.
