Trichomoniasis in Pregnancy: Risks, Symptoms, and Safe Treatments

May, 16 2025

So you’re pregnant, your body is already going through a million changes, and on top of all the usual worries, your doctor brings up trichomoniasis. The word itself can trip you up—trich-uh-moe-NYE-uh-sis—but what’s scarier is the uncertainty that comes with it. Trichomoniasis is one of the top non-viral sexually transmitted infections (STIs), but most moms-to-be have no clue it's even a thing until they hear about it from their ob-gyn. It’s not something anyone wants to think about during pregnancy, but here’s the reality: it’s more common and more treatable than you probably imagine. Still, ignoring it can mean avoidable risks for you and your baby—which is why it deserves more than just a passing mention in a pamphlet at your next check-up.

Understanding Trichomoniasis and Its Impact During Pregnancy

Most people wouldn’t expect to learn about trichomoniasis in a pregnancy handbook, yet this STI affects about 3 million people in the U.S. every year. What makes it sneaky? Up to 70% of people infected don’t show clear symptoms, so it can hang around undetected for months. During pregnancy, this is even trickier because some of trichomoniasis’s classic signs—like discharge or vaginal discomfort—can get brushed off as normal pregnancy changes. Expecting moms may shrug off itchy feelings or odd smells thinking it’s just hormones. But ignoring it is risky.

The infection is caused by a tiny protozoan parasite called Trichomonas vaginalis. This little invader spreads through sexual contact, complicating things for couples who might be dealing with STI stigma or who didn’t realize they were exposed. While men usually carry the bug without much drama (or even knowing it), women—especially those who are pregnant—can experience real health effects. Left untreated, it ups the chances of preterm birth, low birth weight, and babies who might need extra time in the NICU. In rare cases, there’s even a risk of passing the infection to the newborn during delivery, which can cause respiratory or genital infections in infants.

If you’re reading this and freaking out, hang tight. Knowledge is power. Some medical centers automatically screen for trichomoniasis, especially if you report symptoms or are considered at higher risk for STIs. However, routine testing isn’t universal—meaning you may have to advocate for yourself. The American College of Obstetricians and Gynecologists (ACOG) recommends getting screened if you have symptoms or new sexual partners.

Now, let’s talk numbers. CDC data from recent years reveals pregnant women with untreated trichomoniasis are roughly twice as likely to deliver prematurely compared to those without the infection. Preterm babies often face breathing problems, feeding difficulties, and are more likely to need extra medical support after birth—none of which any parent wants to gamble with. Another twist? Trichomoniasis can also make it easier to catch or transmit HIV if you or your partner are at risk. So when experts talk about trichomoniasis “complicating” pregnancy, it isn’t just talk.

But one thing trichomoniasis doesn’t do is invade the womb or directly harm your baby’s brain or organs before birth. The biggest risk is indirect: causing your body to go into labor early or your water to break before you’re ready. Scientists are still trying to figure out exactly how the infection triggers early labor, but there’s enough evidence for doctors to take it seriously.

Symptoms can be maddeningly vague, but here’s what catches doctors’ attention: frothy yellow-green discharge, strong fishy odor, vaginal redness, itchiness, and pain during peeing or sex. But remember—plenty of pregnant women have none of these. Nearly half learn they have trichomoniasis only after a routine urine or swab test. Don’t hesitate to mention anything unusual to your provider, even if you chalked it up to pregnancy weirdness.

Sometimes, your partner may have the infection without showing any signs. That’s why it’s important to get both of you tested, or else you risk passing it right back and forth like an unwanted game of ping pong.

Managing Risks: What Can Happen Without Treatment?

No one wants extra appointments or medications. During pregnancy, it’s totally normal to worry about how any treatment could affect your baby. But skipping care for trichomoniasis isn’t a good option. The real danger? Preterm birth. Preemies are at a higher risk for lung problems, jaundice, and feeding challenges. Some studies link trichomoniasis to breaking the amniotic sac early (your “water” breaking), which can cause infection in the uterus or the baby—and that’s when things get complicated in labor and delivery.

The risk isn’t equal for everyone. Women with a prior history of preterm labor, weak cervix, or other pregnancy health issues should be even more alert. It’s also tougher for women whose partners aren’t ready to get tested or treated. Most OBs will recommend full STI screening if you have new partners or past history of infections—not to “shame,” but to keep baby safe. There’s no judgment in a doctor’s office, just a lot of swabs and questions. The goal is to keep you both healthy, not dish out blame.

Trichomoniasis doesn’t usually climb up into the uterus, but inflammation in the vagina and cervix can set off a chain of immune reactions. It’s like your body ringing alarm bells and sometimes going into early labor. The infection also increases vaginal pH, making it easier for other germs to take hold, and that’s never something you want in the birth canal.

If you have the infection and aren’t treated, it’s possible (though not common) for newborns to pick up trichomoniasis during birth. This can lead to eye infection, discharge, or even pneumonia in rare cases. No one wants that kind of drama at the hospital—especially not when it’s preventable. Quick fact: the infection rarely causes direct miscarriage, but by triggering early contractions or breaking the sac, it can still threaten a healthy pregnancy timeline.

So how can you lower your risk? If you’re planning a pregnancy, get a full STI panel first—yes, even if you feel healthy. If you’re already pregnant and have any odd symptoms (like itching or anything unusual for you), push for a simple test. These usually involve a vaginal swab or urine sample, nothing too fancy or painful. Don’t let embarrassment or fear slow you down; healthcare teams have seen and heard it all.

Another tip: partner screening is key. There’s no point in treating just one of you. The infection can bounce back and forth endlessly, and that means more stress and another dose of medication. Some couples find this a tough topic—if you need backup, sometimes a nurse or counselor can break the ice for awkward conversations. Remember, it’s about the baby too—every awkward chat, every test, and every treatment lowers the risks down the line.

For peace of mind, remind yourself that you’re not alone. Trichomoniasis is more common than chlamydia or gonorrhea worldwide, but it rarely gets as much attention. While social stigma lingers, especially in tight-knit communities, prioritizing your health and your baby’s health is worth more than a little judgment from the peanut gallery.

Treatment Options and Tips for Safer Pregnancy

Here’s the good news—trichomoniasis during pregnancy is totally treatable with a simple prescription. The medications most doctors use are metronidazole or tinidazole, usually taken as a single dose or over a few days. That big “but” you’re probably wondering about? Is it safe for pregnancy? Decades of research say yes. Metronidazole has been used for generations and is backed by studies showing it won’t harm the growing baby when taken properly in the second and third trimesters. Some doctors still avoid it in the first trimester out of extreme caution, even though large studies haven’t found a link to birth defects. Either way, it’s safer to take the medication than to risk an untreated infection.

If your doctor prescribes metronidazole, they may warn you about possible side effects: metallic taste, nausea, or stomach upset. Taking it with food can help, and the discomfort typically passes quickly. Pro tip: skip the alcohol while on this medicine, unless you want to risk a truly awful hangover feeling. Some women worry about yeast infections popping up after antibiotics; wearing breathable cotton underwear and snacking on probiotic-rich yogurt often helps keep things balanced down there.

One big mistake? Only one partner taking the treatment. Both of you have to finish the medication, even if one has zero symptoms. Otherwise, you’ll trade the infection back and forth. While sex during treatment isn’t dangerous for the pregnancy, it’s smart to avoid it for about a week after finishing pills—they need time to do their job, and re-infection is very possible if you jump the gun.

Pregnancy brings enough surprises—medication shouldn’t be one of them. If you’re worried about the safety of any pills, ask your provider to break down the risks and benefits, and don’t be shy about asking for the safety data. Your doctor should help you feel confident in your choice, and reputable clinics will always put mom and baby first.

Aside from medication, lifestyle tweaks can make a difference. For example:

• Always wipe front to back in the bathroom to prevent spreading bacteria.
• Wear loose, breathable underwear and change out of sweaty workout gear ASAP.
• Limit use of scented soaps or vaginal sprays—they can upset your natural balance and make infections more likely.
• If you’re in a new relationship, both of you should get tested before having unprotected sex, even if it feels awkward. It’s just smart planning.

If you have a history of STIs or live somewhere with higher infection rates, prenatal care visits are a great time to ask about extra screening—no question is too silly. On rare occasions, women may have trichomoniasis that keeps coming back despite treatment. If that happens, ask your provider about further testing, as sometimes it can mean partners have not been fully treated, or (very rarely) there’s a resistant strain. Consistent follow-up matters.

While it’s normal to stress over every little thing during pregnancy, trichomoniasis is one worry you can cross off the list with a few smart steps. Fast diagnosis, safe treatment, and a little lifestyle awareness will keep you—and your little one—right on track. If reading this gave you a new worry, just remember my cat Luna’s motto: stay curious, ask questions, and don’t let fear keep you from checking out what’s really happening.