Bacterial vaginosis during pregnancy requires antibiotic treatment from your healthcare provider. There are no effective home remedies that clear BV, and some popular ones are explicitly unsafe during pregnancy. The good news: the same antibiotics used for non-pregnant women are considered safe throughout pregnancy, and treatment typically takes just seven days.
BV matters more during pregnancy than at other times. A large meta-analysis found that pregnant women with BV face roughly double the odds of preterm delivery compared to those without it. That alone makes prompt treatment worthwhile.
How to Know It’s BV and Not a Yeast Infection
The two most common vaginal infections during pregnancy look and feel quite different. BV produces a thin, grayish-white discharge with a distinct fishy smell. It generally does not cause itching or irritation. A yeast infection, by contrast, produces thick, cottage cheese-like discharge with little odor but significant itching and irritation.
This distinction matters because yeast infections can be treated with over-the-counter antifungals, while BV requires a prescription antibiotic. If you’re noticing a fishy odor, especially after sex, that’s the classic signal pointing toward BV. Your provider can confirm the diagnosis quickly during a routine prenatal visit using a vaginal swab, checking for changes in pH (above 4.5) and the presence of certain cells under a microscope.
Antibiotic Options That Are Safe in Pregnancy
The CDC’s treatment guidelines confirm that pregnant women can use the same BV regimens recommended for non-pregnant women. The two most common options are an oral antibiotic taken by mouth and an antibiotic cream applied vaginally.
The oral option is typically a 7-day course taken twice daily. Clinical trials have specifically tested this regimen in pregnant populations and confirmed it works, with cure rates around 70%. Some providers prescribe a slightly lower dose taken three times daily instead, which has also been shown effective in pregnancy trials.
The vaginal cream option is applied at bedtime for seven days. Older studies once raised concerns about using vaginal antibiotics during pregnancy, but more recent data have demonstrated this approach is safe for both the pregnant person and the baby. Your provider will choose between these options based on your preferences, how far along you are, and whether you have any medication sensitivities.
Both routes take the full seven days to work. It’s important to finish the entire course even if symptoms improve after a few days, since stopping early increases the chance the infection comes back.
Home Remedies to Avoid
Several home remedies circulate online for BV, and most are either ineffective or actively dangerous during pregnancy.
Boric acid suppositories are the most important one to skip. Multiple medical guidelines, including those from ACOG, Canadian health authorities, and British sexual health guidelines, explicitly state that boric acid is contraindicated in pregnancy due to potential harm to fetal development. Boric acid can also be fatal if swallowed, which makes having it around the home an added risk.
Douching with apple cider vinegar or any other solution disrupts the vaginal microbiome further and can push bacteria higher into the reproductive tract. This is risky for anyone but especially so during pregnancy.
Probiotics are the most plausible-sounding natural option, and they’ve been studied in pregnant women. A systematic review and meta-analysis found that probiotic supplementation during pregnancy showed no significant benefit for clearing BV. The overall odds ratio was 0.91, meaning probiotics performed essentially the same as placebo. Probiotics are not harmful, but they won’t replace antibiotics for an active infection.
What Happens If BV Comes Back
BV recurrence is common in general, and pregnancy doesn’t change that. If your symptoms return after completing treatment, your provider can prescribe another course. Don’t try to wait it out, since untreated BV carries ongoing risks for preterm birth throughout the pregnancy.
For recurrent cases, there’s a newer development worth knowing about. In late 2025, ACOG recommended for the first time that male sexual partners of women with recurrent BV be treated with a combination of oral and topical antibiotics at the same time. This recommendation followed growing evidence that sexual activity plays a significant role in BV recurrence. Previously, partner treatment wasn’t thought to help, but newer data show it can reduce the cycle of reinfection. If BV keeps returning, ask your provider whether concurrent partner treatment makes sense for your situation.
Timing and What to Expect
Most women notice the fishy odor fading within two to three days of starting antibiotics. Full resolution of discharge typically takes closer to the end of the seven-day course. If symptoms haven’t improved at all after finishing treatment, let your provider know, as you may need a different antibiotic or a reassessment of the diagnosis.
BV screening is not part of standard prenatal care for women without symptoms. But if you’ve had BV before or notice any change in discharge during pregnancy, bringing it up at your next appointment is the fastest path to treatment. There’s no need to wait for a special visit. A vaginal swab takes minutes, and your provider can call in a prescription the same day.