Quick Answer: STD symptoms during pregnancy often look like normal pregnancy signs, spotting, fatigue, unusual discharge, or mild pelvic discomfort. Because many STDs are asymptomatic or mimic hormonal changes, they go undetected without testing.
This Isn’t Just “Pregnancy Fatigue”, And Here’s Why
There’s a type of exhaustion that comes from building a human, and then there’s the bone-deep, can’t-keep-your-eyes-open weariness that’s a warning bell. Fatigue is one of the most searched symptoms in early pregnancy, but it’s also a common early sign of chlamydia or trichomoniasis, especially when paired with low-grade fever or back pain. The problem? Pregnancy already makes you feel like crap, so most people don’t clock the difference.
According to the CDC, many STDs in pregnant individuals are entirely asymptomatic, but when symptoms do show, they often hide in plain sight. One 2023 review in PubMed found that more than 60% of people with chlamydia reported “vague discomfort” that could easily be confused with pregnancy fatigue, round ligament pain, or even morning sickness.
So when someone shrugs off their exhaustion with “just pregnancy things,” they might be right, but they might also be incubating an untreated infection that can cause premature birth or pneumonia in their baby. That’s why a negative test from week eight isn’t enough if new symptoms show up later. STDs can be contracted mid-pregnancy, especially if a partner’s status changes or the original screen missed something.
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When “Hormonal Spotting” Isn’t Hormonal at All
“My OB said it was normal because I’d just had sex,” says Aria, 27, now in her second trimester. “But something felt off. The bleeding kept happening, not heavy, but weird. And then came this smell.”
The smell she’s referring to, a sour, fishy odor, ended up being a symptom of trichomoniasis, a treatable STD that can cause complications during delivery if left unchecked. She only found out because a friend nudged her to do a second test at home. Her clinic hadn’t screened her for it because “she didn’t have symptoms.”
Bleeding in pregnancy has a dozen explanations. But when it’s mixed with discharge, odor, or pelvic pain that comes and goes like waves, don’t just write it off. According to March of Dimes, untreated trichomoniasis increases the risk of low birth weight, and syphilis, yes, it still exists, can lead to stillbirth if not caught and treated early.
Here’s the harsh truth: most OBs don’t test for every STD automatically. If your test panel didn’t include trich, herpes, or even gonorrhea, and you’re experiencing new symptoms? You need to advocate for more screening, or take matters into your own hands with a reliable at-home test.
When Discharge Isn’t Just “Hormonal Flux”
Pregnancy changes everything, your sense of smell, your pelvic pressure, your cervical mucus. So it’s easy to dismiss an uptick in discharge, especially when it’s chalky or white. But if it suddenly becomes yellowish, green-tinged, or smells sharp and metallic, that could be a sign of gonorrhea or bacterial vaginosis, the latter of which increases your risk of preterm labor.
“I’d been pregnant before. I knew what was normal for my body,” said Lina, 31. “This time the discharge felt different, stickier, kind of frothy. But I was embarrassed to bring it up because everything ‘down there’ felt weird anyway.”
Lina’s at-home test came back positive for gonorrhea. She got antibiotics, her symptoms cleared, and so did her guilt. “I realized it wasn’t shameful. I was just listening to my body.”
Discharge gets the silent treatment in most prenatal appointments, even though it’s one of the clearest early signs of infection. If you’re noticing new textures, colors, or smells that linger past a few days, or flare after sex, it’s time to check in with more than just Google.
Your Test Was Negative at Week 8. So… Now What?
Many people assume that once they’ve had an initial STD screening during pregnancy, they’re in the clear. But infections don’t run on your appointment calendar. According to a 2024 Mass General Brigham study, nearly 30% of STIs diagnosed during pregnancy occurred after the first trimester, and many were in people who had previously tested negative.
This isn’t about blaming your partner or policing your past. It’s about protecting your health right now. Life is complicated. People aren’t always monogamous. Test results get lost. Clinics skip panels they think you “don’t need.” You deserve better than guesswork. You deserve real answers, and you don’t need permission to get them.
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“But I’m in a Monogamous Relationship”, And Other Dangerous Myths
Let’s talk about the elephant in the exam room. So many pregnant people skip retesting or ignore symptoms because they think, “I’m in a committed relationship. I don’t need to worry.” But here’s the deal: monogamy isn’t a shield unless it’s backed by regular, honest testing from both partners. And even then, some infections can lie dormant for months before showing signs, or spreading.
One 2024 survey by ASHA found that 1 in 5 adults believed STD testing was “only necessary if you have symptoms.” That belief alone delays diagnosis, even in high-risk pregnancies. And the kicker? Many OBs don’t ask follow-up questions once that “yes, I’m monogamous” box is ticked.
“I hadn’t slept with anyone else in years,” says Maya, 34. “But I didn’t think to ask about my husband’s last test. Turns out he’d been exposed years ago and never knew. I had gonorrhea for months, and I was almost 20 weeks pregnant before I found out.”
No one wants to question their relationship while also growing a baby. But protecting your child doesn’t mean accusing your partner. It means understanding how STDs work: silently, often without symptoms, and sometimes without intent.
Herpes. Chlamydia. HPV. Gonorrhea. All of these can be present without any visible symptoms, and still cause complications during birth or later in pregnancy. You don’t have to have sores, discharge, or burning to be infected. You might just feel... normal. Or bloated. Or irritable. Like, you know, every other pregnant person on the planet.
According to a 2023 review published in PubMed, over 70% of pregnant individuals who tested positive for chlamydia and trichomoniasis reported no symptoms whatsoever. But untreated, these infections can lead to:
- Premature rupture of membranes
- Early labor
- Neonatal infections (like pneumonia or eye infections)
- Increased HIV risk (for both mother and infant)
In other words, no news isn’t always good news. Especially when your baby’s health is on the line. The hard truth? Prenatal STD screening is often incomplete. In the U.S., unless you’re considered “high risk,” many providers will skip screening for herpes, trichomoniasis, or HPV entirely, assuming they’ll treat anything that “pops up later.” But later might be too late.
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Stigma Is the Real Infection
You don’t have to be reckless or irresponsible to have an STD. You don’t have to be sleeping around, or cheating, or dirty, or any of the toxic words people still attach to infections. You can be in love. You can be careful. You can have one partner for life. And still, because of one moment, or one missed test, or one slip years ago, you can carry an infection into pregnancy without ever knowing.
STD stigma isn’t just harmful. It’s dangerous. It keeps people from speaking up, asking questions, or requesting second tests when something feels off. It keeps them quiet about symptoms like spotting, itching, or pain that come and go. It silences them in the one moment they need to speak loudest, when they’re protecting a child.
“I almost didn’t say anything,” says Jess, 29, who found out she had syphilis during her third trimester. “I was terrified of what people would think. But I’m so glad I pushed through the shame. My baby was treated right after birth, and he’s totally healthy now. That could’ve been a very different outcome.”
Her story isn’t rare. What’s rare is someone speaking up about it.
Still Not Sure? Here’s What to Listen For
If you’ve made it this far and you’re still wondering whether that ache, that odor, or that bleeding is “normal,” you’re not alone. That’s the problem. So many people feel something’s off but don’t want to be “dramatic” or “annoying” or “paranoid.” Pregnancy already puts your body under a microscope, who wants to add more anxiety?
But here’s your permission slip: trust your gut. If your discharge smells different. If your spotting doesn’t follow the usual pattern. If the itch feels deeper than just dry skin. If your energy crashes even after sleep and food. If you feel a pelvic pull that doesn't sit right. You don’t have to wait until your next checkup. You don’t have to ask for permission. You can test from home, in your bathroom, in your own time, and take back control.
So You Tested Positive, Now What?
First, breathe. Finding out you have an STD while pregnant doesn’t make you a bad partner, a bad parent, or a bad person. It makes you informed. And informed people protect themselves and the people they love. What you do next is what matters, and treatment is often simpler than you think.
If you test positive for something like chlamydia, gonorrhea, or trichomoniasis, your provider will likely prescribe a single-dose antibiotic that’s considered safe for pregnancy. For syphilis, it’s a shot of penicillin. For genital herpes, antiviral meds can help reduce outbreaks and minimize the chance of transmitting it during labor.
You do not have to suffer in silence. And you do not have to wait until the next scheduled prenatal visit. If you’ve used an at-home test and gotten a positive result, you can bring that result to your OB, midwife, or local clinic and get follow-up care right away.
Pregnancy is a high-priority window for STD treatment because the health system knows what’s at stake. Infections like syphilis or untreated herpes can pass to your baby during delivery. Others, like chlamydia or gonorrhea, can affect your placenta or cause neonatal infections. The earlier you act, the more control you have over outcomes, and the less stress you’ll carry.
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How to Talk to Your Doctor Without Feeling Judged
It’s not your job to be an STD expert. It’s your job to ask questions when something doesn’t feel right. And it’s your provider’s job to answer without condescension, blame, or silence. If you’re not getting that kind of care? That’s a red flag, not your symptoms.
When bringing up STD concerns, use plain language. You don’t need medical jargon. Try:
“I’ve noticed some spotting and a smell that doesn’t feel normal for me.”
“I was tested at 8 weeks, but new symptoms just started. Can we re-test?”
“My partner hasn’t been tested recently, and I want to be cautious.”
If your provider brushes you off, you’re allowed to advocate harder. Or seek a second opinion. Or use a confidential at-home test while you wait. Your body deserves attention. Your pregnancy deserves safety. Your concerns deserve more than a shrug.
And if shame starts to creep in? Remember this: asking for care isn’t selfish. It’s sacred. Your voice is part of your baby’s protection plan.
Test Early. Test Again. Test Without Shame.
You don’t need to wait for symptoms, or approval, to test for STDs during pregnancy. You can test early, at home, even if your doctor didn’t mention it. You can test again in your second or third trimester, especially if something feels different or your relationship dynamics shift.
According to the CDC’s STD Treatment Guidelines, pregnant individuals at risk of infection should be tested at the first prenatal visit, and again in the third trimester if they remain at risk. That includes anyone under 25, those with a new or multiple partners, or anyone whose partner’s status isn’t clear.
But here’s the kicker: many people don’t fall into these categories, and still test positive. That’s why risk-based screening often misses the mark. It assumes people tell the full truth about their sex lives. It assumes partners are always transparent. It assumes shame isn’t distorting what people say.
FAQs
1. I got tested early in my pregnancy. That means I’m good, right?
Not necessarily. You might’ve been clean then, but infections don’t wait around for your OB schedule. If your partner hasn’t been tested recently, or new symptoms show up mid-pregnancy, it's worth testing again. One screen isn’t a forever pass.
2. How the hell am I supposed to know what’s “normal” discharge?
Great question, and welcome to pregnancy, where discharge is basically doing its own thing every week. But if it’s suddenly green, yellow, smells metallic or fishy, or comes with itching or burning? That’s not just hormones. That’s your cue to check for infections like trichomoniasis or gonorrhea.
3. Can I have an STD with no symptoms at all?
Oh, absolutely. Most pregnant people with chlamydia or trich don’t feel a thing. No itch, no smell, no clue. That’s why STDs spread so easily, and why testing matters even when everything seems fine.
4. What happens if I do test positive while pregnant?
You treat it, just like any other infection. Most STDs can be handled with pregnancy-safe antibiotics or antivirals. Chlamydia? One dose. Syphilis? A shot. Herpes? Daily meds if needed. It’s not the end of the world, it’s a detour with a fix.
5. Is it safe to test at home while I’m pregnant?
Yep. Totally safe, totally smart. At-home kits let you take control without sitting in a clinic waiting room full of outdated magazines. Fast, private, and doctor-trusted. You’re allowed to make things easier on yourself.
6. I’m in a monogamous relationship. Why would I need to test?
Monogamy doesn’t always mean mutual testing. Your partner may not know their own status, or they may have carried something from before you got together. Testing isn’t about trust, it’s about truth and health, for both of you.
7. There’s a rash on my hand. Could that be… related?
Weirdly, yes. A painless rash on your palms or soles can be a sign of secondary syphilis, especially if it shows up with fatigue or fever. It’s one of the most missed signs because people think it’s eczema or pregnancy swelling. Don’t ignore it.
8. How do I bring this up to my OB without sounding “dramatic”?
Easy: you don’t apologize. You say, “I want to rule out STDs because this symptom feels off.” That’s it. You don’t owe them a reason, a backstory, or a breakdown. If they dismiss you? Find a provider who listens, or test on your own terms.
9. Can my baby get infected if I don’t treat it?
Unfortunately, yes. Some infections can pass to your baby during labor, or cause preterm birth, low birth weight, or other issues if left untreated. That’s why we don’t wait. The earlier you treat, the better the outcome.
10. I’m freaked out. I didn’t know any of this. Am I a bad parent?
No. You’re someone who’s trying to learn and protect their kid. That’s literally the definition of a good parent. Shame doesn’t belong here, only action, answers, and care. You’re doing the right thing by being curious.
You Need to Know What’s Going On in Your Body
Pregnancy is messy. Beautiful, yes, but also overwhelming, emotional, and full of changes that make it hard to know what’s normal. You shouldn’t have to play detective every time your body sends a signal. But if something feels off, you deserve answers that go deeper than “it’s probably hormones.”
Your baby deserves a healthy start. You deserve care without judgment. And no matter what your test says, you deserve to be treated like a person, not a risk factor or a walking uterus. That’s what trauma-informed sexual health looks like. And that’s what we believe in.
End the guessing game. Take control of your sexual health, on your terms, at your pace, with tools that honor your privacy and your power.
Testing is care, not shame. Start today.
Sources
2. Marshfield Clinic: STDs During Pregnancy
3. Fertility Center Soc: STDs While Pregnant
4. PubMed: Prevalence and Risk of STIs During Pregnancy
5. Everlywell: STD Symptoms During Pregnancy
