Vaginal probiotics are supplements containing live microorganisms, typically beneficial bacteria, that support the balance of the vaginal microbiome. This ecosystem is important for vaginal health. During pregnancy, questions often arise about their safety and appropriateness. Understanding their role and how to choose them involves examining current scientific insights.
General Safety of Vaginal Probiotics in Pregnancy
Medical and scientific consensus indicates a low risk associated with probiotic use during pregnancy. Studies have not shown an increase in adverse pregnancy outcomes for the mother or baby when probiotics are used by healthy individuals. Systemic absorption of probiotic bacteria into the bloodstream is rare, making it unlikely for these microorganisms to reach the fetus.
A meta-analysis of over 1,500 pregnant individuals found no significant increase in miscarriages, malformations, or differences in birth weight, gestational age, or incidence of cesarean section. Some studies reported minor gastrointestinal side effects like increased vaginal discharge or changes in stool consistency, but these were minimal. Despite the safety profile, it is important for pregnant individuals to consult with their obstetrician or midwife before starting any new supplement.
Reasons for Use During Pregnancy
Pregnant individuals might consider using vaginal probiotics to manage or prevent imbalances in the vaginal microbiome. Hormonal shifts during pregnancy can increase susceptibility to common vaginal infections, such as bacterial vaginosis (BV) and yeast infections (vulvovaginal candidiasis). Probiotics, particularly Lactobacillus strains, introduce beneficial bacteria that help maintain an acidic vaginal pH, inhibiting harmful pathogens.
Specific strains like Lactobacillus rhamnosus and Lactobacillus reuteri have been studied for their ability to restore a healthier, Lactobacillus-dominant vaginal environment and reduce the recurrence of BV and yeast infections. Research also explores probiotic use for reducing Group B Streptococcus (GBS) colonization, a bacterium present in the vagina and rectum of some pregnant individuals. While studies on GBS reduction have shown mixed results, some meta-analyses suggest that probiotic use, especially when started after 30 weeks of gestation, may reduce GBS colonization.
Potential Influence on Infant Health
The maternal vaginal microbiome plays a significant role in seeding the infant’s gut microbiome during a vaginal delivery. As the baby passes through the birth canal, it is exposed to the mother’s vaginal bacteria, which colonize the infant’s digestive tract. This initial microbial exposure is important for the development of the infant’s immune system.
Research suggests that a healthy maternal vaginal flora is linked to positive outcomes for the infant. Studies indicate that a diverse and balanced infant gut microbiome, influenced by maternal microbial transmission, is associated with a lower risk for certain conditions in early childhood, such as eczema and allergies. For instance, interventions with Lactobacillus rhamnosus HN001 during the perinatal period have been linked to a significant reduction in the risk of eczema in offspring up to 11 years of age. This explores how maternal microbial health contributes to the infant’s developing immune tolerance.
How to Select a Vaginal Probiotic
After consulting with a healthcare provider, understanding the different forms and strains of vaginal probiotics is helpful. They can be taken orally or as vaginal suppositories, though caution is advised with unproven over-the-counter suppositories. Oral probiotics with specific strains can travel through the digestive tract and colonize the vaginal environment.
Look for products containing well-researched Lactobacillus strains known to support vaginal health, such as Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Other beneficial strains include Lactobacillus crispatus, Lactobacillus acidophilus, and Lactobacillus gasseri, which help maintain a healthy vaginal pH. Also, choose products with third-party certification, such as NSF International or USP, as this indicates testing for purity, potency, and accurate ingredient labeling.