Birth Myths – The Mucous Plug

First of all, let’s give our inner twelve year old boy some love. “Mucous Plug” is a squirmingly unpleasant term. I’m not arguing that point, it sounds just plain gross. Birth can be gross, and raw, and real. “Mucous Plug” is just an apt description. It’s a plug. Made of mucous.

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You’re excused now, inner twelve year old boys.

If you’ve spent any time on pregnancy message boards, you’ve seen the posts I’m talking about. “I just lost my plug! Am I going into labour?”. It’s a pretty common myth. A lot of us take the presence of a discharged plug to be a tell tale sign of impending birth. It would be nice, to have that one key “You’re about to have a baby!” sign. But unfortunately, it’s not that simple.

So, what is a mucous plug? At the very beginning of your pregnancy, your cervix will begin preparing for the big job of protecting your baby. It will produce a very thick mucous barrier, rich in antibiotic properties, to completely seal off the cervix. This forms a barrier between your baby and the outside world. Towards the end of pregnancy, when your baby is reaching readiness for the outside world, your hormone levels will change. Your cervix will undergo gradual changes. Softening, perhaps thinning or dilating a bit. When these changes occur, the mucuous plug slips out.

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Often, you won’t even notice it’s happened. It may come out in the toilet, or in the shower. You may mistake it for ordinary vaginal discharge. Particularly in first time birthers, it may not come out all at once, which makes it particularly easy to miss. For those of us who do spot the plug, you can expect to find (in your panties, or on your toilet paper) very thick semi transparent off-white mucous, often tinged with a small amount of blood. The blood is added by burst capillaries in the cervix, from the changes in it’s structure that caused the loss of your plug to begin with. There’s an extremely wide range of normal for mucous plugs. It may be thin, or thick. Intact, or in small pieces. In the perfect shape of your cervical opening, or unidentifiable. Pink, green, brown, white, clear. It’s easy to see how it may get overlooked, with so many possibilities to account for.

Should you worry if you see your plug come out? Short answer, no. The plug’s purpose is infection protection, but it isn’t the only line of defense. Your baby is still safely tucked in, past your cervix, inside your uterus, inside the chorion and amnion, floating in amniotic fluid. There are multiple barriers still in place. Talk to your primary care provider for recommendations regarding infection risks after plug loss, like sex or swimming, as no one practice is universally recommended. If your plug comes out with no pain, no foul odor, and only a small amount of blood, it’s a non emergent situation.

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Credit: “Cervical Mucus Properties Stratify Risk For Preterm Birth”

If you’re past the 37 week mark, it’s essentially safe to ignore the loss of your plug. Really, the only new information offered is that your cervix did something, at some point. Unfortunately it has little bearing on when you’ll go into labor. Particularly for experienced mothers, whose cervixes have not completely closed and hardened after previous births, they may find the plug comes out for little reason at all. You may have weeks left to go before meeting your baby.

If you’re under 37 weeks, there’s no need to panic, but you should place a call to your primary care provider. Early cervical changes put you at risk for preterm birth. The loss of your mucous plug alone does not mean you’re in preterm labour, but it is a sign that you may need further evaluation. The good news is your cervix is constantly producing more mucous. If your plug comes out too early, odds are it will regenerate and continue protecting your baby for weeks or months to come.

On a personal note, I’ve been on opposite ends of the experience spectrum here. With my first baby, I noticed absolutely nothing. Loss of the mucous plug had zero bearing on when my child was born. I could have overlooked it at any time, or I may not have lost it at all until active labour. The second time around, I did see it. Unfortunately, I saw it at 27 weeks pregnant. I started experiencing prodromal labour contractions two weeks later, and we found I had lost my mucous plug due to softening and effacement of my cervix. I needed bed rest, and I was obviously quite concerned. Ultimately, it stopped. I regained cervical length, the plug regenerated, and my baby stayed put until 41 weeks gestation.

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“I lost my mucous plug, I must be going into labour!” This myth is busted. Losing your mucous plug simply means some sort of change may have occurred in your cervix. It’s not a magic countdown clock to your baby’s birthday. On the flip side, it’s okay to be excited! Something has happened. You’re on your way to meeting your baby. Celebrate the journey, even the small steps.

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