The Magical Mucus Plug

As soon as you find out you’re pregnant, there is a slight sense of urgency and panic about the birth. It’s impossible not to want to know about everything. But plenty of things to do with childbirth can be confusing, gross, or downright horrifying. We still need to learn about them, but many resources focus on either the pure medical aspects or the gory details. What most of us actually need is somewhere in between. Enough medical information to feel safe and secure. But enough of the weird and wonderful that we won’t freak out when it starts happening. Enter the mucus plug. 

What is it? What does it even do?

The mucus plug is, as the name suggests, a piece of mucus that plugs up the womb. This isn’t to keep the amniotic fluid in, like some people assume. The amniotic fluid, with your baby floating inside it, is safely wrapped in a thin sack inside your womb. Some babies are even born in their sack. You would not dribble amniotic fluid if you didn’t have a plug! (1) What the plug does is it helps keep other things out. 

The womb is, naturally, a delicate place. It’s an organ with an opening to the outside world. Ordinarily our natural secretions, combined with menstruation, keep the ph balanced and bacteria out. Sometimes we will still get a minor yeast infection, but usually it will clear on its own. But when we have a baby growing inside us, there are two challenges. Firstly the amount of secretions goes down and the menses goes away. This means the womb is “washed” less often. Secondly, the baby is far more fragile than we are. We can survive a yeast infection, but the baby would be put at serious risk because of it. The mucus plug acts as a barrier, keeping all sorts of yeasts and bacteria contained in the vagina, away from the baby. (2) 

Some Mucus Plug Photos

lost mucus plug 36 weeks

mucus plug 37 weeks

lost mucus plug at 35 weeks

38 weeks pregnant mucus plug

Will it come out when I’m having sex?

Naturally, knowing how important it is means most of us will be at least slightly worried. The last thing we want to do is put anything up there. What if we move the plug? What if it comes out? The idea of starting labour early, or exposing our baby to bacteria, can be scary. 

Rest assured that so long as what is entering you is as wide as a finger or wider, and doesn’t go up inside your cervix, the plug is secure. It takes a lot of force to break the plug. Even in inductions, where the plug is medically removed, it’s hard work. They use a long hook like a crochet hook, and have to break through the plug, then use the hook to pull it out. The plug is very firmly stuck there. 

Will it come out when I’m exercising?

Another concern many people have is whether  exercise may disturb the plug. Many women avoid squatting motions, or skip exercise completely, afraid the pressure will push the plug out and induce labour. One thing we know for sure: just tensing your abs or squatting down will not push it out. It’s firmly fixed in there. You may injure yourself, but the plug will stay put. 

That said, there are two kinds of exercise to definitely avoid when pregnant. The first is any exercise where you are bouncing up and down. Vigorous jogging, skipping, or volleyball are completely out. This makes the whole weight of your bump bounce up and down on the cervix. This may damage the cervix, resulting in labour. The second is exercise where there is a risk of falling or impacts. Between the extra weight, swelling in the legs and feet, and blood pressure changes, pregnancy already makes you more vulnerable to falls. Falling risks harming you and the baby. For that rason, avoid sports like skateboarding, climbing, or rugby. 

If your exercise of choice doesn’t involve bouncing or a risk of falling, it is unlikely to upset your mucus plug. 

Are there any circumstances where it may fall out early?

Throughout pregnancy your mucus lining will shed bits of itself and regrow. Tiny clumps of sold, clear or white mucus will leave your body on a weekly to monthly basis. Many people mistake this for the plug coming out. (2) 

That said, on rare occasions the plug will come out early. This may be a symptom of a weak cervix, resulting in premature labour. Or it may put the baby at risk of infections that could harm or kill it. In the vast majority of cases, this doesn’t happen without warning. Usually it happens in women who:

• Have a weak cervix from prior complicated births, age, or surgery.
• Have a hormonal disorder, such as PCOS.
• And have suffered cervical cancer.

If you are at risk of this, your doctors will refer you for a cervical exam. If anything is amiss these will continue throughout the pregnancy. So if you haven’t needed an exam, or your exams are revealing all is well, there is no need to worry about your plug falling out early. (2) 

Will it come out at the start of labour?

Yes and no. When birth starts a series of events take place. Your hormones adjust, softening your cervix and encouraging the pelvic floor muscles to tense. These are what we call contractions. This slowly pulls at the cervix, opening it. The weight of the baby pushes down on your cervix, usually breaking the sack and encouraging your body to release hormones which speed up contractions. The plug is not a part of this. 

That said, for many women the first sign they are in labour, even before their waters break or the first contraction, is the mucus plug falling out. This is because the cervix may be in the process of softening for days or even weeks before labour. When the cervix reaches 1-2cm dilation, usually the mucus has nothing to hold onto and falls straight out. Seeing it in your underwear may be gross and shocking, but as long as you’re getting on for week 37, it’s a good sign! (1) 

On the flip side, some women lose their mucus plug and don’t even notice! This is quite common, especially if your plug is soft, comes out in pieces, or you have thicker discharge. Don’t feel worried if your contractions start and there is no sign of the plug. It will come out when your waters break. (4) 

If it comes out and labour doesn’t start, what does that mean?

If your entire mucus plug has broken free before 36 weeks of pregnancy, you need to call your doctor or hospital urgently, as this could mean a risk of premature birth. In these situations often the plug has come loose for a secondary reason. This means pregnancy ought not to start. You may be allowed to continue as normal, with a few precautions, or you may be prescribed bed rest until labour begins. (2) 

If your mucus plug comes out after the 36^th week of pregnancy, then it could still take up to two weeks for labour to start. If there are no signs of anything beginning after two to seven days, or if you notice fewer movements from your baby, call your doctor or hospital immediately. Based on a scan and other tests they will determine whether to wait for you to enter labour or whether to induce you. (1) 

What does it look like?

So what exactly does the mucus plug look like? As mentioned, sometimes a few tiny pieces of mucus plug will appear as part of routine shedding. Your actual plug will be long and thin. Around 2 inches long and as thick as an earth worm. But it may come out in parts, so it may be smaller, or you may not even notice it. It will be anywhere from clear, to yellowish white. It will probably have a few drops or strands of blood in it, though sometimes it will be very bloody, and other times there will be no blood at all. If you squish it in some tissue paper, you will notice that not all of it breaks apart easily. (2) So, to recap:

• Blood.
• Earth-worm thick.
• Two inches.
• Solid.
• Yellow, white, or clear.

And if in doubt, do an image search. Though preferably on an empty stomach. (3) 

Is it supposed to be bloody?

Finally, some women worry when it is bloody. Not all plugs are bloody. They can be clear, spotted, or even completely pink with red bits. All of this is normal. If it looks very bloody, make sure the mucus is firm. This rules out abnormal bleeding. So long as it’s firm, you’re over 36 weeks, and your baby is moving, it’s probably just a healthy mucus plug elimination. (3) 

But look out if your plug is green, brown, or smells, or if you bleed heavily, like when menstruating. This could be a sign of infection, or even your waters breaking. Call your doctor immediately, sit still, and wait for an ambulance or midwife care. (4) 

1: https://www.babycentre.co.uk/x25006041/how-long-after-the-mucus-plug-comes-out-does-labour-start

2: http://www.mucusplug.net/

3: https://www.babycentre.co.uk/l25008775/what-a-mucus-plug-looks-like-photos

4: http://www.healthline.com/health/pregnancy/losing-your-mucus-plug