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The Mucus Plug

Shieva Ghofrany: [00:00:00] Good morning, sunshines. It's Sunday and I am on call tonight. So I'm gonna hunker down at home all day and get some writing done for my ebook that I'm doing with Jenny, my partner, for our pregnancy kit that's coming up in the next couple weeks. So we're gonna talk about the mucus plug. If I could figure out editing, I would be like the mucus plug. 

Um, the mucus plug, which as I laugh, gets a lot of fanfare in the lay press, meaning the non-medical peer reverter, peer review journals, which is like our gold standard, like the journals that we abide by read look at our peer review. So they have panels of doctors who are reviewing them. , they have to have kind of more objective data. 

Of course, that data can still be skewed, but those are the things that we look at as opposed to kind of like the magazines that can give you great information, but things like parents, magazines, stuff like that. Magazines that I I like, but are different than medical data. [00:01:00] So it's funny because whenever I kind of talk through like, Hey, when to call us in labor and if I have time I'll kind of talk about like, Hey, do you need to call us about the mucus plug? 

And patients are always like, yeah, right? And the answer is no, , thank you. But no, you don't need to call your doctor or midwife when your mucus plug comes out. So a couple of funny things I found about the mucus plug one is that in talking about it, I all of a sudden realized that mucus, the word has two different. 

MUCUS and mucous and I don't know, do y'all know the difference? I actually pulled a bunch of the doctors that are in a private Facebook group, the OBGYNs, and it wasn't exactly split, but there were a lot of us, or a lot of them. Cause I think I said mucus us who were kind of confused like I was about like what is the difference? 

So mucus is the noun. Muus, M C M U C O U S is the adjective. Now mucus plug. If you think of the laws of, um, grammar could be noun or an [00:02:00] adjective, right? Because you're describing a plug made of mucus that could be the adjective, or it is a plug of mucus, meaning the noun here, they use it medically as mucus, M U C U S. 

So that is what we are discussing. Patients will sometimes say, wait, I don't need to call you. I'm so confused. I thought I was told I need to call you. Now, I know that one of our nurses, Emily, who teaches a birthing class to a lot of our patients, is very clear to our patients that you do not need to call with mucus plug. 

But every doctor has stories of the patient who called all excited or worried or anxious that her mucus plug came out thinking that that's like the harbinger of labor to come and the answer. Wa, it's like completely not. Um, so they've also sent us pictures often. So in the stories when I link this video, I'm gonna actually put a couple pictures of mucus plug. 

And actually I decided I would do a little research today. So I researched the lay press to see what they said. And actually a bunch of them said, call your doctor a midwife. One of them actually qualified it and said that, and then [00:03:00] put another statement underneath saying, unless you're bleeding heavily, you don't need to. 

Which confuses you guys. I get it. The, the actual peer reviewed journals. Believe it or not, there's just not a ton of information about the mucus plug full term in labor, which confirms what we know, which is that it doesn't mean a lot. There's a lot of data trying to evaluate the properties of the mucus plug and whether or not, um, kind of damaged properties of a mucus plug, which can lead to low level infection can then cause preterm labor because the mucus. 

Is, as you can imagine, a glob of mucus. It's kind of mediated by hormones like progesterone. It's got antibacterial properties in it to help decrease the risk of an infection because your cervix is like a tube and an in that tube. In that tunnel, there's a chunk of mucus. Your cervix is typically about four centimeters long, like a thick tube, and then the mucus is there through the pregnancy, and then somewhere towards the end, the end could be a couple of weeks. 

That mucus plug [00:04:00] will go. In one of two fashions, it'll either just plop out like a chunk of snot in the toilet or your underwear, which does not mean anything other. That kind of critical mass of time where that that chunk couldn't be held inside your cervix because your cervix was slowly thinning out or slowly dilating as it does towards the end of pregnancy sometimes. 

So it's come out, or the other way is that it just dissipates over time. So in the last couple weeks of pregnancy, again, is your cervix is slowly dilating and thinning out what we call effacing. That glob of mucus can't stay in there, so it just kind of eeks itself out. So if you've noticed a lot of like slippery, watery d. 

That's not water, meaning just kind of that, um, thin mucusy, like I say, uncooked clear egg white type discharge towards the last couple weeks. That's your mu mucus plug kind of slowly dissipating. So don't be like waiting for your mucus plug to come out when it's probably already slowly come out. You're like waiting for a party and it never shows up. 

[00:05:00] So again, if you guys are interested in your mucus plug, I think by all means, look at it differentiate. It's typically like kind of a clearish yellowish chunk of snot looking stuff. It might have some streaks of red or brown, none of which is dangerous. , I'm not your doctor. If I'm not your doctor, you can go ahead and talk to your doctor if she wants you to call her, but I would personally say for us in our practice, and I think the majority of the practitioners in the world, , while they love you and want you to feel like you can call them, you don't need to call about the mucus plug. 

Cuz at three in the morning it's not gonna do anything. It doesn't mean anything. You could drop, drop your mucus, plug on 37 weeks and still go to 41 weeks of pregnancy. So if your doctor examines you and you're like two to three centimeters, That means your mucus plug is long gone. Now, does the mucus plug coming out early? 

Signify preterm labor? Like let's say you're 32 weeks and you notice a big chunk of snot coming out. It's possible that you're gonna go into preterm labor, but it's not a foregone conclusion. And the fact is there's not a lot that you would do otherwise other than [00:06:00] be cautious. So the times I would say I'm cautious to patients are if they are at risk for preterm labor, meaning they had had a previous preterm labor, or they're describing new onset discharge. 

I wanna differentiate between is it like thick, white, creamy, or maybe thick yellowish. You think it's an infection like yeast or bv, in which case we should treat it because it's uncomfortable versus is it a sudden onset of copious clear, uncooked, clear egg white type of discharge? In which case that could mean. 

Either your mucus plug coming out or that your cervix is kind of thinned out early in pregnancy and the fluid almost like seeps across the membrane. So you wanna make sure that if you have a new onset, sudden onset, clear, copious discharge, that you talk to your doctor about it, not alarming, just talk to them so they can see. 

Now again, that's different than, ugh, I've always had discharge. Discharge in pregnancy is normal. There's actually a word for it, Lu. Luke means white rya means [00:07:00] like drippy white discharge, forgot the actual Latin, um, description of Rya, R r H e A, but like dia, rya, luko, rya, rhino, RIA. It's drippy discharge, so luukko drippy white discharge. 

So again, tons of thick white discharges, normal in pregnancy. If it's all of a. Tons of watery, clear discharge that might signify a difference. It might be b, bacterial vaginosis, bv, or sometimes it's part of your mucus plug. And if you're cer very preterm, I would say like less than 35 weeks, then just discuss it with your doctor. 

If you're past 35 weeks, it's really nothing to do about it. Um, so again, do you need to call us with a mu muus Mucus plug? No. Does it mean anything? No. Do you need to take a picture of it? Can you take a picture of it? Can you call your doctor if I'm not your doctor? Absolutely. And if I am your doctor, you can call me, but I'm probably gonna be like, hey. 

Okay. That's great. Yeah. Thank you so much. No, no. We don't need to do anything. No, you don't have to go to the hospital. Yes. I'm gonna go back to sleep. Okay. [00:08:00] Bye. Um, what else can I tell you about the mucus plug? That's it again, gets a lot of like excitement in the, the lay press, but to. Not so consequential. 

Okay. I'm gonna link a couple of like little snippets of articles and maybe even a picture of the mucus plug. Warning. Warning. Warning. Okay, bye.