As a good friend and Labor and Delivery Nurse, I get asked some ooey gooey, awkward questions! The sort that only come out in the all safe zones; like the girl’s nights outs or the baby showers… at least once grandma has left right?  These questions can make you blush, but what is even worse is not knowing! So step right in my all safe, no shame zone and I will be your BFF Labor and Delivery Nurse and answer your questions to the best of my ability!

Your Embarrassing Pregnancy Questions Answered

1. Does Everyone Poop During Labor?/ Can I prevent from pooping during labor?

Lo and Behold… the most common question, and what a fun topic… POOP! The grade school students’ favorite naughty word that gets written on desks and bathroom walls. Pooping, defecating, having a bowel movement, going number two; whatever you want to call it is absolutely normal and VERY COMMON during labor and especially during the pushing part. Unfortunately, I do not have a hard statistic to tell you just how likely it is for you to have a bowel movement while in labor (I don’t personally count).  Although, this statistic would be of little of assistance anyway. What you should know is this- it is nothing to be embarrassed about! I understand growing up, you were taught manners to be lady like and pooping in front of others hopefully did not make that list. But, I can’t think of anything that contains more woman power then creating, growing, and giving birth to a new precious little human being!

When it is time to push, we will tell you to bear down like you are having a bowel movement and we mean it! We don’t want you to hold back, but to push harder then you have ever pushed before! And if a bowel movement comes out, we will discretely clean it up and not even bat an eye. We are not even phased! Okay, I take that back. We are phased, we are excited! We know baby is coming down and you are making progress!

My goal here is to help you feel as comfortable and calm as possible during your labor process because this helps labor to progress. If you are ever feeling anxious or fearful this may slow down the labor process.  If you are stressing over having a bowel movement in front of someone in particular, maybe you should rethink having this person in the labor room with you.

Now, if my attempt to convince you not to worry about having a bowel movement while pushing your baby out has just not reached you, try to use the bathroom frequently while you are in early labor. Some women may request an enema during the first stage of labor to save themselves an embarrassing moment of having a bowel movement later in the labor process. The World Health Organization (WHO) recently published a study that showed higher infection rates seen in women who received an enema during early labor compared to those who did not.  Thus, the use of enemas in labor are discouraged. (Reveiz, Gaitán, & Cuervo, 2013)

2. Should I Shave Down There Before Coming to The Hospital?

If you are having a scheduled c-section, check with your physician prior to arrival. But, if you are planning on having a vaginal delivery, this is your personal decision. If you were to ask me, after a day of work in labor and delivery, to reflect back and remember if my patients were cleanly shaved or as hairy as a gorilla, I honest to goodness would not remember! We have more important things to reflect upon and remember then how much hair you have there.  Some hospitals around the world used to shave the women’s perineum (your private area down yonder) upon arrival to the labor and delivery unit to prevent infection. The newest research published by WHO states, “There is insufficient evidence to recommend perineal shaving for women on admission in labour” (Basevi & Lavender, 2014).  In other words, save yourself the difficulty of reaching over that big belly and possibly having a red, itchy, irritated area! That is, unless it is your personal habit to keep your perineum shaved or trimmed and it helps you to feel at ease, then that is totally fine.

3.  Is Intercourse in Pregnancy Always Safe?

Unless specified by your health care provider, intercourse is safe for you and your growing baby throughout the whole pregnancy. Some reasons your provider may prescribe “No sex”, is if you have a high risk pregnancy. This includes, a history of premature labor or birth, history of a miscarriage, if your water has broken, also known as spontaneous premature rupture of membranes (SPROM). This would also include unexplained vaginal bleeding or abnormal discharge, an abnormal placenta, an incompetent cervix (a cervix that is abnormally thin or prematurely dilated), or if you or your partner have any sexually transmitted infections, intercourse is discouraged. (American Pregnancy Association, 2013)

4. Is it Normal to Have a Decreased Sex Drive (Libido) During Pregnancy?

Your body will be going through specific changes throughout your pregnancy that may change your attitude towards sexual behavior. Some of these specific changes include weight gain, hormonal changes, fatigue, breast tenderness, and an increase of blood flow to the pelvic area.  Make sure to listen to your body and be open with your significant other to make adjustments so you may both enjoy the experience. If you want to increase your sex drive, squeeze a nap into your regular schedule as well as stay physically active.

On average, your breasts will enlarge a total of 25%-50%, thus your breasts may be very sore! (Beckmann, 2010) You could steal the lines from the museum sign, “Observe with your eyes and not your hands.” If you are too uncomfortable or sensitive, encourage your significant other to explore other parts of your body.  You may also want to try more comfortable sex positions with your growing belly such as side to side or with you on top. (American Pregnancy Association, 2013)

5. Is it Normal to Smell Different Down There During Pregnancy?

Have most things taken on a new scent since you have been pregnant? Take comfort in this, your sense of smell is heightened during pregnancy. But please take caution, as normal vaginal discharge during pregnancy has a mild smell. This is called leukorrhea, leukorrhea’s normal characteristics are thin, white, and milky. See your doctor if your vaginal discharge ever becomes green, yellow, or stronger in scent than your normal pregnancy discharge. Also take note if you become itchy and red down there. These symptoms can be caused by a vaginal infection. The most common vaginal infection during pregnancy is a yeast infection (candidiasis) but these symptoms may also be caused by something else such as a sexually transmitted infection (STI). But please, never try to diagnose and treat yourself. See your Provider!

*If you are uncomfortable from the normal increase in vaginal discharge use a panty liner. DO NOT use tampons or douche while pregnant as this can introduce infection. (American Pregnancy Association, 2014).

6. Is it Normal to Be Especially “Gassy” and “Belchy” During Pregnancy?

The female body is absolutely incredible as it changes to house a little growing baby. Incredible as it is, some changes may not be so glamorous as you probably have realized by now.  I like to believe that these transformations help us to become more humble to prepare us for a life-changing event.

During pregnancy, the hormone progesterone increases and thus slows down the movement of the intestinal tract up to 30% longer than normal. This increased duration allows for a greater amount of time for your body to absorb nutrients and is the reason for the increased amounts of gas. This gas is released by burping (belching) or farting (flatulence).

There are some ways to help, such as chewing your food slowly and thoroughly. “Most gas is caused by bacteria in the large intestine working to break down food that was not digested thoroughly by enzymes in the stomach.” (American Pregnancy, 2014) Constipation is also related to gas, thus make sure you stay active and drink plenty of water. American Pregnancy Association also gives advice to decrease gas by avoiding carbohydrate drinks, fatty fried foods, artificial sweetners, and avoid drinking with a straw or wearing tight clothing around the waist. (American Pregnancy, 2014).

7. What is All That Painful Pressure Down There?

There are multiple reasons why you may have painful pressure down. Genital engorgement is one of the main reasons and is due to the increased blood flow to your pelvic area. 10% of pregnant women develop vulvar varicosities, usually with their second pregnancy. These are varicose veins in your private area caused by the increase in estrogen and progesterone. These may cause a feeling of heaviness, itching (pruritus), painful intercourse (dyspareunia), and discomfort with exercising, walking, or standing for long periods of time. (Van Cleef, 2011)

When someone has varicose veins in their legs, they are encouraged to wear compression socks to aid in the pain. Oddly, the vulva is a more difficult area to support compared to a leg and there is no such thing as a vulva sock;). But, there have been support belts made especially for vulvar varicosities that wrap around the crotch, funny looking, but helpful! If you want to try a less expensive method, you may create your own support with a thick cold compress pressed up against your vulva to give support and relief. Also, try changing positions often, elevating your hips when sitting down, and try swimming for exercise. The good news is that these usually resolve within six weeks after delivery of the baby. (Murry, 2013)

Varicosities can also also appear in the anal/rectum area known as hemorrhoids. Hemorrhoids are unfortunately very common in pregnancy and appear most frequently in the third trimester. (American Pregnancy, 2014) Hemorrhoids can be visible (external) but also hidden inside (internal). These little monsters are caused from constipation and an increase in pelvic pressure due to the extra blood flow and growing uterus. (Beckmann, 2010) To prevent hemorrhoids, drink plenty of water throughout the day, keep a diet high in fiber, and stay active. You may want to keep a stash of prune juice in your fridge. Also, when you feel the urge to use the restroom, try to go right away and do not strain while having a bowel movement.

If you are already experiencing itchiness, discomfort, or bleeding from hemorrhoids, try taking a “sitz bath”. After drying off, use local preparations such as witch hazel or tucks pads to reduce the swelling or bleeding. Your bottom may tell you not to sit for long periods of time; listen to it! If you are itchy down there, try using some dry or wet baking soda on the area.

Tip to the wise: Ask your health care provider ANY question you have! They know what is best for you and can help you in the best way.  Remember, they have heard many questions and although you may think your question may be embarrassing, they have probably heard it many times before!

References:

American Pregnancy Association. (Updated 07/2014). Gas During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/gas-during-pregnancy/

American Pregnancy Association. (Updated 03/2014). Hemorrhoids During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/hemorrhoids-during-pregnancy/

American Pregnancy Association. (Reviewed 01/2013). Sex During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/sex-and-pregnancy/

American Pregnancy Association. (Updated 03/2014). Vaginal Discharge During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/vaginal-discharge-during-pregnancy/

Basevi V, Lavender T. Routine perineal shaving on admission in labour. Cochrane Database of Systematic Review 2014, Issue 11. Art. No.: CD001236. DOI: 10.1002/14651858.CD001236.pub2.

Beckmann, C. (2010). Obstetrics and gynecology (6th ed.). Baltimore, MD: Lippincott Williams & Wilkins.

Murry, Mary M. (2013). Vulvar varicosities: I have varicose veins where? Retrieved from: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-blog/vulvar-varicosities/bgp-20055755

Reveiz L, Gaitán HG, Cuervo LG. Enemas during labour. Cochrane Database of Systematic Review 2013, Issue 7. Art. No.: CD000330. DOI: 10.1002/14651858.CD000330.pub4.

Van Cleef, Jean-Francois. (2011). Treatment of Vulvar and Perineal Varicose Veins. Retrieved from: http://www.phlebolymphology.org/treatment-of-vulvar-and-perineal-varicose-veins/