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PREGNANCY SYMPTOMS: WHAT TO EXPECT THE THIRD TRIMESTER

Posted in Health, Pregnancy by

Almost there! The third trimester is full of expectation, as the moment you will hold the baby in your arms approaches. But the excitement comes with a lot of uncomfortable symptoms…

The third trimester lasts from the 7th through the 9th month of pregnancy, that is, from week 28 till the moment you give birth, usually around week 40. This period can be challenging and tiring, as your womb grows and creates a lot of discomfort. Most of the symptoms you will experience are those that appeared during the second trimester, although they will be more intense now: back pain, leg swelling, sleep problems, itchy skin…

But keep a positive attitude! Read this list with the most common symptoms of the last three months of pregnancy and learn what you can do to relieve them. We will focus on the symptoms that appear during the third trimester, or that are somewhat different now. This is what you can expect:

1) Abdominal muscle separation

As your uterus grows, it pushes against the abdominal wall and stretches its muscles (the ‘six pack’ muscles), which will start separating in the middle and cause a bulge, or gap  in the middle of the abdomen. This condition, called diastasis recti abdominis, is more evident when the abdominal muscles are tense, such as during coughing or getting up from a lying down position. Diastasis recti can cause lower back pain, making it difficult to carry out certain activities, such as lifting objects.

Not all women develop abdominal muscle separation; you are more likely to get it if you are older than 35 years-old, have a multiple pregnancy or carry a large baby, or have repeated pregnancies.

What can you do about it:

  • Muscle separation lessens in the months that follow delivery, although some degree of separation may remain. Certain exercises will help you regain abdominal strength after childbirth.
  • During pregnancy, avoid aggressive abdominal exercises (such as sit-ups), which may provoke or worsen diastasis recti.
  • If abdominal muscle weakness associated with diastasis recti is interfering with your daily activities, seek the advice of your care provider or a specialized physiotherapist, who can indicate certain strength and postural correction exercises.

2) Breast leakage

By the end of pregnancy, you may notice a yellowish fluid leaking from your nipples, and this is normal. This substance, called colostrum, will nourish your baby in the first few days after birth.

While some women leak quite a lot of colostrum, others don’t leak at all. Leaking won’t make any difference to how much milk you will produce once your baby is born.

What can you do about it:

  • If you just leak a few drops, then you don’t need to do anything. But if it bothers you, you may wear nursing pads inside your bra to absorb the milk.
  • You should call your doctor or midwife if the nipple discharge becomes bloodstained.

3) Carpal tunnel syndrome

Tingling, numbness, weakness and pain in the hands during the last trimester are usually caused by a condition called carpal tunnel syndrome (CTS).

CTS is common in pregnancy, and happens due to the fluid retention in the tissues of the wrist, which in turn squeezes a nerve (the median nerve), that runs down to your hand and fingers. Women that keep doing forceful or repetitive hand and finger movements (such as long hours at a computer, or the use of vibrating equipment) may have worse symptoms.

What can you do about it:

CTS usually disappears without treatment after childbirth, when pregnancy-related fluid buildup is relieved. In the meantime, you may try the following:

  • Avoid activities that may be causing symptoms.
  • Wear a wrist splint to keep your wrist straight, especially at night, when the symptoms can be more bothersome.
  • Do exercises to stretch and strengthen the muscles in the hand and arm.
  • Alternative therapies, such as acupuncture might help relieve hand pain.
  • If nothing works, talk to your doctor, who may prescribe certain medications.
  • Surgery is the last resort treatment, but unless CTS become intolerable, it will be delayed until after birth.

4) Dreams and nightmares

You knew about the sleep problems during pregnancy. But you may get surprised, even disturbed when you start getting frequent and vivid dreams, occasionally nightmares; you may also realize that you remember your dreams more clearly.

The exact reason of these changes in the dream pattern is not clear, but they seem to be related to hormonal and emotional factors, as well as the frequent sleep disruptions that come with pregnancy (read more here).

What can you do about it:

  • If your dreams are just more frequent or more vivid, you will just have to cope with them.
  • However, if you have frequent nightmares, that are too disturbing, don’t let you sleep or cause you intense anxiety, you may consider sharing them with a friend, your doctor, or a therapist.

5) Clumsiness, waddling

You may have noticed that, as pregnancy progresses, you get clumsier: things fall from you hands, you bump into doors, you may accidentally fall down! It is not just you, clumsiness is normal in pregnancy and is related to many factors: you are heavier and your growing womb changes the center of gravity, making it more difficult to move; your “pregnancy brain” makes it harder for you to concentrate on your activities; in addition, a hormone called relaxin relaxes all the joints in your body. Therefore, you won’t have the balance or dexterity you used to have.

The same reasons explain why, at the end of pregnancy, you will start waddling, which in turn will make you even clumsier!

What can you do about it:

Clumsiness is normal and there is not much you can do to prevent it. However, it is important that you take measures to protect yourself -and others- from accidents:

  • Avoid situations where you have a high risk of falling, such as standing on a ladder, using stairs, riding a bicycle, etc.
  • Wear comfortable shoes, that should not be neither too flat or too high (read more here).
  • Pay attention whenever you walk on wet, icy, or uneven surfaces.
  • Avoid gaining too much weight, which will make clumsiness much worse.
  • Call your doctor if, besides clumsy, you feel dizzy or lightheaded, your have blurred vision, headache, or any pain.

6) Emotional changes

As you get closer to childbirth, your anticipation grows, so do your anxiety, fears and concerns! Besides all the hormonal-related emotional changes, you may start getting worried about the delivery itself, as well as all the changes the baby will bring, your role as a parent, etc (see here).

What can you do about it:

  • Stay calm, mild physical activity can help (read here), eat well (here), indulge yourself with a beauty treatment! (here).
  • Taking childbirth classes can help you feel more prepared to face labor and delivery.
  • Discuss your emotions and fears with your doctor or midwife.
  • Sharing your feelings with friends, your partner or other moms-to-be can be very helpful.
  • Nevertheless, if you feel constantly down or overwhelmed, if you have negative or suicidal thoughts, if you can’t go ahead with your daily life you must discuss it with your doctor.

7) Fatigue

Forget the energy you had during the second trimester: fatigue is back! Carrying extra weight, waking up several times during the night to go to the bathroom, and dealing with the anxiety of preparing for a baby can all decrease your energy level.

What can you do about it:

  • Eat healthy, frequent and small meals: it’s a good idea to keep with you healthy snacks that you can grab whenever you feel out of energy.
  • If you work, take regular, small breaks; you may even consider taking a quick nap!
  • Light exercise can make you feel more energetic: walking, swimming or prenatal yoga are good options, but listen to your body! Don’t force yourself.
  • Check with your doctor if you feel extremely tired, so that she/he may do some blood test to rule out anemia or other problems.

8) Forgetfulness (“Pregnancy brain”)

It’s not a myth: intense forgetfulness, known as “pregnancy brain” is a normal symptom of pregnancy, which nevertheless can be very annoying!

It is mostly related to pregnancy hormones, but sleep disturbances and fatigue can make it worse.

What can you do about it:

Don’t worry! Your brain will work normally again after delivery. Well, sort of, as you will have to deal with the sleepless nights while taking care of your baby 😉

In the meantime, these tips may help:

  • Stay organized! Write down what you need to do, technology may help: reminders on your phone or to-do lists in your computer will make it easier.
  • Ask for help: cut down on what you’re responsible for by delegating some jobs to others.
  • Eat well: certain foods may boost your memory: eating plenty of choline-rich foods and DHA-rich foods during pregnancy may help boost your -and your baby’s- brain function.

9) Frequent urination, urinary incontinence

As your baby grows, the pressure on your bladder increases, causing a constant feeling you need to go to pee. This may be worse during the night, because when you lie down, the fluids you retained in your legs and feet during the day make its way back into your bloodstream and eventually into your bladder.

Many women also experience stress urinary incontinence, that is, they lose some urine when they cough, laugh, sneeze, lift heavy objects, or exercise.

What can you do about it:

To reduce frequent urination:

  • Avoid beverages that contain caffein, which has diuretic effect.
  • It’s not a good idea to cut down on fluids, as your body needs plenty of them during pregnancy. Instead, you may reduce fluid intake in the hours before you go to bed.
  • Lean forward when you urinate: this helps empty out your bladder better.

To avoid incontinence:

  • Empty your bladder before exercising.
  • Wear a panty liner to catch any unexpected leakage.
  • Kegel exercises, which strengthen the muscles of the pelvic floor, can also help minimize stress incontinence.

You should inform your doctor or midwife if you feel pain or burning with urination, if your see blood when you wipe or if you feel the urge to pee even when you produce just a few drops at a time. These could be signs of a urinary tract infection (UTI).

10) Heartburn

Another symptom you may have experienced during the first three months of pregnancy, got better during the second trimester but now came back! While the heartburn you experienced during the first trimester was hormone-related, now your enlarged uterus is to blame, as it crowds the abdomen, pushing the stomach acids upward.

What can you do about it:

  • Eat small, frequent meals, don’t eat too much before going to bed.
  • Avoid too spicy, greasy, acidic or sweet foods.
  • Don’t lie flat, sleep with two or more pillows to have your head at a higher level than your body.
  • Call your doctor if you can’t cope with heartburn, who can prescribe you an antiacid medication that is safe for pregnancy.

11) Pelvic pain

Once you’re in your third trimester, you may experience pain and pressure in your pelvic region, as the weight of your growing fetus presses down on certain nerves that run into the legs; for the same reason you may also feel tingling, numbness and pain along the outer thigh; which can be very annoying for some women.

Relaxed pelvic joints are a common cause of pelvic pain: toward the end of your pregnancy the hormone relaxin helps the ligaments become loose in preparation for childbirth. This hormone can also loosen your pelvic joint, and even cause it to separate a bit. It’s common to feel pain near your pubic bone, and you may also feel like your legs are unstable. This is called Symphysis pubic dysfunction (SPD).

Your fetus’s head can also to rub your tailbone, causing tailbone pain and pressure. The condition is called coccydynia and occasionally the pain can be very intense.

Braxton Hicks contractions can also cause pressure and tightening in the pelvis (see below). Constipation also can cause pelvic pain or discomfort (see here).

What can you do about it:

Be patient! Once your baby is born, all the pressure-related symptoms will be gone; in addition, relaxin production will cease and the joints will be firm again, easing your pain. In the meantime:

  • Get plenty of rest;  a change of position that shifts the pelvic pressure away from the nerves responsible for the pain should provide some relief.
  • Avoid lifting heavy things.
  • Warm compresses on the painful the area may ease soreness.
  • Pelvic support belts can help stabilize the area.
  • If the pain is severe enough, ask your doctor about painkillers.

12) Swelling

During the second trimester some women experience some swelling of the ankles and feet. Now, swelling – or edema will be also evident in the hands, face and upper legs.

Swelling is normal and is caused by the excess blood and fluids your body produces to meet the baby’s needs. This extra fluid will also soften the body and help it expand as the baby grows, and prepare the joints and tissues to open more easily during delivery.

Swelling is usually worse with warm weather, if you stand up for long periods of time, if you consume too much caffeine or salty foods, or if your diet is low in potassium.

What can you do about it:

  • Reduce salt intake, avoid adding extra salt to meals.
  • Avoid caffeine consumption.
  • Eat foods high in potassium (such as bananas).
  • Minimize outdoor time when it’s hot.
  • Avoid long periods of standing or sitting.
  • Move regularly your feet, or keep your legs elevated while sitting.
  • Wear comfortable shoes (read more here).
  • Avoid clothes that are tight around your wrists or ankles.
  • Wear supportive tights or stockings.
  • Get plenty of rest, swimming may also help.
  • Use cold compresses on swollen areas.

13) Shortness of breath

As your pregnancy progresses you may start feeling breathless after minimal amounts of physical exertion, or even when talking!

Mild breathlessness is totally normal; during early pregnancy is due to pregnancy hormones, which make you take more and deeper breaths, so that you get additional oxygen for the baby. But in the third trimester, shortness of breath  is mostly related to your expanding uterus putting pressure on the lungs and diaphragm, making it harder to take a deep breath.

What can you do about it:

  • Don’t overdo it with your daily activities or while exercising; when you feel breathless, slow down.
  • Make room for your lungs to take air: stand up straight, don’t sit down for long periods of time, sleep propped up on pillows.
  • If the shortness of breath is severe, you have chest pain or a quick pulse, call your doctor immediately.

14) Vaginal discharge

Increased vaginal secretions are completely normal and start during the first trimester. These discharge helps prevent infections travelling up from the vagina to the womb.Towards the end of pregnancy, the amount of discharge increases and can be confused with urine; close to delivery it may even contain streaks of thick mucus and some blood (this is called “bloody show”; we will discuss more about it in another post). Vaginal secretions should be white or clear, and should not smell unpleasant.

What can you do about it:

  • You may wear panty liners, but do not use tampons.
  • Prefer cotton underwear, avoid string or thongs that may cause intense rubbing, which together with the increased discharge can favor yeast or other infections.
  • Avoid vaginal douching (which is never a good idea, but especially during pregnancy).
  • Pay attention to washes and wipes that could be irritating, increasing your chances of a vaginal infection.
  • Call your doctor or midwife if you have discharge that is yellow, green or foul-smelling, if you have intense itching or burning, symptoms that may show that you have a vaginal infection. Likewise, call your healthcare provider if you have a lot of watery, vaginal discharge, which may signal that you broke your water bag.

15) Vulvar varicose veins

If you feel something “like worms” on your genital area, together with some pressure, swelling of discomfort in the vulva, don’t panic! These are dilated vulvar veins and occur due to the increased blood flow to the area, and the pressure the growing uterus puts on the veins of your lower body. Vulvar varicosities are seen quite often during pregnancy, either alone or with varicose veins of the legs, or hemorrhoids. Long periods of standing, exercise and sex can aggravate them. Occasionally though, they are completely asymptomatic, and the only way you’ll know you have them is because your doctor tells you.

What can you do about it:

Most of the times, vulvar varicosities don’t affect your mode of delivery, and they go away on their own after birth. If they are bothersome, you may try the following:

  • Wear support garment specifically designed for vulvar varicosities.
  • Avoid standing for long periods of time.
  • Swimming helps lift the baby from the pelvis and improves blood flow, relieving your pain.
  • Elevate your hips slightly when lying down to promote circulation; you may place a folded towel beneath your hips.
  • Cold compresses applied to your vulva may ease discomfort.

What else to expect

Baby movements

  • During the second trimester and beginning of the third, your baby has plenty of room in the womb, so most likely you will feel pushing, swirling, twisting, and kicking. But as he/she grows bigger, there is less space for movement; thus probably you won’t get the punches and kicks you were used to. Instead, you’ll feel more wiggles, stretches and turns. Although by the end of pregnancy mobility may be reduced when he gets engaged in the pelvis, the baby should keep moving until the moment he is born.
  • Keep in mind though that the baby is not constantly on the move: there are times when she sleeps. Towards the end of your pregnancy, the baby rests for about 20 minutes at a time, but occasionally the rest periods may be as long as 50 or 75 minutes.
  • Although you may have read or heard you need to count the baby’s kicks, there is a huge variation among babies, and no normal values for baby’s kicks have been determined; therefore, a written record of your baby’s movements is not necessary. Since every baby has a different pattern of waking and sleeping, what is important is to follow up on your baby’s own pattern of movements. If you notice a change in your baby’s pattern of movements, or are worried at any stage, contact your midwife or doctor, so that they can check the baby’s wellbeing with certain specific tests.
  • At some point you may not be sure whether you felt your baby kicking. Keep in mind that you’re more likely to be aware of your baby’s movements when you’re lying down rather than sitting or standing. Therefore, in the doubt, have a snack, particularly something sweet, lie down on your side and wait. You may also try making some noise, or playing loud music. If your baby starts moving around, most likely everything is fine.

But you should contact your midwife or doctor right away if you notice any of the following:

  • You don’t feel several movements while lying on your side for two hours.
  • Your baby doesn’t start to move in response to noise or some other stimulus.
  • There’s a big decrease in your baby’s movements, or a gradual decrease over several days.

Weight gain

  • You should aim for a weight gain of about 1-2 kg per month during your third trimester, but it is not unusual to lose 1 or 2 kilos by the end of pregnancy, as your stomach gets compressed by the baby and you get a feeling of fullness even with small meals. In total, you should have put on about 12 kg (8-16 kg). However, your doctor may recommend that you gain more or less weight if you started out your pregnancy underweight or overweight.
  • It is very important that your weight gain doesn’t exceed these limits, as it may lead to several complications in pregnancy and delivery, such as high blood pressure, gestational diabetes, backache or delivery complications due to increased fetus weight. Not to mention that it will be more difficult to get back to your pre-pregnancy weight…

Braxton Hicks contractions

  • Pressure or tightening in the pelvis that comes and goes could be contractions, but if they’re sporadic and not painful, they’re most likely Braxton Hicks contractions. They usually begin as early as the second trimester; however, they are most commonly experienced in the third trimester.
  • Braxton Hicks are also called “practice contractions” because they are a preparation for labor. They are irregular in intensity and frequency, usually painless or just uncomfortable (although sometimes they may be painful).
  • As Braxton Hicks intensify close to the time of delivery, they are often referred to as “false labor” and they may help prepare the uterus for delivery. These practice contractions may be more intense or frequent when you are too tired, your baby is very active, after sex or due to dehydration.

If you are not sure whether the contractions you feel are true or false labor, try the following:

  • Lie down, get some rest and wait.
  • Take a warm shower or bath.
  • Drink some fluids.

If none of these steps works at any stage of pregnancy; or if you are less that 37 weeks pregnant and you have contractions every 15 minutes or closer that persist over two hours, contact your health care provider.

Signs of Labor

When getting closer to the due date, most certainly you will start wondering: What are the signs labor is coming? How will it feel? and mainly: Will I understand when it’s time? A post answering these questions will follow soon… Stay tuned!

When to worry

Any of these symptoms could be a sign that something is wrong with your pregnancy. Call your doctor right away if you experience any of these symptoms:

  • Severe abdominal pain or cramping
  • Severe nausea or vomiting
  • Bleeding
  • Severe dizziness or fainting
  • Rapid weight gain or intense swelling
  • Fever (unrelated to a cold)
  • Pain or burning during urination
  • Watery vaginal discharge
  • Abundant green, yellow, foul-smelling discharge.

This list of not exhaustive; do not hesitate to contact your healthcare provider for any other symptom you are unsure whether it’s normal or not.

References

  • NICE: Antenatal Care- Routine Care for the Healthy Pregnant Woman. March 2008, UK
  • HAS: Comment mieux informer les femmes enceintes? Avril 2005, France

Photo credits

Intro: Flickr.com; 1) lifeopedia.com; 2) sheknows.com; 3) momjunction.com; 4) answerforsleep.com; 5) health.com; 6) Flickr.com; 7) healthymamabrand.com; 8) healthywomen.org; 9) intimina.com; 10) baby-pedia.com; 11) onlymyhealth.com; 12) medicmagic.net; 13) dnaindia.com; 14) pinterest.com; 15) amazon.com; Baby movements: babycenter.ca; Weight gain: parenthub.com.au; Braxton Hicks: birthcentered.com; When to worry: herb.co

GENITAL HERPES: ALL YOU NEED TO KNOW

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Just got diagnosed with genital herpes? You are not alone! You should know that this is a very common condition, and that usually does not cause any serious health problem; however, anxiety, anger or even depression are common feelings every time the virus makes its appearance… And, as with HPV infection, misinformation makes things worse…

In this article you will find the most important facts regarding genital herpes:

Getting to know genital herpes

Genital herpes is a sexually transmitted infection (STI). It is caused by a virus called herpes simplex virus (HSV).

The herpes virus causes painful sores and blisters in the genital area, the anus, the thighs and the buttocks. Sometimes though, the HSV infection causes no symptoms at all; in fact many people are infected with HSV and don’t know it.

There are two types of HSV: HSV-1 and HSV-2. In general, type 2 affects the genital area and HSV-1 is the main cause of cold sores on the mouth or face. However, both types can cause either genital or oral infections.

How common is it?

It is estimated that 1 or 2 in 10 people (10-20%) are infected with the HSV; of those, 80% don’t have any symptoms. Genital herpes is more common in women than in men.

How did I get genital herpes? 

  • As stated before, genital herpes is sexually transmitted: the HSV is spread through direct contact with herpes sores during vaginal, oral or anal sex. The virus can be passed to others during a first infection, with subsequent outbreaks or even if there are no evident sores (see below).
  • The HSV dies quickly away from the body; thus, it’s extremely unlikely -if not impossible- to get genital herpes any other way than by sexual contact, such as from towels, toilet sits or hot tubs.
  • It is possible to get infected by sharing sex toys with a partner who has the virus.
  • Infected people can transmit the virus to other parts of their own bodies (for example if you touch your cold sore on the mouth and then you touch your genitals). This process, known as autoinoculation, although theoretically possible is extremely rare, as our body develops -in most cases- antibodies that protect us against autoinoculation.

Is there any way of knowing how long I’ve had the herpes virus?

When a person is first infected with HSV, symptoms appear about 2–20 days after the virus enters the body.

However, many people have genital herpes for years or even decades without knowing it; that is, the virus remains silent for years, and at some point it becomes symptomatic. This situation can create misunderstanding in a monogamous couple, as a person assumes his/her partner was unfaithful, which may not be true.

What are the symptoms of genital herpes?

The symptoms are different the first time and the recurrent episodes.

–During the first herpes infection you may have:

  • flu-like symptoms: such as fever, chills, muscle aches, fatigue and nausea;
  • swelling of the lymph nodes in the groin;
  • stinging or burning feeling while urinating.
  • sores: initially small, fluid-filled blisters, often grouped in clusters; the area where the sores appear may be swollen and tender. Over a period of days, the sores open and release fluid, become crusted and then heal without leaving scars.

The first outbreak of genital herpes may last 2-4 weeks.

After this first infection, HSV remains in the body for life, within some specific nerve cells. Under certain circumstances (see below), the virus becomes active again: it travels along the nerves back to the genital area, and causes a new outbreak of sores. This is called a recurrence.

-During the recurrent outbreaks the symptoms are:

  • a prodrome: a burning, itching, or tingling sensation in the lower back, buttocks, thighs, or knees;
  • few hours later, sores may appear, usually without fever or swelling in the genital area.

The sores heal more quickly, within 3-7 days in most cases. Also, recurrent outbreaks usually are less painful.

What can trigger herpes outbreaks?

Although it is not always clear why or when the herpes virus will reactivate, certain factors are known to trigger herpes outbreaks. The most common are:

  • Stress: either physical (fatigue) or emotional (depression, anxiety).
  • Weak immune system: caused by sickness, infections, certain medications, etc.
  • Trauma or irritation of the genital area: due to vigorous sex, intense sweating, tight clothes, etc.
  • Exposure to sunlight or ultraviolet light.
  • Hormone fluctuations: some women may notice that outbreaks are more common right before their period, or during pregnancy.
  • Excessive alcohol consumption.
  • Certain foods: some studies (here and here) have found L-arginine, an amino acid present in food can aggravate or cause more frequent herpes outbreaks. Foods high in arginine include: nuts (almonds, walnuts, cashews, peanuts), grains (whole wheat, oats, brown rice, flour products), chocolate and caffeinated beverages.

How often will I have symptoms of genital herpes?

  • The frequency and intensity of the outbreaks vary with each person. While some people have frequent, painful outbreaks with many sores, others have only rare and mild symptoms.
  • Outbreaks usually are most frequent in the first year after infection. For many people, the number of outbreaks decreases over time.

Is genital herpes a serious condition?

  • Genital herpes is not life threatening in itself.
  • One of the biggest problems of genital herpes is the emotional burden. The fact that genital herpes causes painful symptoms, imposes certain limitations on sexual activity, and it’s a lifelong condition may lead to frustration, anxiety, anger and depression (read more here). Don’t hesitate to discuss your feelings with your doctor, who can advise you how to cope with them.
  • Having herpes sores makes it easier for HIV (the virus that causes AIDS) to enter the body. Moreover, having both viruses together may make each one worse.
  • A pregnant woman can pass herpes on to her baby (see below). Therefore, it is very important that you inform your doctor if you are pregnant and have herpes.

How can I find out if I have the herpes virus?  

If you think you have genital herpes you should consult a healthcare provider, who can diagnose herpes by performing a physical exam and certain laboratory tests:

  • If sores are present, a sample of fluid taken from a sore can show if you have the virus and what type of HSV it is. The sample may be tested with several techniques, of which cultures and polymerase chain reaction (PCR) are the most utilized.
  • Blood tests can detect the antibodies our body produces to fight the virus; these tests can show the type of HSV as well.

How is genital herpes treated?

  • There is no cure for genital herpes.
  •  However, antiviral medications – aciclovir, famciclovir and valaciclovir – can reduce the duration of the outbreak and make symptoms less severe. There is some evidence that these drugs also reduce the risk of giving herpes to someone else.
  • When taken on a daily basis, medications can decrease or completely prevent the outbreaks. This is called suppressive therapy and is indicated, among other situations, in persons suffering very frequent outbreaks (usually more than six episodes per year).

How can genital herpes be prevented?

  • Condoms may reduce your risk of passing or getting HSV, but do not provide complete protection: areas of skin that have the virus but are not covered by the condom can spread the infection.
  • Avoid sexual intercourse if you or your partner has visible sores on the genitals; likewise, you shouldn’t receive oral sex from someone who has a sore on the mouth. Also, pay close attention to the prodromic symptoms announcing an outbreak: sexual contact should be avoided from the time you feel the prodrome until a few days after the sores have gone away.  Although less contagious, herpes can be spread even if there are no visible lesions, through a process known as shedding (means that the herpes virus is active on the skin). Unfortunately, there is no way to know when a person is shedding.
  • Wash your hands thoroughly after any possible contact with sores, in order to avoid reinfecting yourself or passing the virus to someone else.
  • In certain cases, suppressive therapy may be proposed to reduce the risk of passing the infection to your partner.
  • Once you got the virus, avoiding known triggers may reduce the frequency and intensity of outbreaks: a good diet, enough rest, stress management may all help.

Will herpes affect my pregnancy or my baby?

  • If you are pregnant and infected with HSV you may pass it to your baby, who may eventually develop a severe infection called neonatal herpes.
  • Although the virus may rarely spread through the placenta, most babies get infected during a vaginal birth, with the passage through the infected birth canal (vagina).
  • This is most likely to occur if you first become infected with HSV during pregnancy and if you have your first outbreak late in pregnancy. It is possible to transmit the virus even if you were infected before pregnancy and you have a recurrent outbreak near delivery, but the risk is much lower.
  •  In certain cases, you may be offered herpes medicine towards the end of your pregnancy to reduce the risk of having any symptoms and passing the virus to your baby.
  • If you have sores or warning signs of an outbreak at the time of delivery, you may need to have a cesarean section to reduce the odds of infecting your baby.

Can I breastfeed my baby if I have the herpes virus?

  • In most cases you will be able to breastfeed; in fact, herpes virus is not transmitted through breast milk.
  • Whether you breastfeed or not, the baby may get infected by touching a sore on your body. To avoid spreading the virus, cover your sores and thoroughly wash your hands before holding your baby. If you have a herpes blister on your breast don’t nurse from that side until the area has completely cleared up.

 

References

Centers for Disease Control and Infections: Genital Herpes: CDC Fact Sheet (USA)

The American College of Obstetricians and Gynecologists: Genital Herpes (USA)

British Association for Sexual Health and HIV: 2014 UK National Guideline for the Management of Anogenital Herpes (UK)

Haute Autorité de Santé: Prise en charge de l’herpès cutanéo-muqueux chez le sujet immunocompétent (France)

WHEN SEX IS PAINFUL: 8 COMMON PROBLEMS – AND HOW TO FIX THEM

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Sexual intercourse is supposed to provide pleasure, satisfaction and fulfilment. We -particularly women- tend to expect flawless, movie-like sex, romantic, luscious or passionate, with music playing in the background! Well, in real life sex is not always that perfect: according to an American survey, about 1 out of 3 women reported pain the last time that they have had sex. What’s more, many women feel ashamed to talk about it, giving up the idea of pleasurable sex. It is not unusual for these women to avoid having intercourse, leading to couple conflicts and eventually to psychological problems…

But why so many women feel pain while making love?

Whether it happens each time or occasionally, you feel just some discomfort or unbearable pain, dyspareunia (painful intercourse) can be related to a gynecological or medical problem, to your emotions or your state of mind; occasionally your partner is to blame, or maybe both of you, let’s not forget that it takes two to tango!

Below you will find 8 common painful situations you may encounter during intercourse. Understanding the type and location of the pain will help us pinpoint its cause, so that you can take some measures to get over it!

Problem # 1: “I feel a burning sensation outside the vagina”

painful-intercourse-burning-loveYou may feel a painful, burning sensation in your vulva (the external genitals), the area may be red and eventually swollen.

Possible causes:

  • Yeasts or other infections: a yeast infection will cause “cottage cheese-like” discharge; other bacteria can produce yellow or green discharge which may also be foul-smelling.
  • Contact dermatitis: you may realize that the problem starts after using certain lubricant, soap or cream, laundry soaps or softener; certain clothes can also be responsible.
  • Allergic reaction to condoms: the burning feeling starts after having sex, usually within 48 hours.
  • Menopause: although menopause generally causes vaginal dryness, some women also feel intense burning, which gets worse with intercourse.

What to do about it:  

  • Check with your doctor, who can give you a treatment for your yeast infection, if you are prone to get them, over-the-counter medications are available.
  • In the doubt, your doctor may order a culture, to see which bacteria is responsible for your symptoms.
  • In case of dermatitis or allergic reaction, stay away from possible irritants, your doctor can prescribe you a cream to soothe discomfort.
  • If you are allergic to latex (the material condoms are made of), stick to non-latex condoms.

Problem # 2: “I have a painful bump in my vulva”

painful-sex-bumpYou may feel a sharp, localized pain; while trying to precise its location you may touch a “bump” in the vulva. If you look with a mirror you may be able to identify the spot. Sex, due to rubbing, will make it even more painful.

Possible causes:

  • Pimple or ingrown hair: these are the commonest “bumps” appearing in the genitals. They can be quite sore if they become infected. A clogged sweat gland can also cause a painful pimple.
  • Bartholin gland cyst: they are soft cysts arising at the opening of the vagina. They can be very large (like a walnut) and become extremely painful if they get infected.
  • Herpes: genital herpes is a sexually transmitted infection. It causes itchy, burning and painful lesions that often start as a sore spot, becoming over a few days one or several blisters. Read more here.
  • Other dermatological or medical problems: rarely, diseases causing genital ulcers may be the cause of pain.

What to do about it:

  • Check with your doctor if you are not sure what is causing you pain.
  • Pimples may require a local cream to relief pain. If they are infected antibiotics may be necessary; more rarely incision and drainage are needed.
  • Bartholin cysts are treated with warm sitz baths. If infected antibiotics, incision and drainage may be necessary.
  • Herpes is managed with antiviral medications (locally or by mouth), painkillers may also be required.

Problem # 3: “I’ve tried everything, but penetration is impossible and triggers excruciating pain”

painful-intercourse-obstacleYou were never able to have penetration; even introducing tampons is impossible because you feel there is an “obstacle”.

Possible causes:

  • Hymen problems: you hymen may be abnormally thick, or imperforate.
  • Vaginal problems: your vagina can be too narrow or have a septum.
  • Vaginismus: see below.

What to do about it:

If penetration was never possible, check with your doctor who can rule out any anatomical problem; most of them can be solved with a simple surgical intervention.

Problem # 4: “I have intense pain in the opening of the vagina during penetration”

painful-intercourse-pins-and-needlesEven if you are aroused and willing to have sex, penetration triggers an intense pain in the entrance of the vagina; this is called entry dyspareunia.

Possible causes:

  • First time: we tend to have high expectations about our first intercourse; however many times it is less extraordinary than expected, and this includes pain; sometimes (but not always) bleeding may occur.
  • Trauma: this can be the result of childbirth (a tear or an episiotomy) or surgery; occasionally injury can be sex-related.
  • Vaginitis: due to yeast or other infection (see above).
  • Vulvodynia: it is a distressing, long-lasting condition in which the vulva is so sensitive that just touching the area makes the woman jump with pain. When pain is confined to the vestibule (the area around the opening of the vagina), it is known as vulvar vestibulitis syndrome (VVS). Its cause is unknown.
  • Emotional reasons: see below.

What to do about it:

  • If it is your first time, don’t worry too much about it. Many women have pain or discomfort during their first intercourse, an even a larger percentage will not have an orgasm. Be patient, try to be as relaxed as possible, discuss with your partner the means to reduce pain. If the problem persists, discuss it with a doctor.
  • If your just delivered, wait to have intercourse for at least six weeks after childbirth; some discomfort may persist for a few months, especially if you breastfeed, since your vagina also feels dry (see below). If pain continues for a long time or is very intense, talk to your doctor.
  • Vulvodynia may require medications, or eventually surgery. Read more here.

Problem # 5: “My vagina feels too dry”

Vaginal dryness is extremely common, and does not always mean problem. While some women produce  a lot of vaginal secretions, others are drier. However, there are factors that influence natural lubrication levels: sexual stimulation increases the amount of secretions; therefore, adequate and prolonged foreplay will help you being aroused. Sometimes though, your vagina keeps being dry and sex becomes painful.

Possible causes:

  • Menopause: due to the low level of estrogen (the hormone in charge of lubricating your genitals), your vagina will feel extremely dry and sex can be very painful, sometimes impossible.
  • Breastfeeding: also related to low estrogen.
  • Medications: some medications such as birth control pills, decongestants and antihistaminics may reduce vaginal moisture; contraceptive pills can also decrease sexual desire.
  • Medical problems: certain medical conditions can indirectly affect sexual response: diabetes, cancer, and thyroid problems, among others.
  • Your emotions: see below.

What to do about it:

  • Use a lubricant. Water-soluble lubricants are the best choice if you experience vaginal irritation. Silicone- based lubricants last longer and are more slippery. Do not use petroleum jelly, baby oil, or body lotion with condoms, as they can cause the condom to break (read more here).
  • For chronic cases, you may try long-acting vaginal moisturizers which, unlike lubricants, are absorbed into the vaginal lining for 3 to 4 days, mimicking natural secretions.
  • For menopausal women, when lubricants or moisturizers won’t work, a vaginal estrogen product may be necessary. More info here.
  • In any case, talk to your doctor if lubricants or moisturizers don’t help.

Problem # 6: “My vagina is just not opening”

Each time you try to have sexual intercourse, your vagina “closes”; any attempt of penetration is painful, and usually impossible.

Possible causes:

  • Vaginismus: it is a tightening (or reflex contraction) of the muscles of your vagina which occurs during penetration, but eventually also while attempting to insert a tampon, or during a gynecological exam. Its cause is unknown, although it is frequently related to anxiety, or fear of having pain during sex. Learn more here.
  • Your emotions: see below.

What to do about it:

  • Progressive desensitization consists of special exercises aimed at learning to relax your vaginal muscles.
  • Medical treatment may be useful in certain situations.
  • For women whose vaginismus is related to fear or anxiety, psychotherapy usually helps.

Problem # 7: “I feel pain in my bladder during intercourse together with constant urge to urinate”

painful-intercourse-tap-waterWhile having intercourse, you feel low abdominal pain and a persistent need to pee.

Possible causes:

  • Cystitis: read more here.
  • Interstitial cystitis (IC): also called bladder pain syndrome (BPS) is a chronic problem, which causes a feeling of pain and pressure in the bladder area, together with burning during urination. IC may feel like a bladder infection, but it’s not an infection; in fact, its cause is unknown.

What to do about it:

  • Read here to see what you can do if you have a bladder infection, particularly if you get one very often.
  • Regarding BPS, check with your doctor. No single treatment works for every woman, it should rather be individualized and based on symptoms. Learn more here.

Problem # 8: “I feel a deep pain in my abdomen during sex”

A deep pain or cramping in your abdomen during sex -or deep dyspareunia – can be the result of numerous problems.

Possible causes:

  • Gynecological problems: endometriosis, fibroids, ovarian cyst, adhesions, or infection (pelvic inflammatory disease). Many of these also cause painful periods.
  • Irritable bowel syndrome: a chronic condition that affects the large intestine; it commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. More info here.
  • “Collision dyspareunia”: a funny name to describe the pain you may feel if the tip of your partner’s penis hits your cervix. This can happen if your partner is longer than average, if you’re not fully aroused, or if your cervix is unusually positioned. Read more here.
  • Other reasons: constipation, a retroverted uterus, a forgotten object in the vagina (usually a tampon).

What to do about it: 

Although many of the causes of deep dyspareunia are not important, some of them can be serious; therefore, you should see a doctor, especially if it is a new-onset problem. Many of these situations will be treated with medications, others require surgical intervention.

THE EMOTIONAL FACTOR

Our emotions are tightly related to our sexual life; thus, negative emotions are frequently the source of painful sex. Some examples are:

  • The way you feel about having sex: fear, embarrassment, guilt, being concerned about your physical appearance, being to too anxious about “doing it right” can all may make you unable to relax; therefore, arousal is difficult and you end up having pain.
  • Stress, fatigue, anxiety, depression: your everyday life problems can affect your desire to have sex. In addition, your vaginal muscles tend to tighten; this can also contribute to painful sex.
  • Relationship problems: problems with your partner may be related to painful sex by reducing arousal or provoking vaginismus.
  • A previous bad sexual experience: such as women with a history of sexual abuse, who tend to relate sex with something bad or negative.

WHEN YOUR PARTNER IS THE PROBLEM…

Painful sex is not always your fault!

  • Your partner may have sexual problem, which in turn can make you feel anxious about sex.
  • If your partner is taking a drug for erectile dysfunction, he may have delayed orgasm, causing long and painful intercourse.
  • Size problem: feel that your partner is “too big”? In fact, when a woman is aroused and relaxed, the vagina extends by several inches – so most women should be able to accommodate most males! Nevertheless, if size is indeed a problem, try a lubricant, and check which sex positions are less likely to make you hurt. Come close, a new device can be a good option for you.

SHARED PROBLEM: SEXUAL MISMATCH

Besides size mismatch, or differences in the way you both enjoy sex, a common issue leading to painful sex is mismatched sexual desire. Read more here.

TAKE HOME MESSAGE

painful-intercourse-dont-want-to-talk

If you have pain during sex, talk about it! It may be embarrassing to discuss your sexual problems with a doctor, but you should know that, with proper care most problems can be solved; therefore there is no reason to condemn yourself to a pleasureless, painful sexual life!

In the meantime, these are some tips that may help you relieve your pain:

  • Talk to your partner: mutual communication is essential. Discuss with your partner where and how is the pain, so you can both find ways to avoid it or minimize it.
  • Use a lubricant: a simple measure that can ease your suffering. It’s a good idea to keep always one with you.
  • Make time for sex: not always easy to include sex into our busy schedules! Nevertheless, try to find a moment of the day when you and your partner will be less tired or anxious.
  • Engage in sexual activities that don’t cause pain: if penetration is painful, you may consider other forms of pleasure, such as oral sex.
  • Try different sex positions: if you have deep dyspareunia, it can be worse in certain positions. Try to find those that are less likely to trigger pain.
  • Include relaxing activities: your partner may give a massage.
  • Take steps to relieve pain before making love: take a warm bath, empty your bladder, take a painkiller.
  • If you experience burning after intercourse: apply a frozen gel pack or some ice wrapped in a towel to your vulva.

References

  1. The American College of Obstetricians and Gynecologists: When sex is painful.
  2. Lori J, Heim LTC: Evaluation and Differential Diagnosis of Dyspareunia. Am Fam Physician. 2001 Apr 15;63(8):1535-1545.
  3. NHS UK: Why does sex hurt?

Photo credits

Intro: dailymedicalinfo.com; 1: rascoecam.wordpress.com; 2:liferunning.wordpress.com; 3: daroachbooks.blogspot.gr; 4: pixabay.com; 5: scienceclarified.com; 6: newauthors.wordpress.com; 7:diversehealthservices.wordpress.com; 8: everythingselectric.com; Take home: pinterest.com

PREGNANCY SYMPTOMS: WHAT TO EXPECT THE SECOND TRIMESTER

Posted in Health, Pregnancy by
Embed from Getty Images

You just made it through the first trimester of your pregnancy! Congratulations!

The second trimester – which lasts from the beginning of week 14 through the end of week 27- is for most women, the easiest of all three: the annoying symptoms of the first trimester usually disappear and you feel full of energy again! In addition, you will be less heavy, tired and anxious than during the third trimester…

The fact that you feel better doesn’t mean that nothing is going on! Your baby grows very fast during this period, and your body is working incessantly; thus you will notice many changes…

From all the symptoms you had during the first trimester (see here), many will disappear, other persist and some new will show up.

These symptoms usually disappear or ease during the second trimester:

  • 2nd trimester B&Wnausea and vomits,
  • food aversions,
  • heartburn,
  • frequent urination,
  • acne.

These are symptoms that may persist:

  • dizziness,
  • bleeding of gums and nose,
  • stuffy nose,
  • vaginal discharge,
  • headache,
  • constipation,
  • food cravings.

In this article we will focus on the symptoms that make their appearance during the second trimester, or that are somewhat different now. Here is what you can expect:

1) Backache

While back pain during the first trimester is mostly related to mild uterine cramping, as pregnancy progresses it’s caused by weight gain and  the shift of your center of gravity as a result of the growing uterus. Thus, you gradually adjust your posture, which results in back pain or strain.

What can you do about it:

  • avoid standing up for long periods of time,
  • sit up straight; use a chair with good back support,
  • sleep on your side; a pillow tucked between your legs may help,
  • avoid carrying anything heavy,
  • wear comfortable, low-heeled shoes with good arch support (read more here),
  • a heating pad may provide some relief,
  • if you feel really uncomfortable you may have a pregnancy massage.

If these measures don’t work or if the pain is strong, call your doctor, who can prescribe you a pain medication suitable for pregnancy.

2) Breast enlargement

2nd trimester breastsWhile the tenderness and swelling you experienced during the first trimester usually wear off by now, your breast will keep growing in preparation for breastfeeding. You may occasionally have some leakage of milk.

What can you do about it:

  • wear a support bra; most likely you will need a bigger size,
  • avoid lacy or wired bras.

3) Emotional changes

2nd trimester emotional prenatal yogaAs pregnancy progresses your body changes, so do your emotions! Your hormones certainly play a role, but it’s not only that: there is so much going on! So it’s natural to be worried or anxious at times, or to have mood swings (see here).

You will most likely feel less tired and with more energy than before, so enjoy your pregnancy! Start preparing yourself for the coming of your baby, you can learn more about labor and delivery. Focus on healthy lifestyle regarding nutrition (read here) and physical activity (here). This may be also a good time to indulge yourself with a trip, or some vacations! (see here).

Some women experience increased sexual desire during this period of pregnancy (more info here); others may feel unattractive as the womb grows. Spoil yourself with some beauty treatments! (read more here).

Although mood swings are an inextricable part of pregnancy, keep in mind that if you feel constantly down or overwhelmed, if you have negative or suicidal thoughts, if you can’t go ahead with your daily life you must discuss it with your doctor.

4) Hair changes

2nd trimester hairHormonal changes during pregnancy favour hair growth. This may be great for the hair on your head, which usually becomes thicker, but not so great for hair growing on your face, arms or back!

What can you do about it: 

  • Shaving, tweezing and waxing are safe options, although not always easy to implement as your belly grows!
  • Regarding laser, electrolysis and depilatory creams the experts’ opinions are divided (read more here).

You may discuss with your doctor which is the best technique for you.

5) Hemorrhoids

2nd trimester hemorrhoidsMost women will feel, at some point in their pregnancy, some soft lumps around the anus. In fact, hemorrhoids are swollen veins, which enlarge in pregnancy due to the increased pressure exerted by the growing uterus.

Although sometimes hemorrhoids are asymptomatic, the can be itchy, or painful; they may eventually bleed.

What can you do about it:

  • avoid constipation – they will get worse,
  • you may try a sitz bath (that is, you sit in warm water),
  • if they are too uncomfortable, you may ask your doctor about a hemorrhoid ointment.

6) Leg cramps

2nd trimester leg crampsPainful leg muscle contractions typically affect the calf, foot or both; they are common during pregnancy, and usually occur at night.

The exact cause of leg cramps isn’t clear; possible reasons include pregnancy hormones, compression of the legs’ blood vessels, and calcium or magnesium deficiency.

What can you do about it:

  • regular physical activity might help prevent leg cramps; stretch your calf muscles before bedtime,
  • stay hydrated,
  • choose comfortable footwear with good support,
  • a hot shower, warm bath, ice or muscle massage can all help,
  • eat magnesium-rich foods, such as whole grains, beans, dried fruits, nuts and seeds.

Discuss with your doctor whether it’s OK for you to take a magnesium or calcium supplement.

7) Restless leg syndrome (RLS)

2nd trimester restless legIf you are among the 20% of pregnant women who suffer from this condition, you may have felt an itchy, pulling, burning or creepy-crawly sensation which causes an overwhelming urge to move your legs.

RLS usually strikes at night, when you are lying down or sitting for prolonged time periods; it may also affect the arms. Once you move your legs or arms, the feeling subsides; the problem is that, by then, the movement has already woken you up, making you feel tired and cranky during the day…

The cause of RLS is unknown, but in some women it may be triggered by a deficiency of iron or folic acid.

What can you do about it:

Be patient! RLS goes away right after birth… If your RLS is not that severe, simple lifestyle changes may help:

  • avoid drinking beverages with caffeine (coffee, soda, etc), particularly during the afternoon or evening,
  • don’t exercise close to bedtime (exercising can wind you up),
  • establish a sleep routine: go to bed and wake up at the same time every day,
  • relax before bedtime: take a warm bath, read a book…

When you wake up with RLS:

  • massage your  legs,
  • apply warm or cold compresses to your leg muscles,
  • get up and walk or stretch your legs,
  • a vibrating pad placed under the legs (Relaxis) seems to help some women.

The treatment of severe RLS is challenging during pregnancy, as medications used for its treatment are possibly dangerous for the baby.

  • You may ask your doctor to check your iron levels, if they are low you can take an iron supplement.
  • If RLS makes you feel miserable, discuss with your doctor the possibility of a medical treatment (opioids); this would be the last resort as opioids can cause withdrawal symptoms in the baby.

8) Round ligament pain 

2nd trimester round ligament painAs the womb grows, the ligaments that support it start stretching, making them more likely to become strained.

Round ligament pain is one of the most common complaints during pregnancy. Sudden movements can cause the ligaments to tighten quickly, which provokes a quick jabbing feeling, often felt in the lower belly or groin area on one or both sides, most commonly on the right side. Generally the pain is triggered by exercise, sneezing, coughing, laughing, rolling over in bed or standing up too quickly, and lasts only a few seconds or minutes.

What can you do about it:

  • avoid sudden movements,
  • flex your hips before you cough, sneeze, or laugh,
  • mild exercise will help you strengthen your abdominal muscles,
  • stretching exercises and yoga can be helpful,
  • a heating pad or a warm bath may ease pain,
  • you may take a painkiller such as acetaminophen.

Round ligament pain usually doesn’t last long. If you have severe pain that lasts more that a few minutes, or if it is accompanied by fever, burning with urination, or difficulty walking you should call your doctor right away.

9) Skin changes

2nd trimester skin changes woman with hatPregnancy hormones and your growing uterus are responsible for numerous skin changes that you will start noticing from now on. Here are the most common:

Pregnancy glow: pregnant women often look as though they are “glowing” because hormones increase the skin oil production and vascularisation, thus your face may appear flushed and shiny.

Mask of pregnancy: also called chloasma;  an increase in the pigment melanin leads to brown marks on the face.

Linea nigra: related as well to increased melanin, it’s a dark line down the middle of the abdomen.

These skin changes should fade after the baby is born. In the meantime, you can use makeup to conceal them.

Keep in mind that your skin is more sensitive to the sun right now, so make sure to wear a high-protection sunscreen;  limit also your time in the sun, especially between 10 am and 4 pm; a hat and sunglasses will provide extra protection.

Itchy skin: as your skin stretches due to your growing belly -and weight gain- it may feel itchy and dry, especially around your womb and breasts2nd trimester skin changes.

To relieve it, moisturize often with mild skin care products; do not take hot showers and baths, which will dry out even more your skin. Also, avoid synthetic clothing which may irritate your skin.

Inform your doctor if your itching is unbearable, she/he can recommend you a medication adequate for pregnancy, and eventually rule out certain rare conditions which may be dangerous for you or your baby (though they usually appear during the third trimester).

Stretch marks: as with itching, stretch marks are the result of your skin expanding. Starting now, you may notice red or purple lines on your abdomen, breasts or thighs.

Watch your weight gain! The more weight you gain, the more likely to get stretch marks. Many creams and lotions are available to prevent them, although their efficacy is not backed up by much scientific evidence… In any case, most stretch marks will fade on their own after delivery.

10) Sleep problems

2nd trimester sleep problemsWhile everybody tells you to rest now to get prepared for the sleepless nights ahead once the baby is born, sleeping in pregnancy is not easy! A recent study showed that 3 out of 4 women! experience poor sleep quality: from all women included in the study, all of them reported frequent awakening, mostly due to frequent urination and difficulty finding a comfortable sleep position; insomnia, breathing problems (snoring and sleep apnea) and restless leg syndrome (see above) were also common complaints.

And let’s not forget heartburn, leg cramps, stuffy nose, eventually vivid dreams or nightmares…

What can you do about it:

  • avoid caffeine in the afternoon or evening,
  • stay away from sugar at night,
  • don’t drink too much right before bedtime to avoid frequent visits to the toilet,
  • work out, but only until early evening, as exercise can be energizing,
  • have a light snack before bedtime to prevent “hunger attacks” at night,
  • a glass of warm milk before sleeping may help,
  • take a warm bath just before bed,
  • keep your room cool; research has shown that is useful for better sleep,
  • a massage before sleeping can soothe you, as well as relaxation exercises, deep breathing, meditation, yoga, etc,
  • making love can also help!

You should mention any sleep problems to your doctor, who might be able to suggest more tips or eventually prescribe you medications that are safe during pregnancy.

11) Spider and varicose veins 

2nd trimester spider and varicose veinsYour blood circulation increases to send more blood to your baby; this can cause tiny red veins known as spider veins. Pressure on your legs from the growing uterus can result in swelling of your legs’ veins, which become blue or purple; these are called varicose veins.

What can you do about it:

Spider veins usually fade once your baby is born.

Varicose veins should improve within three months after you deliver. In the meantime, you may prevent them from getting worse:

  • avoid standing up for long periods of time,
  • get up often, move throughout the day,
  • keep your legs elevated (prop them on a stool) whenever you have to sit for a long time,
  • wear support hose.

12) Swelling of the ankles and feet

2nd trimester swollen legsA very common symptom, is experienced by about three in four pregnant women, starting at about week 22 of pregnancy and lasting until delivery.

What can you do about it:

  • try to keep active,
  • avoid long periods of standing or sitting,
  • if you can’t avoid sitting or standing for a long time, move regularly your feet, or
  • keep your legs elevated while sitting,
  • support hose can help.

What else to expect

“Quickening”, baby movements

At about 20 weeks you will probably start feeling the first flutters of movement in your belly, which is often called quickening. Quickening may be first felt as early as week 15, but usually around weeks 18 to 22. A multipara (that is, a woman who has been pregnant before) usually feels the baby earlier. Some women won’t experience quickening until week 26, so don’t worry!

Keep in mind that babies, like the rest of us, are all different: while some are very active, others are more calm; activity also varies among different days and within the same day.

Weight gain

2nd trimester what elseYour appetite should be back during the second trimester, once nausea and vomits have diminished or gone away. Since now you will feel hungrier, be aware of how much you’re eating! You only need about an extra 300 to 500 calories a day during the second trimester, and you should be gaining about 1,4 -1,8 kilograms a month until delivery. However, if you were overweight before pregnancy, your doctor may recommend gaining less weight.

Discuss with your health care provider what’s best in your case in order to manage your weight throughout pregnancy.

Braxton Hicks contractions

During the second trimester, your uterus may start contracting. These contractions, called Braxton Hicks, should be weak and come and go unpredictably.

If contractions become painful or regular, they could be a sign of preterm labor, so you should inform your doctor.

When to worry

2nd trimester warningAny of these symptoms could be a sign that something is wrong with your pregnancy. Call your doctor right away if you experience:

  • Severe abdominal pain or cramping
  • Bleeding
  • Severe dizziness or fainting
  • Rapid weight gain or intense swelling
  • Fever (unrelated to a cold)
  • Watery vaginal discharge
  • Abundant green, yellow, foul-smelling discharge.

 

References

  • NICE: Antenatal Care- Routine Care for the Healthy Pregnant Woman. March 2008, UK
  • HAS: Comment mieux informer les femmes enceintes? Avril 2005, France

Photo credits

Intro: Getty images, businessinsider.com; 1) simplebackpain.com; 2) pinterest.com; 3) kentuckianamommies.com; 4) drdina.ca; 5) hemorrhoidexpert.org; 6) newkidscenter.com; 7) babygaga.com; 8) viphealthandfitness.com; 9) woolworthsbabyandtoddlerclub.com.au, beautysouthafrica.com; 10) thebabychecklist.com; 11) pinterest.com; 12) pinterest.com; What else: popsugar.com; When to worry: earlypregnancy.net.

CONTRACEPTION: 14 COMMON MYTHS – BUSTED

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Contraception myths teen couple kissing

How good is your knowledge on contraception? Statistics show that even if contraception awareness is on the rise, there are still a lot of important gaps, and many misconceptions persist.

If you are like most young people, your “education” on birth control comes mainly from your friends, and the internet. And you may have learnt valuable things from them! But there is still a lot of misinformation going around, leading in many cases to misunderstandings and unpleasant surprises…

Following are some of the most common myths, rumours and misperceptions regarding birth control that you should know in order to avoid an unplanned pregnancy.

MYTH # 1: I won’t get pregnant if my partner pulls out before he comes

4eme withdrawal method cartoonThis is one of the most common misconceptions, responsible for many unwanted pregnancies. Also known as the withdrawal method, it has a high rate of contraception failure. This is because some pre-ejaculation fluid (or pre-come) may be released before the man actually ejaculates; this pre-come contains spermatozoids, and it takes only one sperm to get you pregnant! In addition, some men may not have enough self control to withdraw in time…

Keep in mind that pre-ejaculation fluid can also contain sexually transmitted infections, so pulling out will not prevent you from getting an infection.

MYTH # 2: I don’t get pregnant if I have sex during my period

Contraception myths pregnant with periodThe chances of getting pregnant while on your period are low, but it may happen, mainly in women with shorter cycle –i.e., if you get your period every 21-24 days. In such case, your ovulation occurs around the 10th to 12th day after the beginning of your period. Since sperm can live up to 5 days inside your body, if you have sex towards the end of your period, sperm can wait for the egg to be released and you may become pregnant.

But even in women with longer, regular cycles, the ovulation may eventually take place earlier… So remember, you can get pregnant at any time of the month if you have sex without contraception.

MYTH # 3: The morning after pill is dangerous, you can’t take it more than once or twice in your lifetime

Emergency contraception keep-calm-and-take-the-morning-after-pill-7It has been suggested (mostly by internet rumours) that it is dangerous to take the emergency contraception pill more than one or twice in your life. According to the World Health Organisation: “Emergency contraceptive pills are for emergency use only and are not appropriate for regular use as an ongoing contraceptive method because of the higher possibility of failure compared with non-emergency contraceptives. In addition, frequent use of emergency contraception can result in side-effects such as menstrual irregularities, although their repeated use poses no known health risks.” Emergency contraception pills are very safe and do not harm future fertility. Side effects are uncommon and generally mild. Read more about the morning after pill here.

MYTH # 4. I don’t get pregnant if I have sex standing up or if I’m on top

Contraceptive myths teenage couple standing up

Some women believe that having sex in certain positions, such as standing up, sitting down, or if they jump up and down afterwards, they won’t get pregnant as sperm will be forced out of the vagina. In fact, sperm are very strong swimmers! It has been showed that within 5 minutes, sperm are able to reach the tube, where the fertilisation of the egg takes place, and this happens regardless of the position you have sex in.

There’s no such thing as a “safe” position if you’re having sex without a condom or another form of contraception. There are also no “safe” places to have sex, including the bathtub, the shower or the sea.

MYTH # 5. There are only 3 contraceptive options: the condom, the pill and the IUD

Although these three methods are the best-known, there are 15 different methods of contraception (the available options differ in each country). Unfortunately -for women- there are only two choices for men (the male condom and permanent sterilisation). Women have a choice of about 13 methods, including several of long-acting reversible contraception -this means you don’t need to remember to take it or use it every day or every time you have sex.

MYTH # 6. The IUD is not suitable for teenagers and women without children

Contraception myths IUD in teens 1

In the USA, 44% of adolescent girls ages 15 to 19 have had sexual intercourse. Although most of them have used contraception, teenagers frequently use methods with high failure rates -such as withdrawal, or they incorrectly use more reliable methods -such as the pill. In fact, 8 out of every 10 adolescent pregnancies are unintended.

The intrauterine device (IUD), a small device that is inserted into the uterus, has been traditionally reserved to women who have had children. However, new guidelines issued by the American College of Obstetricians and Gynecologists have changed this old perception: the IUD, together with the contraceptive implant, are considered now first-line contraceptive options for sexually active adolescents and young women, as they are the most effective reversible contraceptives for preventing unintended pregnancy, with about 99% effectiveness.

Of course, the IUD and the implant do not protect against sexually transmitted infections, therefore you should also use condoms for that purpose.

MYTH # 7. You can’t get pregnant if it’s the first time you have sex, or if you don’t have an orgasm

Contraception myths sex first timeThese persistent misconceptions are, unfortunately, still responsible for many unplanned pregnancies. If the intercourse takes place during your fertile period, you may become pregnant, whether it’s the first or the hundredth time you’ve had sex, whether you liked it or not.

MYTH # 8. Two condoms are better than one

Contraception myths two condomsCondoms may occasionally break. Many people think that using two condoms (also known as “double bagging”) is safer than using one. Actually, it’s exactly the opposite: using two condoms causes friction between them, increasing the risk of breakage. Thus, two condoms should not be used, neither for pregnancy prevention or for safer sex; this is also true for using a male and a female condom at the same time. When used properly, a male condom  is 98% effective at preventing pregnancy, a female condom is 95% effective.

MYTH # 9. I can use any lubricant together with the condom

Contraception myths personal-lubricant

During intercourse, adding lubricant may ease penetration, so sex is pleasurable and not painful. This is important when, for many reasons (such as stress, medications, taking the pill, etc) the natural wetness of the genital area is reduced.

Lubricants can be made from water, oil, petroleum or silicone; however, when using condoms, water-based lubricants should be used: oil-based products such as petroleum jelly, creams, or baby oil and can damage the latex and make the condom more likely to split, resulting in no contraceptive protection.

Silicone-based lubricants are a newer form of lubrication; they are safe to use with condoms. However, they can be harder to wash off and may cause irritation.

MYTH # 10. If you take the pill for many years, you won’t be able to have children in the future

Contraception myths the pillThis is another very common misconception. After stopping the oral contraceptive pill you may get pregnant immediately, but sometimes it may take two or three cycles for your fertility to fully return, no matter how long you have been using it. Some studies have shown that, within a year after going off the pill, 80% of women trying to get pregnant will get pregnant – exactly like women who were never on the pill.

MYTH #11. You don’t get pregnant if you douche right after sex

Contraception myths vaginal doucheVaginal douching (washing out the vagina) after sex won’t help to prevent a pregnancy. Again, this has to do with spermatozoa being fast swimmers. By the time a woman starts douching, sperm are already well inside the uterine cervix, where no douching solution can reach them.

In fact, you should never douche: douching can lead to many health problems, including problems getting pregnant, vaginal infections and sexually transmitted infections.

MYTH #12. I’m breastfeeding so I can’t get pregnant

Contraception myths breastfeeding

While you’re less fertile when breastfeeding, you may become pregnant; there is no accurate way to predict when fertility returns, even if you breastfeed exclusively. You may not menstruate for several months after giving birth, but at some point you will have your first ovulation -where you can get pregnant- and this will occur two weeks before you get your first period.

Thus, when nursing you should use birth control if you wish to avoid pregnancy.

MYTH # 13. You’re only fertile one day a month

If you have a regular cycle of 28 days, the ovulation usually occurs the 14th day of your cycle. But it’s not only that day that you are fertile. As said before, sperm can live in the cervix for up to 5 days, waiting for the egg to be released. Studies have shown that most pregnancies result from intercourse that takes place during a six-day period ending on the day of ovulation. Once the egg leaves the ovary, in about 24 hours it dies, and the fertile period is over.

However, even in women with a perfectly regular cycle, the hormonal balance involved in the ovulation process can be disrupted by many factors: stress, medications, etc, leading to an earlier or delayed ovulation. Thus, trying to avoid a pregnancy by just having intercourse on the “safe” days can be difficult and may eventually result in an unwanted pregnancy.

MYTH # 14. I don’t need a condom because I’m taking the pill

Contraception myths condomsA survey conducted in France showed that “…one in ten young women ages 15 to 20 is not aware that the pill does not protect against HIV and sexually transmitted infections”. In fact, the only contraceptive method that offers protection against STIs is the condom. Even other barrier methods, such as the diaphragm, do not to keep bacteria out of the vagina, and the pill and IUD offer no STI protection at all.

 

The bottom line:

Don’t be afraid to talk to a doctor about birth control! True, discussing contraception and sexual practices with a healthcare professional may be embarrassing… but it’s better to discuss ways to prevent an unintended pregnancy rather than dealing with one after it happened!

You can do your research before scheduling an appointment -there are many good sites to learn useful information about birth control – but a doctor will help you decide which is the best contraceptive method for you, and how to use it in a proper way.

Knowledge is empowerment! Learn your choices, be aware of the dangers of irresponsible sexual practices, be the advocate for your own sexual health!

 

Find out more about contraception here:

Centers for Disease Control and Prevention, USA. Contraception

National Health System, UK. Your contraception Guide

FPA UK. My contraception tool

 

Photo credits

Intro: evoke.ie; 1: your-life.com; 2: aboutgettingpregnant.com; 3: keepcalm-o-matic.co.uk; 4: pinterest.com; 5: xonecole.com; 6: teenplaybook.org; 7: geekandjock.com; 8: contraception.about.com; 9: hackcrow.com; 10: telegraph.co.uk; 11: aliexpress.com; 12: fidias.net; 13: dailymail.co.uk; 14: blog.path.org; bottom line: contraception-about.com.

PREGNANCY SYMPTOMS: WHAT TO EXPECT THE FIRST TRIMESTER

Posted in Health, Pregnancy by
Embed from Getty Images

Pregnancy usually comes with a lot of joy… but sometimes it can be pretty overwhelming! Especially the first trimester, when your body starts changing. These changes are not the same for all women, though: while some women feel great and full of energy, others feel completely miserable…

Food cravings, nausea, mood swings… You have most likely heard about these pregnancy symptoms, but… what is normal? What to do about them? When to call your doctor?

In this article you will find a list of 16 common symptoms you may experience during the first trimester of pregnancy (weeks 0 to 13), you will learn why they happen, what you can do about them, and when to call your doctor -or midwife.

1) Abdominal cramping and backache

Pregnancy symptoms back painWhy it happens: one of the earliest pregnancy symptoms, this slight cramping confuses many women who believe they’re about to have their period. Abdominal and back pain are caused by normal, mild uterine contractions related to the increasing pregnancy hormones.

What can you do about it: nothing, unless pain gets intense or comes with vaginal bleeding.

When to call your doctor: if you experience strong pain, or if you have pain and bleeding, in order to rule out certain pregnancy complications (see vaginal bleeding) or other conditions unrelated to pregnancy.

2) Acne

Pregnancy symptoms acneWhy it happens: this is a very common symptom -pimples appear in about 50% of women- and sometimes can be quite intense. The β-HCG hormone (beta – human chorionic gonadotrophin), which raises from the beginning of pregnancy has androgenic effect (mimics male hormones), leading to increased skin oil production and the appearance of acne.

What can you do about it: most of medications used to treat acne are not allowed throughout pregnancy -isotretinoin, one of the most effective acne medications is also one of the most dangerous during pregnancy. Be patient! pregnancy acne will resolve after childbirth.

In the meantime, just get some good medication-free skin care:

  • wash your face and body with a gentle cleanser, alcohol and oil-free,
  • avoid over-cleansing as it may have the opposite effect,
  • shampoo regularly and avoid oily hair mousse,
  • do not pop your pimples, since it may cause permanent scarring.

When to call your doctor: If your acne is severe, you may consult a dermatologist to get the most adequate care for your skin type.

3) Bloating and constipation

Pregnancy symptoms constipationWhy it happens: during pregnancy a hormone called progesterone relaxes the bowels wall and slows down their activity in order to allow the absorption of more nutrients to feed your growing baby. The downside: you may feel bloated, gassy and get frequently constipated.

What can you do about it: 

  • increase your fiber intake,
  • avoid foods that cause bloating (beans, cauliflower, etc),
  • drink plenty of fluids,
  • engage in physical activity.

When to call your doctor: if constipation really bothers you, ask your doctor for a laxative or stool softener that is safe for pregnancy.

4) Breast swelling and tenderness

Pregnancy symptoms breast pain 2Why it happens: your breasts, under the influence of the high hormones, start getting ready for breastfeeding, thus they engorge and receive more blood supply; this will cause tenderness and swelling.

What can you do about it:

  • wear a support bra (you may need to get a bigger size),
  • avoid lacy or wired bras.

When to call your doctor: if you get severe breast pain or redness, or if you palpate any lump.

5) Dizziness and fainting 

Pregnancy symptoms dizzinessWhy it happens: your blood vessels dilate to increase blood supply to the womb and to your baby, leading to a drop in blood pressure, which can make you feel dizzy, lightheaded, or even faint. Dizziness can also be due to low blood sugar, especially if you are not eating adequately.

What can you do about it:

  • avoid prolonged standing,
  • rise slowly when you get up from sitting or lying down,
  • be especially careful if you drive or execute activities that require special concentration,
  • eat healthy, frequent meals (every two to three hours),
  • drink plenty of fluids to raise your blood pressure.

When to call your doctor: if your experience intense dizziness, especially if you have bleeding or intense abdominal pain, to rule out a miscarriage or an ectopic pregnancy (see vaginal bleeding).

6) Fatigue and sleepiness

Pregnancy symptoms fatigueWhy it happens: from early pregnancy, your body has some extra work to do! Your metabolism increases and you start preparing the placenta; these changes together with the high progesterone levels are responsible for this constant feeling of drowsiness and intense fatigue. Your body reminds you that you should get some rest, so you will be stronger to carry your baby!

What can you do about it:

  • take naps and rest when possible,
  • eat healthy,
  • drink plenty of fluids,
  • avoid standing up for long periods of time.

When to call your doctor: if you feel that your drowsiness affects your daily activities, inform your doctor who can rule out other possible causes of fatigue such as anemia. If you have intense sleepiness together with negative feelings, hopelessness or sadness, inform your doctor to rule out depression.

7) Food cravings, food aversions

Pregnancy symptoms cravingWhy it happens: the sudden hormonal increase changes your food tastes; therefore, you may get food cravings -a sudden and intense urge to eat something in particular, which may eventually be quite unusual- or food aversion -repulsion for certain foods, even with the thought of them.

It is believed that during pregnancy our body asks for what it needs -hence cravings- and makes us reject things we don’t need or may be harmful, such as aversion to cigarette in smokers (unfortunately, this is not always the case).

What can you do about it:

Cravings:

  • Go ahead and indulge yourself with what you crave, provided that you generally follow a balanced and healthy diet,
  • when you crave for unhealthy foods, try to avoid excess: eat one scoop of ice cream, not the whole 1-kilo carton!
  • if cravings are too frequent, try to do activities to distract yourself so that you don’t think about food all the time: go for a walk, talk to a friend, read a book, go to the movies…

Aversions:

  • Most food aversions will go away after the first trimester, so most likely you will be able to eat meat or drink milk again thereafter,
  • if you keep having aversion to certain foods, try to find healthy substitutes for what you can’t tolerate, e.g., have calcium-fortified cereals if you can’t drink milk.

When to call your doctor: If you crave for clay, ashes or dirt -a condition called pica– as this can be really dangerous for you and your baby; if your food aversions are too intense and followed by frequent vomiting (see Nausea and vomiting).

8) Frequent urination

Pregnancy symptoms frequent urinationWhy it happens: you may notice from very early in pregnancy that you need to pee more often. As your body blood flow increases with pregnancy, more blood goes to the kidneys in order to flush more waste products out of your body; this leads to increased urine production. Urination is more frequent during the night because the fluid you had retained in your legs during the day will get reabsorbed when you lie down. In addition, as the uterus grows it starts putting pressure on the bladder.

What can you do about it:

  • don’t hold you urine, as this can predispose you to urinary infections,
  • avoid too much caffeine (coffee, tea, cola drinks) since they have diuretic effect,
  • don’t drink too much before going to bed.

When to call your doctor: If, besides frequent urination, you feel burning or pain when you pee, or you see blood when wiping: these can be signs of a urinary tract infection.

9) Headaches

Pregnancy symptoms headacheWhy it happens: headaches occur frequently early in pregnancy mostly due to the increased hormone levels; but low blood pressure, low sugar, anemia or dehydration can all worsen headaches. Women who had migraines before getting pregnant may experience worsening in the first trimester, but usually improvement as the pregnancy progresses.

What can you do about it:

  • drink plenty of fluids,
  • eat frequent meals,
  • get some rest when possible.

When to call your doctor: If headaches persist, check with your doctor whether you can take acetaminophen (Tylenol), which is usually allowed throughout pregnancy. Contact you doctor if your headaches are too intense, do not subside with Tylenol or are accompanied by visual disturbances or other symptoms.

10) Heartburn, heavy stomach

Pregnancy symptoms heartburn 2Why it happens: Again, progesterone is responsible for relaxing the sphincter (ring of muscle) that separates the stomach from the esophagus; this leads to acid reflux.

What can you do about it:

  • eat small, frequent meals, don’t eat too much before going to bed,
  • avoid too spicy, greasy, acidic or sweet foods,
  • don’t lie flat, sleep with two or more pillows to have your head at a higher level than your body.

When to call your doctor: if you can’t cope with heartburn, ask your doctor to prescribe you an antiacid medication that is safe for pregnancy.

11) Mood swings

Pregnancy symptoms mood swingsWhy it happens: mostly because of your hormones, but eventually increased by your dizziness, nausea or other pregnancy symptoms, you may feel at times irritated or depressed, anxious or out of energy, overjoyed or panicked! Is not only hormones,  though. Pregnancy will bring major changes to your life, so it’s natural to worry about many things: whether your will make it through labor and delivery, if you baby will be fine, whether you will be a good mother, if the relationship with your partner will be affected, etc, etc… Most women will also become more forgetful; while this is normal, it may be quite frustrating…

What can you do about it:

  • talk about it, find someone who can listen to you: your partner, a family member, a friend, or other mums-to-be,
  • ask for understanding and support, not only psychological but also physical: if you can’t do certain activities at work or a home, let someone help you,
  • get some rest: you may feel worse if you are tired or sleep-deprived,
  • engage in activities that calm you down and relax you; mild exercise can also help.

When to call your doctor: if you feel constantly down or overwhelmed, if you have negative or suicidal thoughts, if you can’t go ahead with your daily life; in these situations you may need professional help.

12) Nausea and vomits

Pregnancy symptoms nauseaWhy it happens: nausea is one of the commonest pregnancy symptoms (occurs in about 85% of pregnancies). It is not fully understood why it happens, but it seems to be related to β-HCG levels: the higher levels, the more nauseous you may feel (e.g., women carrying twins).

Nausea and vomits usually start around the 6th week of pregnancy and persist until week 13, although they may last up to the 16th – 20th week, or more rarely beyond 20 weeks. They can be of variable intensity, for some women very mild, for others very severe, leading to continuous vomiting. Nausea may be more intense during the morning -that’s why it’s called morning sickness– although this is not always the case.

What can you do about it:

  • nausea gets worse when you have empty stomach, therefore, have frequent and small meals,
  • foods with high starch content may relieve nausea (crackers, potatoes, rice, pasta), but each woman find which foods can tolerate and which not,
  • avoid food with strong smell or taste,
  • ginger can help (either raw ginger, ginger ale or ginger pills),
  • accupressure, motion sickness wristbands and vitamin B6 can also be effective,
  • stress and tiredness can worsen nausea, therefore try to get plenty of rest,
  • keep drinking to avoid dehydration, but drink small amounts of fluids at a time, since large amounts can make nausea worse.

When to call your doctor: if nausea doesn’t allow you to eat or drink anything, or if you can’t stop vomiting, your doctor can prescribe you certain medications that may be helpful. Sometimes intense vomiting may lead to dehydration, a condition called hyperemesis gravidarum, which requires admission to a hospital for rehydration and intravenous treatment.

13) Nosebleed, stuffy nose, gum bleeding

Pregnancy symptoms stuffy noseWhy it happens: blood flow increases in pregnancy, and your gums and nasal lining are very fragile and bleed easily. Gums may bleed when you brush your teeth. Nosebleeds may appear when you blow your nose; you may also notice that your nose gets more easily congested, also as a result of the increased blow flow to the nose’s mucous membranes.

What can you do about it:

  • keep seeing regularly your dentist to rule out certain gums problems, which are common in pregnancy and may increase bleeding,
  • switch to a softer toothbrush,
  • to stop nose bleeding pinching your nose for a few minutes should help,
  • for your nose congestion you may use a humidifier, or try a saline nasal spray,
  • don’t use nose spays or other decongestants without checking with your doctor.

When to call your doctor: if your gum or nose bleeding are heavy or too frequent. If your nose congestion gets too intense and you can’t breathe.

14) Smell intolerance, increased sense of smell

Pregnancy symptoms smellsWhy it happens: many women won’t stand certain strong smells, either from food, cosmetics or others sources, triggering nausea or vomits. This sensitivity to smells is hormone-related; it is said that nature prepares you to “sense” dangerous threats in order to protect your baby.

What can you do about it:

  • avoid foods with intense smell,
  • you may need to stop cooking for a while -if possible,
  • don’t use scented cosmetics if the smell bothers you; this is also true for laundry soap, softeners, air fresheners, etc.

When to call your doctor: in case your smell intolerance leads you to intense vomiting (see Nausea and vomits).

15) Vaginal bleeding

Pregnancy symptoms vaginal bleeding 2Why it happens: Bleeding during the first trimester is extremely common (it happens in about 25% of pregnancies) and is usually of no concern. A slight bleeding may be due to the implantation of the embryo in the uterus; sometimes a small detachment of the sac from the uterine cavity -or subchorionic bleeding- may be the reason; an inflammation of the cervix may occasionally cause slight bleeding (mainly with intercourse). Sometimes though, bleeding can be worrisome, i.e., when related to threatened miscarriage or ectopic pregnancy (a pregnancy outside the uterus).

What can you do about it:

  • keep track of the amount and characteristics of the blood,
  • don’t have intercourse, don’t use tampons,
  • according to the cause of the bleeding, you may be asked to get some bedrest, and refrain from heavy work or heavy lifting.

When to call your doctor: If you see blood, you should inform your doctor, even if you have light bleeding, as it may not be always easy to understand when bleeding is to worry about. But you should call your doctor right away (or go to the emergency room) if you have heavy bleeding, cramps (like intense period pain), or sharp pain in your abdomen, as these can be signs of miscarriage or ectopic pregnancy.

16) Vaginal discharge

Pregnancy symptoms vaginal discarge 2Why it happens: Your high hormones are responsible for an increase in vaginal discharge, that should be white or clear, and thin.

What can you do about it:

  • you can wear panty liners, but you should not wear tampons,
  • prefer cotton underwear,
  • avoid string or thong underwear that may cause intense rubbing, which together with the increased discharge can favor yeast or other infections.

When to call your doctor: if you have discharge that is yellow, green or foul-smelling, or if you have intense itching or burning.

 

Stay tuned! More posts with symptoms to expect during the second and third trimester of pregnancy will follow…

 

References

  • NICE: Antenatal Care- Routine Care for the Healthy Pregnant Woman. March 2008, UK
  • HAS: Comment mieux informer les femmes enceintes? Avril 2005, France
  • American College of Obstetrician and Gynecologists: Nausea and vomits, Vaginal bleeding

Photo credits

Cover: Getty images; 1) dornascostasnuncamais.com.br; 2) babycenter.com; 3) adriseaplanes.eu; 4) thealphaparent.com; 5) pregnancymagazine.com; 6) womenshealthcaretopics.com; 7) motherandbaby.co.uk; 8) ladycarehealth.com; 9) momjunction.com; 10) ladycarehealth.com; 11) fitbottomedmamas.com; 12) not-equal.eu; 13) womenshealthcaretopics.com; 14) health-and-parenting.com; 15) zliving.com; 16) privatepregnancy.co.uk

MY NATURAL HOSPITAL BIRTH STORY

Posted in Health, Inspire me, Pregnancy by

Wonderful. Empowering. Overwhelming. It is difficult to find a word to describe the experience of a vaginal birth. As a mother -who went through this experience-  and obstetrician, even after having delivered thousands of babies, I can’t help but admire every single time the beauty of a vaginal birth, it always feels to me like a perfectly designed choreography…

But the fact that something is natural doesn’t mean that is devoid of risks or complications. Thus, a hospital natural birth allows a woman to deliver with minimum intervention, while assuring peace of mind in case something goes wrong. And believe me, sometimes things DO go wrong, and then we may have just a few minutes to save the mother or the baby… 
True, hospitals can sometimes interfere with the process of a natural birth: measures such as fetal monitoring or the IV line are usually non-negotiable requirements for a hospital birth, but they can be invaluable, even life-saving in case an emergency ensues.
A natural, unmedicated hospital birth IS possible, it’s just a matter of having a motivated mom and a supportive team…
Here, KM shares her experience of a natural birth at a hospital and provides some tips to overcome the obstacles that may present in the process…

Natural Birth KM 2 resized

My Natural Hospital Birth: Overcoming obstacles to get to the birth I had

“I gave birth without pain relief and I consider my fifteen hours of labour as some of my best. My husband turned ace birth partner – a nice surprise, and a lucky one considering we opted not to hire a midwife or doula. We swayed to Don Carlos’s Rivers of Babylon and Simon and Garfunkel’s I am a Rock, among other soothing tunes in our Labour Chill Mix; moo-ed like cows; and got tennis balls rolling on my back. The first ten hours at home and en route to the hospital felt like a date: laughter, teamwork, watermelon juice (it was August, we live in Greece)… and some manageable pain thrown in to rally against together.

Natural Birth KM 1 resizedWhat I found least pleasant about my birth experience wasn’t the pain. It was the hospital admittance process keeping my husband and me apart and waiting. The hospitals I know prioritise hospital practicalities and legal self-protection over emotional wellbeing. Routine procedures like the IV are designed to allow quick and easy access to medical intervention, not for soothing pregnant women to “open up and let the baby out”. We didn’t expect the hospital setting to encourage natural birth, so we worked with my obstetrician ahead of time to overcome the obstacles we could predict.

Having read Birthing from Within and Ina May’s Guide to Childbirth (one of these suggests moo-ing like a cow to relax and open the cervix), attended birthing classes at Eutokia and Babycenter’s online birthing course, we were convinced that the less unnecessary medical intervention the better for both mom and baby. Avoiding unnecessary intervention seems like common sense, but as my obstetrician reminded us: common sense is not so common. We prepared for birth in the country with the highest rate (at 70%) of caesarean births in the world, a Human Rights in Childbirth case study.

Here is what was at stake at the hospital and how we managed each concern:

A. My rights over my body – My obstetrician kept me informed of my choices throughout. Her track record in vaginal births, willingness to explain our options, welcoming attitude to our attempts to be informed all set the stage for mutual respect. When she suggested interventions, we agreed. I had a membrane sweep a day before my due date and had my waters broken when I was about 8cm dilated.

B. My responsibility towards my baby – Protecting my birth experience felt like a first success at parenting. The memory still provides a deep well of confidence that we draw from in the endurance sport of parenting.

C. Recovery time – I was able to walk to the toilet by myself after the birth, and to walk to the nurse’s desk to ask for my baby back.

D. Breastfeeding success – I chose to room in with my baby and I enforced this choice by asking for my baby back. Even though we were “rooming-in”, our baby spent a lot of time out of our sight. My obstetrician informed the hospital staff that I was interested in exclusive breastfeeding and asked that they not to offer formula or water. Leaving the hospital after 24 hours ensured that any accidental feeds during the baby’s long absences from rooming in didn’t sabotage my breastfeeding goals.

E. The opportunity to bond with baby – My obstetrician did her best to remove unnecessary separations between us and our new baby. She arranged some alone time for the three of us before the hospital’s priorities took over again after the birth. She also signed off on our “early” release at 24 hours.

Natural Birth KM 5 resizedEight tips to having a natural birth in hospital: 

  1. Learn about what you can expect. We had read about the “I don’t think I can do this” moment getting through the last couple of centimetres. Knowing about this ahead of time kept us calm and later we laughed in recognition of the predictability of it. Just because childbirth (and breastfeeding, for that matter) is natural, it doesn’t mean that it comes easily or without need for knowledge.
  2. Be vigilant about what you want and get your birthing team on the same page. My husband and I wrote our birth wishes down (see below) and talked them over with each other, our obstetrician and the hospital staff until we reached a version that was more realistic. The process of writing this one pager was invaluable – it helped us become more informed and helped us mentally prepare for what success could look like.
  3. Arrive at the hospital late. On our obstetrician’s advice, we didn’t leave our home until after my contractions were about three minutes apart, ten hours into labour. I credit my obstetrician with sharing this advice, but I imagine that the advice she is able to give varies based on how informed a couple is.
  4. Make yourself at home in the hospital. We dimmed the lights, brought music and admittedly a small suitcase full of other personal touches we didn’t end up using. It turned out that I was focused inward much of the time in the later stages of labour at the hospital and my husband and music were all I needed to feel relaxed. I still claim that having the little suitcase of other supplies was comforting.
  5. Have at least one champion who will be vocal about what you want. There came a time when I was in another zone and talking was difficult. I was lucky to have both my husband and obstetrician fend off well-meaning nurses offering an epidural too late into my labour,  when it was tempting but would have been counter productive. I later roomed with a mom who was given such a late epidural, essentially sabotaging her natural birth efforts after having done most of the hard work.
  6. Rooming in – ask for your baby back! In my experience “rooming in” babies seem to spend a surprising amount of time in some auditorium that parents aren’t allowed even to look into. They are not returned after their individual checks are done but when they are all done, unless you ask.Natural Birth KM 4 resized
  7. Ask for the advice you need to care for your baby yourself – how to change a nappy, how to hold the baby to wash away poop, how to help baby latch onto nipple, how to breastfeed lying down. Many of these are much easier to learn with guided practice rather than through books. I noticed that hospital staff are used to parents who are content to let them handle the baby, but who miss out on learning while in the hospital.
  8. Get out as soon as possible, unless you find the hospital setting a rest from home (my obstetrician suggested I keep an open mind about this since the hospital can be a nice break when there are other children waiting at home). I gave birth at the only Greek hospital at the time that allowed exit after 24 hours, assuming all is well. We fought for our exit and the two couples we roomed with decided to do the same. We were much more relaxed at home and I could stop demanding for my baby back.

The husband adds:

Natural Birth KM 3 resizedPreparation was key to having an excellent birth experience. To support my wife, it was important to be involved, not just by being present for the labour but at an early stage. Reading the books Katerina mentions, Birthing from Within and Ina May’s Guide to Childbirth, were critical to understanding exactly what was going on – and what to expect — at all of the stages of labour, and how panic can cause the process to go into reverse. Doing my homework beforehand allowed me to remain calm and focused. Being involved also created a sense of shared endeavour with Katerina, an important bond necessary for fostering the feelings of trust and safety between us during the labour.

One more thing: if you’re a birth partner, and you have any feelings of self-consciousness about not behaving “seriously” during the labour, get over them. The books were full of useful tips about what to do in specific situations to help Katerina overcome fears and relieve tensions that commonly crop up. If she was going to open up her whole body to let a human out, mooing like a cow was a small ask for me.

 

BIRTH WISHES

KM & MB

Due date: Sunday, 11 August 2013

Baby details: Our first, a girl, we intend to name her CLLB

Obstetrician: Dr. Liliana Colombero

 

We are open to any intervention that Dr. Colombero judges is necessary for the safety of mom and baby. We ask that, outside of an emergency, we are informed before any procedures and be allowed to ask questions about the pros and cons. We are aware that things can change suddenly. Below is our best case scenario, as we imagine it today, 9 August 2013. Thank you for taking the time to read our birth wishes. 

HOSPITAL ADMISSION & PROCEDURES 

Once I’m admitted, I’d like to: 

Prep

  • Opt out of being shaved, assuming I’ve shaved myself already.
  • Opt out of the enema, assuming my system has emptied out ahead of time on its own.
  • Have a heparin lock instead of routine IV, assuming I’m not going for an epidural or c-section.

Environment

  • Listen to music and limit outside noise.
  • Dim the lights when visibility isn’t important.
  • Drink water, or other clear fluids.

LABORING AND BIRTH

As long as the baby and I are doing fine, I’d like to:

  • Avoid a cesarean.
  • Avoid being induced with pitocin.
  • Try a membrane sweep before induction by pitocin.
  • Progress in labor without time limits.
  • Not be offered an epidural, unless I request it.

When it’s time to push, I’d like to:

  • Try different positions.
  • Try perineal massage or compress.
  • Push instinctively when I have the urge.
  • Get guidance about how to push during crowning to reduce the chances of perineal tearing.
  • Avoid an episiotomy, unless Dr. Colombero feels that tearing will be very extensive.

After birth, I’d like to: 

  • Have the baby placed on my stomach immediately for skin-to-skin contact.
  • Hold off on the cutting of the umbilical cord until it stops throbbing.
  • Try to nurse immediately.
  • Wait for the placenta to be delivered in its own time, as much as possible.
  • Hold off on procedures (labelling, shots, tests) for an hour to allow for nursing and bonding.
  • Stay together during recovery with my husband and baby as long as possible.

IF CESAREAN IS REQUIRED

  • I would like to be conscious and have skin-to-skin contact with the baby as soon as possible.
  • Please use double-layer sutures to raise my chances of a VBAC in future.
  • I would like to stay together with my baby during recovery, and to breastfeed as soon as possible.

POSTPARTUM 

While recovering, I’d like to: 

  • Choose 24-hour rooming-in with our baby.
  • Have procedures on our baby done in our presence, as much as possible.
  • Breastfeed exclusively.
  • Speak to a lactation consultant as soon as possible.
  • Avoid baby formula, sugar water, or a pacifier being offered to my baby without my consent.
  • Go home as soon as possible, if all is well.”

 

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