Your perineum is probably a part of your body that you haven’t paid very much attention to. The truth is, most people don’t need to pay attention to it until they are pregnant. However, it plays a huge role in your physical recovery from childbirth!
Did you know?!?
According to a 2007 study, an estimated 85% of vaginal deliveries will result in some kind of perineal trauma, with between 60 and 70% requiring suturing.
So what can we do?
According to the American Pregnancy Association, perineal massage in the last 3-4 weeks of pregnancy can decrease your chances of tearing during labor.
While you are in the second stage of labor (pushing/baby is being born), have your partner or doula press a warm, wet cloth against your perineum. Just like when your muscles relax when you take a warm bath, the heat and moisture from the cloth will help to relax your perineal muscles. Just make sure to discuss this with them prenatally-you definitely won't remember while you're pushing!
The nurses in the hospital will tell you this, but I'm going to go ahead and warn you now-the first few times you pee postpartum, it HURTS. Even if you don't tear, this area of your body will have just gone through a major trauma! Everything is swollen and sensitive, so be gentle with yourself.
Can I have sex during pregnancy?
Yes! There are certain medical conditions when your care provider will advise you not to have sex, like if you are at risk for preterm labor. If you are concerned, talk to your doctor or midwife. If your water has broken, you should not have sex as it increases the risk of infection.
Will having sex hurt my baby?
No. No matter how large, a penis cannot reach into your uterus. In addition, during implantation, your cervix was sealed up with a mucous plug-so even if a penis could reach that far, the way is blocked!
Can I have unprotected sex while I’m pregnant?
If you are in an STD-free relationship, it is safe to have unprotected sex while pregnant. While the mucous plug does prevent baby from getting infections, both it and baby will eventually come out and having an STD greatly increases your baby’s risk of infection.
Will having sex cause me to go into labor?
Semen does contain prostaglandins, which are known to ripen the cervix, and orgasms are caused by oxytocin-the same hormone that causes contractions. However, scientific studies have been pretty mixed on whether this is a reliable tool to induce labor. Check out Evidence Based Birth for more information and links to scientific studies.
What positions are safe?
Pretty much any position that doesn’t put pressure on your belly or have you laying on your back. Get creative, especially in the third trimester!
Cramping during or after sex is normal, especially after orgasm. But if it lasts more than a few minutes or you have any bleeding, call your care provider. Have fun!
The location of your placenta on the uterine wall can have a pretty significant impact on your pregnancy. It is something that is typically checked during an ultrasound so it can be monitored if necessary; placentas that attach low in the uterus can sometimes block part or all of the birth canal, which can make a vaginal delivery dangerous and even impossible. This is called placenta previa and it affects about 1 in 200 women. Your risk may be higher if you have had prior uterine surgery (including Cesarean section) or if you are carrying multiples.
Placenta location can affect your pregnancy in less dramatic ways as well. At term, a placenta weighs 1-2 pounds. If you have an anterior placenta (located directly behind your belly button on the ‘front’ of your uterus), those two pounds can get awfully heavy as your belly grows out. This can cause a lot of back strain. Wrapping your belly with a woven wrap can help alleviate the stress of carrying weight so far outside of your center of gravity. You will likely know if your placenta is anterior because it will be a little more challenging to find baby’s heartbeat at your checkups-this isn’t because anything is wrong with baby! It is simply a side effect of the Doppler having to go through an extra organ.
While there are plenty of uncontrollable factors that go into every birth, one of the most significant choices you can make is that of your care provider. So, how do you decide which care provider is right for you?
First, write down what your ideal birth looks like. Do you want an epidural? Would you prefer a water birth? While you're laboring, do you want to be left alone or have extra support? Do you have strong opinions on procedures like episiotomies or IVs during labor? When you interview care providers, ask what their opinions are on the things that are important to you.
The most important thing is to have a care provider who supports your view of birth and is willing to work with you and your birth team to help you feel supported and empowered no matter what kind of birth you end up having.
Here is a sample list of questions to ask when interviewing care providers:
Last year, the CDC published a study that has been tracking the age of first time mothers. The study concluded that the age of first time mothers has increased across every ethnicity, mostly due to the decrease in teen pregnancy since its peak in 1990.
Age during pregnancy can be a factor in calculating a woman's pregnancy risks, specifically if she is 35 or older. These factors include having a baby with Down syndrome, as well as a higher rate of spontaneous miscarriage.
If you would like more information on the risks of advanced maternal age on pregnancy and childbirth, check out this article from Evidence Based Birth. And, as always, discuss your personal risks with your care provider.
The most common question a birth professional gets (after "am I in labor?") is: When should I head to the hospital? In our culture, there is a huge fear of 'not making it' and having an accidental unassisted birth at home, in the car, or on the side of the road. It's also becoming more common for women to want to labor at home as long as possible to avoid being 'on the hospital clock.' So how do you know when to leave?
Basic rule to remember is: 5-1-1. When your contractions are 5 minutes apart, 1 minute in length, for 1 hour, you are definitely in active labor. If you head out earlier, the adrenaline and excitement of getting in the car, driving to the hospital, and going into triage can cause your labor to stall. This usually means they will send you home, but at some hospitals, they will admit you. If you are concerned about being 'on the clock,' this is definitely something you want to avoid.
As always, talk to your care provider about when they want you to call them and what their recommendations are for arriving at the hospital.
Skin to skin care is discussed in almost every text about postpartum. The benefits of it are numerous and long lasting; it is heartening to know that studies like these reinforce these benefits for all newborns and not just those that are full term.