Newly pregnant women have questions…lots of them. Here are some of the most common questions women have, but are often too embarrassed to ask.
Is it normal to pee your pants while pregnant? Will it continue after pregnancy? What should I do if it does?
Urinary incontinence is common while pregnant and during the postpartum period. During pregnancy, as the fetus and uterus grow, there is less bladder capacity (less room for the bladder to fill completely) which increases the frequency of urinary incontinence. After delivery, the pelvic floor muscles can be temporarily damaged, which can cause problems with urinary retention (from swelling) or urinary incontinence. Up to 1/3 of women can have urinary incontinence at 8 weeks after delivery and about 15% may have symptoms at 12 weeks. Sometimes it takes 12 months for symptoms to completely resolve. Pelvic floor muscle exercises, called Kegel exercises, can help strengthen the pelvic floor and help improve symptoms.
When your water breaks is it a gush like Niagara Falls or a slow trickle?
Either can happen. Sometimes you will feel a gush and feel like you wet your pants. Sometimes it is less obvious and can be a small leak. If you are not sure if your water has broken or if you just wet your pants, change your underwear and see if it happens again. If it does, it is probably because your water has broke and you should go to the hospital to be evaluated.
I’ve heard many women get hemorrhoids after giving birth. What causes that? How long does it take to go away?
Pregnancy causes an increase in varicose veins and hemorrhoids are basically varicose veins of the rectum. Constipation, which is also a common complaint in pregnancy, can cause straining, which can contribute to hemorrhoids as well. They usually get better after delivery; however, may not disappear completely. Giving birth doesn’t typically cause them, but may worsen symptoms.
Does having an epidural make you more or less likely to tear? Why do you tear? What’s the recovery process like?
Having an epidural doesn’t affect how likely you are to tear. Tearing occurs as the perineal muscles are stretched with the delivery of the baby’s head and often the shoulders. A controlled delivery usually can prevent significant tearing. However, for a first time mom, some tearing is usually expected. Typically, these tears are repaired with dissolvable suture. Recovery is typically about 6 weeks.
How do I recognize if I’m experiencing postpartum depression or if it’s just my hormones getting back to normal?
Postpartum blues are common after delivery and usually occur within 2-3 days of delivery. The blues are usually thought to be secondary to hormonal changes and resolve within 2 weeks. Symptoms are common (approximately 40-80% of postpartum women) and usually mild. Postpartum depression is less common (approximately 10-20% of postpartum women) and symptoms are more severe. Usually the symptoms start within 4 weeks postpartum, but can occur up to 12 months after delivery. If the “blues” are lasting longer than 2 weeks, it may be a sign of postpartum depression and you should contact your doctor. If you have thoughts of harming yourself or your baby, you need to seek medical attention right away.
Can I exercise when I am pregnant? What about working until I deliver?
Yes for both. Exercise is fine as long as you keep the intensity at a moderate level. A good measure is the “talk test”. If you can’t carry on a conversation, you are probably working too hard. Most women can also work until their delivery. Some jobs may require modifications depending on the type of work.
Can you induce labor with castor oil?
No. However, you will often induce diarrhea if you take it.
Should I give myself an enema prior to going into the hospital to deliver?
No. Some women have small amounts of stool while pushing/delivering, which is normal. An enema usually causes diarrhea and can make you dehydrated.
How much weight should I gain when I am pregnant?
That depends on where you are starting from. Normal weight women should gain approximately 25 to 35 lbs; underweight women should gain more (up to 40 lbs). Obese women should limit their weight gain to 10-15 lbs. Women who are morbidly obese should not gain any weight.
How long should I bleed after giving birth?
Bloody discharge postpartum is called lochia. It can change color and consistency throughout the postpartum period (ranging from bloody discharge to mucous-like discharge to a yellow-white discharge) and sometimes increases after it has decreased to almost nothing. It can last up to 6 weeks.