06 August 2007

Not for the sensitive viewer

There’s more to being pregnant than buying fluffy blankets and cutesy clothes. Much, much more. Reader beware, says Robyn von Geusau.

Pregnancy is fabulous in a million different ways. But it really gives your body a run-around, and all sorts of things start to behave badly. Some are routine, others more worrying. And you don’t want to raise the symptoms over a cappuccino with friends. So we’re doing the best-friend thing here:

Yes, sadly. This is one of the least glamorous side-effects of pregnancy. Your increasingly large baby presses down on your rectum, interfering with venous flow to the heart. The blood pools, causing the veins to dilate to accommodate the dammed-up blood. They can either form internally or protrude through the anus.
What to do: Help yourself by keeping your bowels regular and the stools - you’re going to hear this word a lot during your pregnancy so best get used to it now - soft, with plenty of fibre. This will help you avoid, er, straining. (Hold this thought: if, during labour, you lose the desire to push because of the epidural effects, you can also think of sitting on the porcelain throne. It’s supposed to help. Seriously.)
Lifting weights increases intra-abdominal and back pressure in the rectal veins, so go easy in the gym.
There is no risk to baby from your haemorrhoids, just to your dignity.
Sitting on a pack of frozen peas can ease discomfort. Brand names are irrelevant.

Watch out for these in the groin and under the breasts, due to excess weight gain and sweat (your body temperature may be higher) that accumulates in the skin folds. A common, intensely itchy rash is urticaria with red, irregularly shaped flat or slightly raised hivelike patches - sometimes with tiny fluid-filled blisters in the centre - that develop on the abdomen and spread to the thighs and buttocks and sometimes to the arms.
What to do: Keep yourself clean and dry, and apply calamine lotion if necessary. Avoid polyester, which tends to trap moisture; and for goodness sake, wear cotton broeks.

The show
This has nothing to do with Broadway or the West End but rather a blood-tinged plug of dense mucus, which has been the seal in your cervix throughout your pregnancy. This becomes dislodged during the onset of labour when the cervix begins to dilate.
However, if you have an incompetent cervical canal - usually diagnosed only after a miscarriage - where the amniotic bag has sagged through into the vagina, doctors can intervene by stitching a soft, non-absorbable thread around your cervix to tighten it during your next pregnancy. About seven days before term it will be cut to allow the baby to be delivered vaginally.
What to do: There’s nothing you can do - just keep an eye on things.

Oesophageal reflux may cause heartburn because of the relaxation of the sphincter at the top of the stomach. And because the entire musculature of your intestinal tract is relaxed, there are fewer contractions to push the food along, so you have fewer bowel movements which can often lead to constipation.
What to do: Drink lots of water, eat as much roughage as you can, and walk briskly for about 20 minutes daily. Oh yes - heartburn and burping are also common because food remains in the stomach longer.

In certain circumstances, the perineum (the area between the, um, anus and vagina) and vaginal wall need to be cut to facilitate delivery. It might comfort you to know that the episiotomy is the most commonly performed operation in the West - and enlarges the vaginal outlet to avoid tearing as the baby’s head is crowning. It is usually done if the perineum is under severe stress, and if forceps are necessary. If the rectal sphincter is damaged either during the episiotomy or torn during delivery, it generally heals well if repaired immediately.
What to do: Not much, really. Discuss it with your obs/gynae in advance.

During the second stage of delivery, when you push your baby out, you may pass a stool or urinate.
What to do: Do not give it a second thought. It is perfectly normal and will be dealt with by your attendants. They’ve seen it before. And if you’re ever challenged, deny it completely.

Don’t be afraid if your nethers turn a gentle shade of purple - this is due to the increase in blood supply to the area thanks to the massive rise of oestrogen in your body. And because the vaginal walls become softened and relaxed, a watery substance is produced in increasing amounts, so expect a rise in your discharge levels.
And about the increase of blood flow in the pelvic region: this can result in the labia minora and lower end of the vagina becoming engorged, and may cause slight discomfort, particularly after intercourse, when they remain swollen and aching post orgasm.
What to do: Neither the increased blood flow nor the discharge are normally problematic. If you do start to get concerned… well, you don’t really have any secrets from your gynae any more, do you.

Also not nice, this yeast infection is characterised by a thick, white discharge from the vagina, accompanied by dryness and intense itching in the general area. It may also burn when you pee. Infection occurs when the yeast grows uncontrolled by other bacteria, sometimes following a course of antibiotics.
What to do: Cut down on the choccies as excess sugar aggravates it. Also avoid wearing tight pants and trousers, as this encourages infection. Cotton panties are best. The doctor may prescribe pessaries that you place in your vagina at night. A prescription cream will also stop the itching. A couple of drops of tea-tree oil in your bath won’t go amiss either.

- (Robyn von Geusau, FitPregnancy)


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