What if part of my placenta doesn’t come out of my uterus? What will my care provider do?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

If part of your placenta doesn’t vacate your uterus within around thirty minutes after baby is born (something called a retained placenta), it will be evicted. As a full or partial retained placenta could cause hemorrhage (excessive bleeding) or infection, your care provider will utilize various methods until the entire organ has been birthed or removed. But you don’t have to be too worried about this, as it’s pretty rare. According to an article in the International Journal of Women’s Health, a retained placenta occurs in only 1 to 3 percent of deliveries.

There are three types of retained placenta:

1. Placenta adherens occurs when contractions are too weak to push the placenta out and it remains loosely attached to the uterus. This is the most common type of retained placenta.

2. Trapped placenta is when the cervix begins to close before the placenta has been expelled.

3. Placenta accreta occurs when the placenta attaches to the muscular walls of the uterus, instead of the lining of the walls. This is sometimes diagnosed before birth and usually results in the care provider recommending a C-section.

You care provider will check your placenta after its birth to confirm that it’s fully intact. If they suspect part of it is missing, they may perform an ultrasound to confirm. From there, they’ll take steps to remove the remaining pieces. However, it’s possible for a care provider to miss that a portion of the placenta is still in the uterus. In that situation, you might experience a fever, excessive bleeding, constant pain, or stinky discharge.

How does my care provider get it out? One of the first things they’ll likely do is administer medication that encourages the uterus to continue contracting. (This is often done preemptively.) Breastfeeding can also trigger contractions. You might also be told to urinate, as a full bladder can impede the placenta’s expulsion. If these methods don’t work, they may have to move on to manual removal, or surgery. In the case of manual removal, the care provider administers anesthesia and/or analgesia, reaches their hand into your uterus, and “sweeps.” Essentially, they feel around and remove lingering placenta. This doesn’t feel great — but it usually works. Surgeries to remove the placenta include dilatation and curettage (aka D&C), hysteroscopy, and laparoscopy. A hysterectomy is needed in rare cases. Antibiotics are given after the treatment to reduce risk of infection.

What to do

While there’s not much you can do to avoid the rare occurrence of a retained placenta, there are a few ways to be proactive:

Avoid prolonged use of Pitocin. According to the article in International Journal of Women’s Health, prolonged use of Pitocin could increase the risk of a retained placenta. So use Pitocin only if it’s absolutely necessary — not just because a care provider thinks it would be cool to speed things up.

Pay attention to your postpartum symptoms. If your care provider believes the full placenta was birthed but you experience fever, excessive bleeding, constant pain, or stinky discharge, or you just feel that something is off, let your care provider know so they can confirm you don’t have pieces of retained placenta.

Know how to stay calm if you experience a retained placenta. Stick a few of these retained-placenta-relaxation tools in your back pocket for the unlikelihood of this happening to you:

  1. If you’re told you have a retained placenta, immediately start taking deep breaths, helping to prevent panic from taking over.
  2. Have someone on hand to hold the baby, as pain medication may need to be administered. However, continue focusing solely on your baby until a recommendation is made and you make a decision. This can help your mind from spiraling into a place of fear.
  3. Keep reminding yourself that you’re being taken care of by trained professionals. While it’s not fun to have a retained placenta, they’ll take care of you, and you’ll be fine.
  4. If a manual removal or surgery is needed, close your eyes and envision your body filled with and surrounded by a warm, golden light that’s keeping you calm and safe.

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Will I be judged if I want to eat my placenta? And is it worth it?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Maybe, to both questions. I believe that anyone who judges you for your birthing or parenting decisions isn’t worth your time. Sure, people close to you have every right to not understand your decision, but they don’t have a right to make you feel shame for the decision. And what’s the deal with some people having such a strong reaction to those wanting to ingest their placenta? Well…

Many believe that consuming the placenta is a dangerous, “hippie dippy” thing to do. They’re not entirely wrong. It can be dangerous in certain circumstances, and I know lots of hippies who are all about noshing on that placenta. But I believe what’s really behind these conceptions is that the idea of someone eating their placenta brings up visions of dicing up the organ and tossing it in the frying pan, or even throwing a few raw chunks in a smoothie. While that’s been known to happen, it’s not what placenta consumption usually looks like. Most women get the placenta encapsulated and take a few of the pills each day.

Before I get into the specifics of ingesting the placenta, know that it’s a controversial topic because very little research has been done on it. And the studies that have been done were limited, providing inconclusive results. Because of this, I think it’s important to talk to your care provider before making this decision. Then do what feels best to you.

To increase your knowledge of what it means to consume your placenta, let’s look at some facts:

How is it encapsulated? The placenta is washed, steamed (sometimes with herbs), dehydrated, and ground, and then the powder is encapsulated.

How could eating it help? Anecdotal evidence has suggested that ingesting the placenta can do the following:

  1. Increase energy
  2. Balance hormones
  3. Prevent anemia through restoration of iron levels (However, it’s been found that most placenta pills contain a very modest amount of iron.)
  4. Lower chances of developing postpartum depression

Some believe these benefits are caused by the placebo effect. As a big believer in the mind-body connection, I don’t think there’s anything wrong with that. But I’ve also heard from women who felt that their placenta pills dampened their mood and energy. In addition, there are potential risks to consider.

What are reasons I might not want to eat the placenta?

* Group B strep: If you have group B strep (GBS), there’s a possibility it could infect the placenta. The infection could then be passed to the baby through breastmilk after you ingest the pills. I’ve known plenty of women who tested positive for GBS, encapsulated their placenta, and had no issues with their baby being infected, but it’s important you’re aware of the risk before making the decision.

* Infection: In addition to GBS, it’s possible for the placenta to be contaminated by other intrauterine infections. There’s also the potential for contamination during the encapsulation process, if it’s not handled properly.

* Hormones: Estrogen in the placenta pills could increase the risk of blood clots. And the presence of progesterone could impede prolactin, which is responsible for milk production. Estrogen can also suppress prolactin.

What to do

Talk with your care provider. If they simply tell you not to encapsulate, ask them why. Ask questions until you get a clear view of where they’re coming from. If you feel that what they’re sharing is primarily based on personal beliefs instead of more solid evidence, consider talking with a few placenta encapsulating specialists to receive a more well-rounded perspective. After gathering information from numerous sources, sit with the decision until you’re clear on what you feel most comfortable with.

If you choose to move forward with placenta encapsulation, here are questions to ask the specialist:

Did you receive formal training and certification? What did that consist of? Do you engage in continuing education?

How many placentas have you encapsulated?

What are the risks of placenta encapsulation? Have your clients ever had adverse effects?

Are there certain STDs or infections that would rule me out as a candidate for encapsulation?

How do you handle and store the placenta before you’re ready to encapsulate?

Where do you encapsulate? What are the sanitation procedures for your equipment and workspace?

Would you be willing to encapsulate in my kitchen if that’s what I’m most comfortable with?

How do you make sure my placenta isn’t mixed up with someone else’s?

How do you encapsulate the placenta?

What temperature do you use to steam the placenta? Is it high enough to kill potential bloodborne pathogens?

What do you encapsulate the powder in?

Will you be immediately available to pick up my placenta? If not, how should I store it until you arrive?

How soon will you deliver my pills?

Will you provide a dosage recommendation?

When you start taking the pills, pay attention to how they make you feel. If you start feeling down or notice a drop in milk supply, consider not taking the pills for a few days to see if the negative symptoms go away. Because there isn’t much quality evidence about this, each woman taking these pills is essentially acting as a guinea pig, which ends up great for some, and not so much for others. Each body seems to respond a bit differently.

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birth podcast, Childbirth, Pregnancy, pregnancy podcast

What To Do When You Can’t Stand Your Doctor or Midwife


Why you shouldn’t feel guilty about firing your doctor or midwife, and tips for finding a medical care provider who makes you feel safe and empowered during pregnancy and childbirth.


What’s it really like to push a baby out?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

It’s like pushing a flaming watermelon out a fleshy hole the size of a baseball. Just kidding. Actually, this experience is completely different for each woman. I’ll give you a couple of examples.

My client Chelsea had taken my HypnoBirthing class and was a devout believer in breathing her baby down (an alternative to pushing). For weeks beforehand, she practiced the birth breath every time she was having a bowel movement, and in her regular meditation practice she envisioned successfully helping her baby emerge in this gentle way. When she went into labor, the midwife and I were called to her house and she began a very long journey through labor.

Tired but determined, Chelsea worked her HypnoBirthing tools, continuously focusing on surrendering and expanding. Twenty-four hours later, the midwife said the head was almost out. Chelsea began doing her birth breathing, and ten minutes later the midwife said, “Give me one big push.” And just like that, her baby was born. I was shocked. Almost every birth I’ve attended consisted of a big announcement when the mom was fully dilated, and everyone getting in position to help her push. A nurse or midwife would then loudly coach the mom to press her chin to her chest and push like her life depended on it. It was usually a long process. But not this time.

My birth, on the other hand, was the epitome of the classic pushing you see in the movies. My feet were in those scary-looking metal stirrups, I had a spotlight on my vagina, a nurse was nervously watching the monitors, my husband looked like he was about to faint as screams, blood, and probably some poop came out of me, and the doctor kept telling me to “Push harder! Harder! Harder!”

I did as I was told. I wailed like a banshee and worked so hard I spiked a fever. I pushed for three hours before Hudson came out. When he arrived, his hand was pressed against his face (something called nuchal hand), which is likely what made the pushing such a long, hard process. But I don’t think that was the only reason. Even though I knew about the birth breathing technique I hadn’t really believed in the power of it , and I didn’t have a doctor who supported it. But who knows, even if I had Chelsea’s unwavering belief in breathing the baby down, I might still have needed to push harder harder harder, whether because of the nuchal hand or just the structure of my body.

I share these stories to make the point that the experience of pushing (or breathing) a baby out can range from gentle to super-duper intense. So much of it depends on the woman and the baby. And while how the pushing process unfolds is mostly out of your hands, there are ways you can prepare yourself for the experience, which I cover in the “What to do” section. Before we get to that, let’s look at the questions about pushing I get most often.

What does it feel like? For many women, pushing doesn’t feel nearly as uncomfortable as they think it will, even if they don’t have an epidural. Because of the pressure of baby’s head on nerves in the vagina, a numbing sensation is often present during pushing. This numbing is usually accompanied by intense pressure — essentially, it feels like you’re about to take the biggest poop of your life. Some women report a “ring of fire,” an intense burning sensation, when baby’s head is crowning. But most women I’ve worked with (myself included) said they never felt it. As strange as it sounds, I found pushing to be the most comfortable part of childbirth, albeit the most exhausting.

What can make it harder? A baby in the posterior, or “sunny-side up,” position is one of the most common situations that can make their emergence trickier. In this position, baby’s face is pointing toward the front of your body, which can make it challenging for them to get past your pubic bone. It doesn’t make vaginal birth impossible, just harder. There are tips for repositioning a posterior baby in the “What to do” section. You’ll also find a link for the video “How to Reposition a Posterior, or Sunny Side Up, Baby” in the book’s “Recommended Resources” section.

Numerous other circumstances can complicate pushing — here are the ones you can actually do something about:

􏰀 Lying on your back: This position doesn’t utilize gravity and can narrow the birth canal. Being on all fours, lying on your side, or squatting are all preferable for most women. If you have an epidural, ask if you can lie on your side while pushing.

􏰀 An epidural: As an epidural can make it difficult to feel and coordinate the birthing muscles, pushing when you have one can be tricky, but not impossible. I’ve witnessed many midwives tell moms with an epidural who had fully dilated to not push, and let contractions do the work instead. In many of these cases, the mom didn’t have to push until baby was almost out. Some call this delayed-pushing technique laboring down. You can also ask if the epidural can be turned down when you’re ready to push, so some sensation returns.

􏰀 A tired uterus: If you’ve had an incredibly long labor, your uterus might get tired, and tired uterine muscles can complicate baby’s descent because they may not be able to contract as effectively as needed to push baby out. Some care providers recommend Pitocin if they suspect the strength of contractions is waning, as it can give the uterus a much needed pick-me-up.

How long does it take? Unfortunately, there’s no answer for this one. Some women push for ten minutes and the baby is out, and others push for hours and still need the support of forceps or vacuum. Following the tips in the “What to do” section can increase your chance of shortening your push time.

What is it like for baby? While it’s impossible to know what baby is thinking during this process (I suspect it’s something along the lines of “WTF is happening?”), monitors tell us that many babies experience a dip in heart rate every time their mom engages in heavy-duty pushing, as there’s usually a drop in oxygen during this time. The heart rate usually bounces back up when the contraction and push are complete. This is another reason why the gentler pushing methods can be beneficial — they don’t require mom hold her breath. However, if there is a special circumstance requiring that baby come out as soon as possible, the more intense pushing could be worth it. Your care provider can help you determine what is safest for you and baby.

What to do

While there’s no way to know what type of pushing will be most effective for your body and baby, or how you’ll process that experience, these techniques will help you go into the event as prepared as possible.

Do the perineal tissue massage. This massage will prepare your perineum for baby’s head.

First, coat your pointer and middle finger, or your pointer and thumb, with an unscented, organic oil.

Then insert the fingers two inches into the vaginal opening, and move them in a U-shape along the inner edge of the perineum.

I recommend applying more pressure when you reach the tautest skin (area between the vagina and anus), as this is the skin most likely to tear during birth.

As you push to the point of discomfort, utilize pain-relieving techniques like deep breathing and facial relaxation. This makes the perineum become more elastic, and helps mentally prepare you for the vaginal stretching during crowning.

I recommend doing this nightly for about ten minutes, starting at around week thirty-four or thirty-five of gestation.

Get baby in the optimal position. Cephalic presentation (the best position for baby to be in) is when baby is head down, facing your back, with their chin tucked to their chest. Your care provider can help you determine if baby is in this position.

If they’re not facing your back, here are a few things you can do to give them the space to get into it, which they’ll usually instinctually do if they’re physically able.

Get into the yoga position called “child’s pose” and really stick your butt into the air. You can also gently sway your hips. Stay in this position for at least five minutes (unless you feel woozy), and practice once a day.

Get on your hands and knees and gyrate your hips.

As often as possible, sit in a position where your pelvis and belly are tilted forward. The easiest way to do this is to sit on a wedge cushion. If you’re sitting on a birth ball, make sure your knees are lower than your pelvis.

Sleep on your side instead of your back.

Avoid sitting in bucket seats, or leaning back into the sofa.

Prepare your pelvic structure. A deep squat (with the support of a spotter) or the yoga poses “child’s pose” and “cat-cow pose” can all help relax and lengthen your pelvic floor muscles.

Practice birth breathing while pooping. Because the “birth breath” stimulates the natural expulsive reflex, it can help you poop and get a baby out with minimal pushing. Many mamas don’t believe this until they experience its effectiveness while having a bowel movement. So . . .

While sitting on the toilet, take in a quick and strong inhalation through your nose.

As you slowly exhale, feel the power of the breath being pushed down the back of your throat, through the uterus, and out your vaginal opening.

While you exhale, you’ll organically create a low sound and gentle vibration in your throat. You’ll also feel your expulsive muscles bearing down.

Repeat until you expel that poo!

Ask your care provider how they typically guide women through baby’s emergence. Gaining an understanding of the instructions your care providers usually provide through this phase of birth helps you determine whether their process resonates with you. If it doesn’t, talk to them about how you’d prefer to navigate pushing.

Think of how you want to be guided through pushing, or breathing baby down, and add it to your birth preferences. After you’ve determined if you’d like to try birth breathing or want to go with more traditional pushing, add it to your birth preferences. I also recommend listing how you’d like to be guided through this experience. For example, women I work with often use the phrase, “I request calm prompts from only one person. No loud ‘cheerleading’ please.”

Utilize the “laboring down” technique. In laboring down, you allow the uterus to push baby out with only contractions, and not your pushing efforts, after you’ve fully dilated. This can conserve energy, reduce your chance of tearing, and provide a gentler experience for baby. Many women I’ve supported use this technique until they can no longer suppress the urge to push.

Choose a position that takes weight off the tailbone. Standing, kneeling, squatting, being on all fours, or lying on your side allow more expansion in the pelvis, potentially leading to an easier emergence for baby. Changing positions can also help if pushing progress seems to stall.

Apply a warm compress and oil. Help the perineum soften and expand (which minimizes tearing) by asking your care provider to place a warm washcloth on your perineum, in addition to massaging it with oil.

Go limp between contractions. Contractions and pushing can take a lot of energy. Allow yourself to recharge between push sessions by closing your eyes, going totally rag doll, and taking slow easy breaths. You can also ask that no one talk to you unless absolutely necessary.

Consider having a mirror held between your legs. Seeing the top of baby’s head between your legs can be an incredibly motivating visual. If you’re into this idea, bring a hand mirror to your birth, and ask someone to hold it between your legs when baby is crowning.

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I’m very reserved and cringe at the idea of screaming or cursing, or having strangers see my vagina, butt, and breasts during birth. Will this impede my ability to labor?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

It’s unlikely that your sense of modesty will impede labor, primarily because even the most modest mamas will tell you their modesty almost entirely dissolved when they were in labor. But even if that doesn’t happen, you’ll still be fine because you have control of who’s in the room with you, and how covered you are. While many believe this is a given for birth at home or in a birth center, somehow they don’t feel they have power over who is in the room at the hospital. But you absolutely do. You can make it clear in your birth preferences that you don’t want hospital staff in the room when you’re laboring, with the exception of the nurses needing to monitor you every hour or so and an occasional visit from your doctor. In regard to delivery, you can request that only absolutely necessary hospital staff be present.

You also have control over the nonmedical staff who are with you. You don’t have to say yes to that friend or family member who really wants to be at your birth if you don’t think you’d be comfortable with them present. You don’t even have to have your partner there if you think their presence will throw you off. (For more on this, see question 38.)

Essentially, you have every right to go into labor with your modesty intact — you don’t have to change. But again, birth might change you anyways, especially if you have an unmedicated birth, as the intensity of the sensations will likely eliminate your concerns about nakedness, cussing, and so on. If you get an epidural, you’ll be more aware of your modesty, but you’ll also have more energy and focus to advocate for your wishes for privacy and coverage. And if you have a C-section, nothing but your abdomen and upper bikini line area will be exposed.

What to do

Home in on the elements that make you uncomfortable. For example, are you hesitant to have your vagina exposed? Do you not want your breasts shown? Are you nervous that you won’t be able to control what you say, or how you sound? Does the idea of your partner seeing birth fluids come out of you make you nervous? Write down everything that’s making you uneasy, then try the following:

Put your needs in your birth preferences. In this document, you can ask to be assigned only female care providers (whenever possible), and that no medical or midwifery students be allowed in the room. You can also request that people knock before entering your birthing space, only stick around if their presence is absolutely needed, keep your lower half covered with a sheet during vaginal exams and baby’s descent, or anything else you think will make you more comfortable. And when making these preferences, don’t worry about offending anyone. This is your birth, and you get to ask for what you want.

Talk with your care provider about your concerns. Discussing your qualms with your care provider will not only help them better understand your needs, but will also give them a chance to offer fresh ideas for keeping you comfortable during childbirth.

Make a “Please Knock” sign. In addition to putting this in your birth preferences, make a sign for the door of the room you’ll be laboring in that says, “Please knock, and wait for permission before entering.” This ensures no one surprises you when you’re in a state of undress, or any kind of state you’re not comfortable certain people witnessing.

Pick out super comfortable clothing. If nakedness is a concern, consider finding a really comfortable nursing bra. You could also bring a robe, and wear underwear that’s not too restrictive. Just make sure these are items you don’t mind getting birth juices on.

Wear earbuds. Nervous about cursing, moaning, or screaming? Pop in your earbuds and play your favorite music or guided meditation, so you’re less aware of what you sound like. As for the people in the room who don’t have earbuds in, I can almost guarantee they won’t care about profanity or any loud noises you make.

Determine how your birth supporters can help. Making a plan for how your people can advocate for your desire to stay covered and maintain privacy helps ensure you don’t have to do anything but focus on birth. Discuss with them beforehand what’s important to you, and offer ideas for how they can best support you.

Request the bare minimum number of vaginal exams. In many cases, vaginal exams aren’t required during birth, so if they make you uncomfortable, opt for none, or few.

Have your partner stand by your head when baby is being delivered. If you’re uneasy with the idea of your partner witnessing the release of discharge and blood, a potential vaginal tear, or other components of your vagina’s journey through childbirth, talk with them about staying away from that area as baby emerges. It’s good to talk about this well before you go into labor, as your partner might have strong feelings about seeing your baby come out. You, of course, have the final say over who sees what during birth, but your partner’s feelings might sway your decision.

Ask that the room be cleared as soon as possible after baby’s delivery, so you can begin breastfeeding (if you’re choosing to breastfeed). If breast exposure is a concern, remind everyone that you want only absolutely essential care providers in the room after baby is delivered. You can also drape a blanket over baby after you place them on your bare chest.

Remember that your care providers have seen it all. The wonderful people who support women through birth have seen all degrees of nudity, heard birthing women scream and curse the wildest of phrases, witnessed them pooping, and observed the whole range of other raw displays that birthing evokes. Essentially, there’s nothing you can do that will make them blush.

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birth podcast, Childbirth, Pregnancy, pregnancy podcast

Development of Tools to Predict and Even Prevent Postpartum Depression


Learn more about research being done on blood biomarkers that could eventually help care providers determine who has a high risk of developing postpartum depression. This research could even lead to discoveries in how to prevent postpartum depression. 


I know everyone asks about pooping during birth, but let’s be real; will the care providers pull a face behind my back if I poop?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

While no one enjoys wiping poop off another human, your poop is the least of your care providers’ worries. They just want you and baby to be healthy. And they’ve likely seen so much poop during deliveries they won’t have much of a feeling about you doing it. They’ll just silently jump into “poop protocol” and swipe it away before you realize what happened. Every mom I’ve seen poop during birth had no idea they’d done so — they were more concerned with other situations, like pushing a human out of their vagina.

Something else to consider is that when people talk about pooping during birth, they’re not referring to a full bowel movement. They’re talking about little bits and pieces popping out. “Rabbit turds” is what a midwife I know lovingly calls birth poops. (Yes, I got into this business for the glamour.)

What to do

Talk with your care provider about that aforementioned poop protocol. They’ll be able to assure you that pooping is nothing to be worried about, and that the people caring for you won’t be offended if that’s part of your story. They can also tell you how they typically handle this incredibly common occurrence. In addition, these steps can help you feel more confident:

Don’t do an enema. This could cause unneeded discomfort and doesn’t make much of a difference during childbirth. The beliefs that an enema could shorten labor or decrease the risk of infection have been debunked.

Stay on top of your fiber and fluid intake as you near that due date. Constipation is always uncomfortable, but it can be especially unsavory when you’re in labor. Drinking plenty of water and eating avocados, lentils, chickpeas, raspberries, and other fiber-rich foods will keep things moving, helping to ensure you don’t have a backlog when it’s baby time. (If you really want a treat, whip out those prunes.)

Visit the bathroom at least once an hour during labor. Even if you don’t feel like you need to go, spending time on the toilet gives your body the freedom to purge any urine or fecal matter you might not know you need to release. And this release enhances comfort.

Tinkle Tip: If you have trouble peeing, put a few drops of peppermint oil in the toilet bowl, place your bare feet on a cool surface, and dip your hand in a cup of cold water. (Who said those prank scenes in summer camp movies weren’t teaching us valuable life lessons?)

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I’m getting really focused on what I’ll look like during and after labor. I’m especially concerned about looking bad in photos. Should I bother with doing my hair and makeup when labor starts?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Before I get into the specifics of this question, I want you to consider that your decisions regarding your looks during labor should be totally based on your feelings about yourself, and not on how you think others might judge you. Anyone around you during birth will be so in awe of what you’re doing they won’t give a hoot what you look like. You’ll look like a goddess to all who lay eyes on you, even if your hair is a mess and you’re covered in sweat.

With that said, I definitely wouldn’t bother with makeup (no matter how much you love it), as it will probably end up running down your face when you sweat, get into water, or cry. Regarding your hair, I can almost guarantee it will also get mussed up during labor. But because the undoing of the hairdo won’t cause anything to run down your face or sting your eyes, there’s no harm in doing your hair beforehand, especially if it ups your confidence and provides a distraction during early labor.

Something I would do during early labor is take a shower — if you have the time. And I would go all in with that shower: wash your hair, shave your legs, exfoliate your butt. Do whatever you need to do to feel super fresh. I did not do this before I went to the hospital to birth Hudson, and I remember many moments of feeling grimy. No one seemed to notice my griminess (nor would I have cared if they did), but I didn’t like the feeling — it was distracting. If you’re wondering why I didn’t just take a shower while in labor, the answer is that I had to use every drop of my mental and physical facilities to move through each contraction — there was nothing left for shampooing.

What to do

As mentioned, let’s skip the makeup, only do the hair if you really, really want to, and say yes to a shower. Regarding photos, if you’ve hired a birth photographer or would like your partner or doula to take photos, and you are concerned about what you’ll look like in the photos, there are a few things you can do to prepare:

Become one with raw images. Consider that you might enjoy having photos that capture the unfiltered realness of your birth experience, wild hair and all. Of course, if that’s not your thing, no worries. Just be your brand of Beauty.

Ask your photographer to check in before taking a photo. Setting this parameter lets you decide in the moment whether the taking of the photos will make you too aware of how you look, distracting you from the task at hand. Or you might decide that you don’t care how you look and are happy to have them capture some of these once-in-a- lifetime moments as is.

Request touch-ups. If the photographer is someone you feel really comfortable with, ask them to touch you up before they start snapping. For example, they can push the hair off your forehead, readjust your robe, or move the barf bag out of the frame.

Bring beauty basics. When you get to the blissful period when baby is in your arms, you might want makeup applied before taking the shots that’ll be texted and posted. You might also want a hair touch-up. If you think this is something you’ll desire, pack a bathroom bag with a hand mirror, hairbrush, and your makeup essentials (e.g., some concealer, blush, and mascara), so your birth companion can easily retrieve the goods while you bond with baby.

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Will it be weird if I want to be totally nude during labor?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Not at all. For some women, having clothes on during birth can feel distracting and restrictive. Taking it all off can leave your mind clear to focus on breathing, moving, or doing any other relaxation techniques that help you move through contractions. And no one supporting you during birth will think twice about you being naked. Doctors, nurses, midwives, and doulas are totally used to all states of undress when supporting a laboring mom.

To ensure you stay comfortable with your nudity during birth, be really clear about who is and who isn’t allowed in your birthing space. For example, if you don’t want your father-in-law dropping in when you’re doing naked hip swirls, let everyone know that no one is allowed in the birth space unless they get explicit permission from you.

What to do

Keep reminding yourself that there’s nothing wrong with being buck naked during birth. Then consider the following:

Put it in your preferences. Add the following line to your birth preferences: “I request complete privacy during birth. In addition to the necessary medical care providers, only the following people are allowed in the birth space [insert names].”

Tell your partner. It can be helpful to give your partner a heads-up about your desire to be nude, especially if you think they’ll be uncomfortable with it. But don’t let them dictate what you do and don’t wear during labor. You can give them the courtesy of a discussion, but you get the final say in what you wear.

Bring “just in case” birth clothes. It doesn’t hurt to have a nursing bra, robe, and loose, comfortable clothing on hand in case you feel like being clothed during certain phases of labor.

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How to Stop Hating Your Partner During Pregnancy


Discover why it can be normal to kind of, sorta, completely hate your partner during pregnancy. And because it’s no fun to despise your special someone we also explore how to navigate the irritation and discord so we can start loving them again. 


Will my vagina look like minced meat after a vaginal delivery?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I’ll not mince words (hee-hee) — most vaginas look pretty beat up after vaginal childbirth. With all the stretching and potential tearing, the vagina won’t be easy on the eyes for a while. But the good news is, it won’t stay that way. Tears heal, and stretched skin (slowly) bounces back. The one thing that might be permanent is a darkening of your vulva, as it could experience a shift in pigmentation. So while your petunia will never look exactly like it did pre-childbirth, it will go back to a semblance of its former self after six to twelve months.

Something else to expect from the first few days of life after birth is that you will have heavy discharge. There will be lots of blood, mucus, and tissue coming out of you, requiring you to don a diaper-like pad. While the load will likely lessen within a week, you’ll probably need pads for four to six weeks.

What to do

If you’re squeamish, or if you experience more pain when focusing on a sore area of your body, don’t stick a mirror down there for a while. However, if you want to marvel at everything your courageous vagina went through, take a look — it’s pretty fascinating. And don’t be embarrassed by its appearance. The two of you went through a lot, and you’re allowed time to heal. Tummies are squishy, stretch marks are prominent, and vaginas aren’t pretty in that fourth trimester — and that’s okay. Be patient with your body, and grateful it helped you grow and birth new life.

Regarding how you can minimize tearing and make your perineum more elastic, check out the “What to do” section from question 63.”

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Is a vaginal tear as scary as it sounds?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

No. My perineum tore during birth, and I had no idea until they started stitching me up. And I didn’t have an epidural. But I get why women are horrified by the idea of a tear in one of the most sensitive parts of their body. It sounds awful. The thing is, the combination of a buildup of

endorphins, the numbness caused by the pressure of baby’s head, and the Goddess-like determination to get the baby out makes many women oblivious to a vaginal tear, regardless of whether or not they have an epidural.

To provide further insight about vaginal tears, here are answers to the most common questions I get about this topic:

How likely is a tear? It’s common for a first-time mom to tear, but again, you probably won’t even notice it until after birth. The recommendations in the “What to do” section can help reduce the likelihood of a severe tear.

How big are the tears? While tears range in size, they’re usually much smaller than we imagine. First-degree tears are only a few centimeters, while a fourth-degree tear (the most intense) is rarely longer than an inch.

How are tears repaired? Minor tears usually don’t need any repair beyond time and rest, while more extensive tears require absorbable stitches. The area will be numbed before the application of the stitches. In rare cases, anesthesia is used.

What is the recovery like? It’s not too bad — you just feel really sore for seven to ten days. Depending on severity, tears take anywhere from a few days to a few weeks to fully heal. The “What to do” section provides recovery tips.

What to do

To help the emergence of baby be a gentler experience for your perineum, thus minimizing your chance of a severe tear, follow all the suggestions in the “What to do” section from question  (the one about pushing). I would especially focus on the perineal tissue massage — make it your part-time job starting around week thirty-four or thirty-five of gestation. It’s one of the best things you can do to make your perineum more elastic and less susceptible to tearing.

If you feel the fear of a tear might hinder your ability to birth with calm and confidence, listen to this fear-release guided meditation: yourserenelife.wordpress.com/fear-of-tearing/. I also recommend envisioning your perineum as a rose that gently and easily opens. You can also watch time-lapse videos of flowers opening, focusing on how easily their soft petals unfurl — there’s no strain in their bloom. As you do this, remember that your perineum was also designed to soften and expand when it’s time to bloom.

In regard to what to do after a tear, here are a few strategies for soothing discomfort and promoting healing:

Kegels: Attempting Kegels (even if you can’t feel them) promotes circulation, which can speed recovery.

Sitz bath: Soaking your perineum in warm water can ease pain and itching. You can also ask your care provider if there are medications or additives you can put in the water to aid healing. If you’d rather not bother with sanitizing your bathtub, purchase a sitz bath kit that fits in the toilet and allows you to dunk your perineum. As an added bonus, a sitz bath also works wonders on hemorrhoids! Yay!

Witch hazel pads: These medicated pad liners — soaked in witch hazel extract— are the vagina’s best friend, offering instant cooling relief when slipped in the underwear.

Anesthetic spray: In addition to the witch hazel pads, ask your care provider to recommend an anesthetic spray to numb the perineum.

Fiber: Your first bowel movement after childbirth might be nerve wracking. I felt certain I would bust my stitches and poop out my innards — but I didn’t, and you won’t either. However, the essential act of clearing your bowels could be uncomfortable if you’re passing hard stools. Soften up that poo by eating fiber-rich foods and drinking lots of water. You can also ask your care provider if they recommend using a stool softener the first few days after birth.

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