I know that millions of women have had babies and blah blah blah, but I keep thinking I’ll be the rare lady who can’t do it. How can I unlock my confidence and courage around my birthing abilities?

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

I don’t think any woman — at her core — can fully fathom a baby coming out of her (unless she’s already had a baby). We can conceptualize it, but the reality of it seems unfathomable. Even when we nod in childbirth prep classes and feel we’re absorbing the information, it can feel impossible to get completely on board with the belief that a baby can exit our vagina, or that muscles and flesh can be expertly cut into so the baby can be retrieved. When we’re sitting at home — vagina, uterus, and abdominal muscles intact — it feels inconceivable that at some point the body will go through a wild transformation to allow the miracle creature within us to emerge.

The thing is, you don’t have to believe any of it is possible for it to be true. You’re off the hook for not fully buying into the fact that you can do it, because whether you believe it or not, you can do it and will do it. Whether “doing it” looks like having an unmedicated birth, Pitocin and an epidural, or a C-section matters not. All of it requires courage that will show up when the time comes.

It’s also important to remember that many other pregnant women can relate to how you’re feeling — a lot more than you realize. The very natural fears and doubts you’re experiencing are so much less isolating when you realize you’re part of a sisterhood that shares those fears and doubts. If you don’t feel chipper about the whole birthing thing, you’re not broken. You’re in good company.

However, having an enhanced belief in your ability to birth your baby can make the time between now and the moment you feel like you need to have a bowel movement but actually just need to have a baby a lot more enjoyable. So let’s get to some practical ideas for how to do that.

Try this:

Find your people. Reach out to pregnant women you know, or meet new ones by joining a prenatal exercise group or another type of gathering that attracts pregnant ladies. When you find a few candidates you connect with, invite them on a mama-date and share your feelings about birth. Many of them will likely respond with similar sentiments and support, helping you feel less alone and more understood. If they don’t, they’re not your people. But keep looking. They’re out there.

Take a childbirth prep class. Investing in this type of instruction can chip away at doubts about your birthing ability by teaching you how the body births a baby, without filling you with fear. It should also provide a bevy of techniques for pain and fear release and relaxation enhancement. Even if you don’t fully buy into the techniques, practice them, as your doubts likely come more from your deep-seated skepticism about your ability to birth than from insufficiencies in the methods. By forcing yourself to practice all of them at least once and continuing to practice the ones that resonate, you’ll build a powerful tool kit for birth. This tool kit will be utilized during birth whether you realize it or not.

As a doula, I’m often amazed to see the “tool kit techniques” that come up from the ether of my client’s subconscious during birth. I often hear, “I didn’t even decide to use that technique, it just happened.” This can occur only if your mind is filled with tools for pain relief and relaxation. Collect the tools, then trust that the ones that need to come to you will.

Treat yourself to a birth doula. Set yourself up for even more birthing confidence by hiring a doula who makes you feel safe and supported. A good doula comes equipped with in-depth knowledge of many of the tips and tricks you’re learning in your classes and books, and they can help you use the tools that will be most effective for your unique needs during each phase of labor and delivery.

If you’re concerned about cost, know that new doulas often provide their services pro bono to gain experience. You can also look into a volunteer doula program. There’s a list of organizations that connect

women with free or low-cost doula services in the “Recommended Resources” section of this book. You can also reach out to a doula in your community and ask them to refer you to a local organization, or specific doula, that provides affordable care.

Listen to this: To fortify your confidence-enhancing preparation, utilize this guided meditation, which helps you visualize yourself having a happy and healthy birth experience: yourserenelife.wordpress.com /enhancing-birth-confidence/. In addition, download this birth affirmations recording: yourserenelife.wordpress.com/feng-shui-mom my-birth-affirmations-download-link/.

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What if I don’t like my labor and delivery nurse? Do I just have to deal with them?

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

Heck, no. If a nurse makes you feel uncomfortable, you get to “bye, Felicia” them. As the nurses assigned to you are the primary care providers you’ll have during birth (doctors usually just show up to help deliver the baby), you want them to make you feel safe and heard. If you cringe every time a certain nurse comes into the room, that’s a clear sign you need to request a different one. Many women don’t realize it’s even an option to ask for a different nurse, but it definitely is, and you won’t be the first person to utilize this right.

The thing is, not every nurse is a great fit for every mother. It’s not personal — it just means their vibe doesn’t jive with your vibe. If you’re wanting an unmedicated birth, for example, and you see the nurse roll their eyes when reading your birth plan, it’s clear their presence is not going to fill you with confidence or empowerment. And you deserve to feel confident and empowered. You deserve nurses who enhance your experience.

What to do

If a nurse makes you uncomfortable, think about what type of personality you would prefer. For example, do you want someone supportive of un- medicated births? Someone with a gentler energy? Someone who is direct and open with information? Someone with a good sense of humor?

Once you’ve determined what type of nurse you do want, ask your birth companion or doula to go to the nurses’ station and request to speak with the charge nurse, as they have the power to assign a new nurse. Your birth companion doesn’t have to go into detail about why you want a nurse reassigned, they can simply say something along the lines of, “My partner and I don’t feel that [insert nurse’s name here] is a good fit for us. We would prefer someone who is more [insert the traits you would like your new nurse to have].”

There’s no guarantee you’ll get the exact type of nurse you want, but chances are they’ll be a better fit than the last nurse, especially because they know you’re willing to advocate for yourself and are paying attention to how you’re treated.

While some women feel that requesting a different nurse is being dramatic, I think it’s one of the most empowered decisions you can make during birth. The people in your birthing space have a profound impact on how your birth unfolds, and you deserve to have the final say over who is and isn’t welcome. This is just another day of work for them, but it’s a monumental experience for you. You get to be as picky as you want. In addition, I wouldn’t worry about hurting anyone’s feelings — you’re not in the hospital to make friends, you’re there to have the happiest and healthiest birth experience you can.

Come prepared: Another option is to ask your care provider if they know of any nurses at the hospital where you’ll be delivering who they think would be a good fit for you. You can then ask for them by name when you check in. If those nurses aren’t available, ask if there’s a nurse who shares your general birth philosophy. For example, if you’re hoping to have an unmedicated birth, request a nurse who has had an unmedicated birth or is skilled at supporting them.

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Does anybody actually pay attention to birth preferences?

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

Yes! There’s an annoying misconception that medical staff snicker behind a pregnant woman’s back if she presents birth preferences. If you’ve found a care provider you trust, they should fully respect your right to set intentions for your birth — which you can do with birth preferences. During my son’s birth, the nurses respected my preferences so thoroughly I had to ask them to ignore some of them when I changed my mind.

However, some care providers do see birth preferences as a threat to their position of power. They see it as someone trying to tell them how to do their job. But the thing is, you’re not a patient coming in for a standard procedure. You’re a healthy woman moving through a natural, biological process that requires the expert knowledge of a doctor or midwife only if a special circumstance comes up, or if you decide you want intervention. You’re not there to receive the care provider’s standard protocol. You’re there to cocreate an everyday miracle with your baby, body, care provider, and birth companions. And you deserve to be at the helm. No one else does. Your birth preferences are a way to plant a flag that says, “Unless my health, or my baby’s, becomes tenuous, this is how I want my birth to unfold. And I reserve the right to change my mind at any moment.”

What to do

Remind yourself over and over again that it’s your prerogative to take a stand regarding how you and your baby are treated during and after birth. This is a sacred experience that you get to guide. Once you’ve tapped into your confidence about your right to lead your birth experience, do the following:

  • Create your preferences. Contemplate each aspect of the birth experience (e.g., onset of labor, active labor, baby’s descent and emergence, baby’s care, and your care after birth) and write out how you’d like it all to play out. My book Feng Shui Mommy has a chapter devoted to birth preferences and includes a sample list you can find here: yourserenelife.wordpress.com/birth-preferences/. This list a good place to start if you’re feeling overwhelmed by the prospect of creating this document.
  • Phrase preferences in a positive tone. Help prevent defensiveness in your care providers by writing what you do want them to do, instead of what you don’t want them to do. For example, you could write, “I would prefer to labor without medication” instead of, “Don’t offer me medication.”
  • Keep it to one page. Your care providers are more likely to read all your preferences if you fit them all on one page.”. This often means that only the most important preferences make the list. You can always verbalize minor preferences.
  • Share preferences with your care provider. Take your preferences to a prenatal appointment at least six weeks before your due date. Have your care provider go through each preference with you. If you’ll be delivering in a hospital, ask if any of your preferences go against hospital protocol. If they do, you could decide to change the preferences, or prepare yourself and your birth companion to advocate for the preferences the hospital may push against. It’s also important to acknowledge that in the event of an emergency, you’re willing to let go of preferences that would inhibit quality care.

If your care provider seems exceedingly unsupportive of your birth preferences, consider hiring someone else.

  • Have extra copies. While the list of birth preferences you gave your care provider should make it into your chart, it may not. Ensure the list is at your birth by bringing at least two copies with you to the hospital or birthing center. And when you arrive, make sure everyone is on the same page by going over the preferences with support staff.
  • Adopt an attitude of adaptability. Remember that just because you wrote the preferences doesn’t mean you will have the exact birth they outline. The unexpected does happen, but the combination of understanding that possibility and still creating preferences sets you up for an empowered and satisfying birth experience.
  • Be thoughtful about the preferences you let go of. If someone besides you suggests pushing aside a certain preference while you’re in labor, think it over before agreeing (unless it’s an emergency situation). It can be easy to just say yes to whatever’s suggested when we’re on the wild journey of birth, but pausing, asking questions, contemplating, then making a decision that feels intuitively right for you allows you to write the story of your birth, instead of being a passive participant.

One mom I supported ended up changing her mind about almost all her birth preferences because of various circumstances that came up. But because she was the one opting to let the preferences go, instead of being forced into the decisions, she has positive memories of her birth experience. She felt confident in making the preferences, and confident in breaking them.

An article in the Journal of Perinatal Education found that a woman’s positive and negative perceptions of her birth experience are more connected to her feelings and ability to exert choice and control during birth than to the specific circumstances of the birth.

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What are my rights during birth? Do I have to do everything my care provider says?

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

You have a lot of rights. Essentially, you have the last word on every facet of your care, and you don’t have to do anything your care provider suggests if you feel it’s the wrong call. But that’s where the water gets murky. Although you should be the key decision-maker during your pregnancy, childbirth, and postpartum experience, the people around you — specifically, your medical care provider — often hold ample sway in how things unfold. Intentionally or unintentionally, these people may manipulate your decisions based on legal or timing considerations, a hospital’s (possibly outdated) culture, or their personal biases. Fortunately, there are ways to get around this — the first being to know your rights. These include the following . . .

The Birthing Mother’s Bill of Rights

  • The right to receive thorough information about any intervention being recommended: You have a right to ask your care providers questions until you’re satisfied with the answers and feel you have enough information to make an informed decision. They should explain — in easily understandable terms — the risks and benefits of anything they’re recommending. You can also ask what information is evidence-based and what is just coming from their personal experience. And you can ask about the cost of everything, down to the stool sampler they’re offering you in that little white cup.

  • The right to request options: If you’re unsatisfied with a proposed course of action, you can ask for other options.

  • The right to turn down interventions: After receiving all the information, you may feel that an intervention is unnecessary. If this happens, it’s your right to turn it down. While you might not be a medical expert, you are an expert on what feels intuitively right for your body and baby. If everything in your being is screaming “No!” you get to listen.

And just because you (likely) signed a consent for care form when you were admitted doesn’t mean the care providers don’t have to obtain your permission before moving forward with any procedure.

The following are procedures that my clients are usually surprised are not obligatory:

Vaginal exams: While it can be nice to know how dilated you are, it’s not an essential part of childbirth. So you don’t have to let anyone perform a vaginal exam if they make you uncomfortable.

Heparin lock: Many hospitals strongly encourage women to accept a heparin lock — a catheter that is placed in a vein with a drop of heparin to prevent blood clotting and is then locked off — so they have an open vein should they need to hook you up to an IV. But you don’t have to agree to it.

  • The right to ask for a second opinion and/or change care providers: If you feel your care provider isn’t providing all the information or is leading you in a direction you feel uncomfortable with, ask to see another care provider. While the current care provider might push back, you’re doing nothing wrong by making this request.

  • The right to move around. If you want monitors, tubes, IVs, and so on removed so you can freely move around during labor, you can ask hospital staff to remove them. Your care provider might recommend staying connected to certain apparatuses because of medical needs, but they can’t force you to do so. You also have the right to get into the position of your choice when delivering your baby.

  • The right to privacy: No one gets to decide who is in your birthing space but you. If you want someone to leave the space, they have to comply, even if they work there. I once was a doula for a mother who felt unsafe around her OBGYN. When the baby was being delivered, she demanded that he leave and send in the on-call midwife. He was beside himself but had to do what she said.

  • The right to know who is in your birthing space. You have the right to know the identity and qualifications of any person in your birthing space.

  • The right to check out of the hospital. I’ve worked with many women who didn’t know they could check themselves out of the hospital “against medical advice.” If you don’t feel like you’re being treated well, you can leave the hospital and check into a new one. The hospital won’t make this easy, but what you’re doing isn’t illegal.

  • The right to receive records. You have the right to request copies of your medical records at any time, and to receive a comprehensive explanation of the contents.

  • The right to speak with hospital administration. If you feel your rights are being violated, you can ask to speak with a supervisor.

  • The right to be treated like the empowered, intelligent woman that you are. No one has a right to talk down to you, or make you feel like you’re not equipped to make well-informed decisions about your body and baby. If someone treats you without respect, you can turn around and demand it.

Note: Demanding your rights in some of these situations may require you to go against your care provider’s recommendations. If the doctor feels strongly enough about a recommendation, you may be required to sign a document confirming your choice to refuse care.

What to do

In addition to understanding your rights, there are numerous ways to ensure that you have care providers who not only honor your rights but encourage you to stand up for those rights. And if you end up being cared for by individuals who don’t respect your rights, despite your valiant efforts (it happens to the best of us!), here are some tools for those situations:

  • Find a care provider who believes in “patient autonomy.” See “Essential Tips for the Journey” on page xx for more information.

  • Create a thoughtful list of birth preferences. I love me some birth preferences. Not only are they a golden opportunity to pour positive intention into your birth experience, but they also allow you to clearly state how you expect to be treated. While all care providers should be well informed of your rights, your birth preferences serve as a clear reminder of what those rights are, and which ones are of particular importance to you.

  • Hire a doula. While most doulas won’t be your voice during birth, they can be the Birthing Angel on your shoulder, letting you know if someone is not honoring your rights. They can also provide ideas for how you and your birth companion can advocate for those rights.

  • Take two childbirth preparation classes. If you’re planning on giving birth in a hospital, I recommend taking both the childbirth prep class offered by the hospital and a class not affiliated with the hospital. I encourage you to take the hospital class first to gain insight into the hospital’s birth culture and what rights you might have to advocate for. This class is largely for recon, and I suggest keeping a running list of questions and concerns about information shared there.

Then, take this list to a childbirth preparation class that’s aligned with your personal birthing philosophy — for example, HypnoBirthing or Lamaze — and share it with the instructor. The instructor can likely help you determine whether there are any red flags that suggest you should find a new hospital, or provide guidance on how to navigate aspects of the hospital’s birthing culture that might go against your own. Both classes will likely help you become more informed and equipped to have an empowered birth experience.

Be clear when refusing treatment. If you ever need to go against your care provider’s recommendation, make it explicitly clear that you’re doing so. You might even need to request they provide verbal confirmation that they understand your decision.
Research the laws in your area. Because each state has their own laws when it comes to childbirth, it’s wise to email the American College of Obstetricians and Gynecologists Resource Center at resources@acog .org and ask for guidance finding the most up-to-date regulations for your state.

Fortify your courage. Advocating for your rights can be difficult, especially in the face of a strong-willed care provider adamant that you follow their lead. But you are so much stronger than you realize, and pushing yourself to call on that innate power during one of the most important experiences of your life will likely transform the experience. Listen to this guided meditation to tap into your inner power source: yourserenelife.wordpress.com/birthing-rights/.

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I don’t want my partner at our child’s birth. Is there something wrong with me? Should I just get over this feeling? Do I even have a say in whether they’re there or not?

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

Oh, partners. They can be lovely, but they can also fudge things up during birth. So it’s more common than you’d think for women to not want their partner present during childbirth. However, few women admit it, even to themselves, because not wanting a partner present at birth makes many moms-to-be think there might be something fatally wrong with their relationship. But not wanting your special someone there while you birth your other special someone doesn’t mean your relationship is doomed.

I’ve heard numerous reasons why women want to have only a doula, or maybe their mom, sister, or nursing staff, present at birth. One mom I worked with (we’ll call her Emily) had a hubby who got seriously squeamish in hospitals and once passed out after seeing blood from a cut. Emily was worried that instead of supporting her, the medical team would end up caring for her husband. Another mom (we’ll call her Yvonne) had a partner who never wanted her to be uncomfortable. If Yvonne were sick, her partner would fuss over her until she had to ask for space. Yvonne worried that her partner’s overattentiveness might be distracting during birth. The other woman who comes to mind (we’ll call her Cassandra) had a boyfriend who was adamant that she not get the epidural, but she wasn’t sure how she felt about the epidural. This sparked discord.

I worked with these moms on plans for discussing these concerns with their partners. In the first two cases, the couples decided to have the partner present only at the very end, when the baby was emerging. And for Squeamish Dad, a nurse was assigned to him in case he got woozy. Regarding No Epidural Dad, when Cassandra determined the epidural was the right choice for her, he couldn’t support her, and they decided it would be best for him to join her after their baby was born.

There are numerous reasons women might want their partner to support them from a distance during labor — and they’re all totally legit and worthy of attention. While your partner is of course an important part of the equation and will be likely a huge part of the child’s life, childbirth is all about what makes you feel most comfortable. While it’s monumental in many ways, birth is also a drop in the ocean of the child’s life; if your partner isn’t there, it doesn’t mean their connection with the baby will be scarred.

What to do

If you’re feeling like you might not want your partner with you during labor and delivery, do this . .

Spend time exploring the reasons behind this feeling. To start, ask yourself, “In what scenario would I be most relaxed?” Then, through good ole meditation, journaling, or talking with a trusted friend whose eyes won’t widen when you tell them your thoughts, get clear on what that optimally relaxed scenario will look like. Who is there? Where are you? What does the room look like? How are you being supported?

As you explore this scene, pay attention to whether or not your partner is there. If they are, how does their presence make you feel? What are they doing that does, or does not, make you feel relaxed? If you don’t see them there, examine and write down the reasons behind their absence.

Talk to your partner. If the previous exercise makes you realize you don’t want your partner at the birth, or want them present only during a certain phase of labor, summon the courage to talk to them. While this may feel like the last thing you want to do, know that having this conversation will seriously lighten your emotional load and help you have a more positive birth experience.

If the reasons you don’t want your partner at the birth strike deep chords in your relationship, it could be beneficial to have this discussion with the support of a counselor. You can even see the counselor alone first to talk through your concerns and make a game plan for how this request for nonpresence will be presented to your partner.

However, if your reasons are more basic, as with the queasy husband or overattentive partner I mentioned, you’re probably safe just having a sit-down with your person. You can start the conversation by asking, “Have you thought about how present you want to be at the birth?” See what they say. You might find that they’re also hesitant about being there. Or they might be full of ideas about how they’ll coach you through breathing and get you into squats. Either way, exploring this topic together will either help you become more resolute in your decision to not have them there, or dissolve many of your initial concerns. After the first phase of this discussion, decide whether you’re good to move forward with the “This is what I want to happen during birth” portion of the talk, or need time to process what was shared.

Make a plan for partner’s involvement. When you’re clear on what you need from your partner, make a plan for how involved (or not involved) they’ll be during birth. While it might be tempting to make concessions in favor of their feelings, make sure to not make compromises that limit your comfort. This conversation could be uncomfortable on the front end, but you will feel so much better when it’s all out in the open and you can move forward.

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I’ve been craving inedible items like clay and dirt. What the heck is going on?

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

A craving for nonfood items does not mean you’re losing your mind, it means you’re likely experiencing a type of eating disorder called pica. While rare, pica can crop up during pregnancy, surprising women by summoning the desire to eat clay, dirt, cornstarch, laundry detergent, and other inedible items. And although ice isn’t inedible, a regular craving for it could also be linked to pica. For some women, pica pushes them beyond cravings, causing them to actually eat their substance of choice.

These cravings are often caused by a deficiency in iron, zinc, iodine, calcium, thiamine, vitamin C, or other nutrients. Pregnant women, especially those with pre-existing conditions or chronic morning sickness, are prone to these deficiencies. I had an intense desire to chow down on snow during my pregnancy. Come to find out, I was anemic.

Pica requires immediate attention, as a lack of nutrients can cause uncomfortable symptoms and impact fetal growth. In addition, ingesting inedible items could be toxic for the mother and baby.

What to do

See your care provider ASAP. They will likely order tests to see if you’re deficient in iron, zinc, iodine, or other nutrients, in addition to performing other evaluations they deem necessary. When nutritional deficiencies are found, care providers typically recommend diet changes or supplements. If they suspect a part of the issue is psychological, they might refer you to a mental health specialist.

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I smile and nod when my care provider is talking, but I have no idea what half the terms or tests they’re mentioning mean. Can I have a crash course on the words coming out of my care provider’s mouth?

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

You got it, toots. Being pregnant can feel like entering an alternate universe where everyone is speaking in baby-tongue, and you just smile and nod because it’s too overwhelming to stop all the baby people every twenty seconds to ask for a definition and explanation. When I went to prenatal appointments, I begged my mind to become a steel trap that could capture all the words my care provider said that I didn’t understand, so I could later ask Google. Why didn’t I just ask my doctor questions, or write down a list in the moment, you ask? Because I was petrified of being seen as illiterate in pregnancy and birth talk. Looking back, I feel so bad for that version of myself. Of course I didn’t know all that stuff — I had never been pregnant before! I wasn’t yet part of that world.

So that’s my long way of saying, when your care provider starts rattling off gibberish, don’t be afraid to pipe up and say, “I actually have no idea what you’re talking about. Please rewind and explain.” To help you out, here are some of the more uncommon terms your care provider might use. There’s also a full list of pregnancy and childbirth terms and definitions in the glossary.

Pregnancy Term Cheat Sheet

amniocentesis: A test typically done between sixteen and twenty weeks’ gestation to test for developmental abnormalities in the fetus. To perform the test, the care provider inserts a hollow needle into the uterus to retrieve a sample of amniotic fluid. This is most commonly done for women thirty-five and older.

APGAR score: A measurement of how baby is handling life outside the womb. The care provider usually performs this evaluation about one to five minutes after birth by rating the baby’s color, heartbeat, reflex, muscle tone, and breathing (which is what APGAR stands for: appearance, pulse, grimace, activity, and respiration). The score ranges from 1 to 10.

birth doula: A person trained in childbirth who provides emotional, educational, and physiological support before and during childbirth. They do not provide any medical assistance, but instead support mom with tasks like the creation of birth preferences, navigating choices during childbirth, utilizing pain- and fear-relieving techniques, and overall helping mom have a calm and empowered birth experience. Birth doulas often support the woman’s partner as well.

cerclage: A procedure sometimes done for a woman with an insufficient cervix (the cervix opening too early). In this procedure, stitches are used to close the cervix. They will be removed near the end of pregnancy.

colostrum: The first substance that comes out of a woman’s breasts after birth. Nicknamed “liquid gold,” colostrum often has a yellowish color and is filled with high levels of protein, salts, fats, and vitamins. Many consider colostrum a superfood for newborns, as it boosts their immune system, coats the stomach and intestines to help prevent illness, acts as a laxative, can prevent jaundice, and lowers blood sugar. You’ll only produce about one to four teaspoons per day, and it will be replaced when your milk comes in about two to five days after birth.

cord blood banking: The process of collecting blood from the umbilical cord and placenta after the cord is cut, freezing it, and storing it in a cord blood bank. Some parents elect cord blood banking because the blood contains hematopoietic stem cells that can be used to treat diseases like leukemia and lymphomas, in addition to some disorders of the blood and immune systems, such as sickle cell disease and Wiskott-Aldrich syndrome. The stem cells can benefit the child or their first- or second-degree relatives.

cord prolapse: A rare, serious complication that involves the umbilical cord dropping through the cervix and into the vagina, before the baby. If you can see the cord (which is not always the case), call 911 and lift your butt into the air, to get the weight of the baby off the cord.

delayed cord clamping: The practice of allowing the umbilical cord to stop pulsating before it is clamped and cut. This allows blood from the placenta to be transported into the baby, sometimes increasing the baby’s blood volume by up to a third, minimizing iron deficiencies and supporting brain development.

dinoprostone (Cervidil): A medication, usually administered as a vaginal insert, used to soften the cervix. One of the mildest forms of induction medication, dinoprostone is often utilized before misoprostol (Cytotec) and synthetic oxytocin (Pitocin). A woman must remain in bed for two hours after insertion; it is removed after twelve hours, or when labor is established.

effacement: The thinning of the cervix. The cervix starts out being about three to four centimeters long, and as labor progresses it gets shorter, thinner, and wider (dilation).

engaged head: The settling of the baby’s head into the pelvis. This generally happens during the end of the third trimester when you’re nearing labor. When this happens, you’ll typically be able to breathe easier, as there’s less pressure on your diaphragm. You might also feel increased pressure in your pelvis.

external cephalic version (ECV): A process used to turn a breech baby into the head-down position for birth. In an ECV, the mother is typically given a medication (via IV) that relaxes her uterus, and then a care provider strategically presses on various areas of the abdomen, trying to turn the baby. An ultrasound is sometimes used to guide the process, and the baby’s heart rate is closely monitored. And will it hurt? Probably. If you need an ECV, use it as practice for childbirth by putting your breathing techniques and other relaxation tools to work.

fontanelles: The two spaces between the baby’s five skull bones where the sutures (soft membrane gaps) intersect. Also known as “soft spots.” The fontanelles are covered by strong membranes that protect the brain. They are located near the front of the skull and on the crown. While many new parents are terrified they’ll poke a hole in baby’s head if they accidentally touch one of these spots too hard, you won’t — they’re a lot tougher than they look (both the spots and the baby as a whole). They should usually close by baby’s twentieth month.

group B strep (GBS): Naturally occurring bacteria that can cause serious illness in newborns. When I tested positive for this, I logically thought it meant pregnancy had given me an STD. But no. GBS is a bacterial infection found in the vagina or rectum of about 25 percent of women. Between weeks thirty-five and thirty-seven of gestation, a swap test will be used to determine if you have GBS. While it typically does not cause symptoms in the mother, it can be dangerous if passed to the baby during delivery. Because of this, care providers often recommend that women who test positive be given IV antibiotics at the onset of labor and then every four hours until baby is born.

lanugo: Fine, soft hair covering the newborn in the womb and helping a protective layer of vernix stick to the skin. The hair usually sheds around month seven or eight of gestation, but it sometimes sticks around for many weeks after birth. Lanugo is most commonly seen on babies born prematurely.

lochia: Vaginal discharge present after birth that contains blood, mucus, and uterine tissue. It typically lasts for four to six weeks, but usually it isn’t too heavy after the first week.
misoprostol (Cytotec): A medication (pill) used to induce labor, administered orally or vaginally. The use of misoprostol is controversial, as it can cause hyperstimulation of the uterus and other potential complications, according to a study published in the Journal of Perinatal Education.

nonstress test: A test done in the hospital or birth center to confirm baby’s health in the womb. It’s noninvasive and only consists of baby’s heart rate being monitored. Care providers specifically want to see how baby’s movements impact their heart rate, as their heart should beat a bit faster when they move. It usually can’t be done before week twenty-six of gestation.

nuchal cord: An umbilical cord that is wrapped around baby’s neck. While it sounds scary, nuchal cord is rarely dangerous. According to a study published in Maternal Health Neonatal Perinatal, 10 to 29 percent of fetuses experience nuchal cord. My little overachiever also had this.

nuchal hand: When baby’s hand is by their face when they’re born. Also called compound hand. My son did me the favor of being in this position as I pushed him out. Nuchal hand is likely what made that stage of labor take longer, and made it so hard I sounded like a constipated boar whilst pushing.

placenta abruption: A rare occurrence where the placenta prematurely detaches — either partially or completely— from the wall of the uterus, sometimes causing heavy bleeding and a lack of oxygen for the baby. If this happens early in pregnancy, the baby will be closely monitored through ultrasound. If it occurs later in pregnancy, the baby will probably be delivered through C-section.

placenta accreta: When the placenta grows too deeply into the uterine wall. This often prevents the placenta from detaching completely from the uterus after baby’s birth, which could cause hemorrhaging. In this situation, the baby is usually delivered through cesarean. And in severe cases, a hysterectomy (the surgical removal of the uterus) may be required.

placenta previa: When the placenta is covering part or all of the cervix. The primary symptom is vaginal bleeding (often with bright red blood), unaccompanied by pain. Sometimes, placenta previa resolves itself. When it doesn’t resolve by the time a mother is full term, the baby is often delivered via cesarean.

postpartum doula: What I like to call an “Earth angel” — an individual trained to swoop in for a few hours each day, for the first few weeks of baby’s life (or more!), to provide support with breastfeeding, infant care, and mama’s emotional and physical recovery. In addition, postpartum doulas often help with housekeeping, meal prep, errands, childcare for siblings, and pretty much anything the parents and baby need.

prodromal labor: The frustrating phenomenon of early labor that feels like much more than Braxton Hicks contractions but isn’t actually doing much to dilate the cervix. However, this type of labor isn’t totally pointless, as it can help baby get into the ideal position and prep the muscles, pelvis, and your brain for active labor. This is different than early labor because the contractions often start and stop (for example, you might have them only at night), instead of progressively getting longer, stronger, and closer together, as often happens when a woman is experiencing early labor that transitions into active labor. I recommend using prodromal labor as an opportunity to get into the groove of birth by practicing pain-relieving techniques, even if the contractions aren’t intense.

Rh factor testing: Ready for a science lesson? Here goes. Rh is a protein found on the surface of red blood cells. If you have the protein, you’re Rh positive. If you don’t, you’re Rh negative. Most people are Rh positive. During your first prenatal visit, your care provider will likely order a blood type and Rh factor screening test to see what blood type you’re working with. If you’re Rh negative, the baby’s father will be tested. If the man is Rh positive, it’s likely your babe is also Rh positive, which means the two of you are Rh-incompatible. In this case, your care provider will likely recommend the RhoGam shot.

Rh immunoglobulin (RhoGAM): If you and baby are Rh-incompatible, you’ll get a shot of Rh immunoglobulin (brand name RhoGAM) during week twenty-eight of pregnancy, and within seventy-two hours after delivery if it’s confirmed that baby is Rh positive. The shot prevents your body from making antibodies during your first pregnancy that could attack the fetus during subsequent pregnancies. Without the shot, your immune system would detect the foreign proteins on baby’s blood cells (foreign only if you’re Rh negative and they’re Rh positive) and create antibodies so it could attack the foreigner should it show up again — which it would if you get pregnant again with an Rh positive baby.

transverse: When baby is lying sideways, instead of head down. Most babies transition into head down, but if they don’t by around thirty-six weeks’ gestation, your care provider might recommend an ECV.

vernix caseosa: A waxy, cottage cheese–like coating on baby’s skin that protects them from the “pruning” effects of amniotic fluid. In addition, when baby swallows vernix caseosa in utero, it can help develop their gut bacteria, serves as a lubricant during birth, protects baby from bacterial infections after birth, and helps heal vaginal tears, as the vaginal opening is exposed to it as baby emerges. Because of these post-birth benefits, the World Health Organization recommends waiting six hours before giving baby a bath. If you want to maximize these benefits, request on your birth preferences that baby not be wiped off after birth, and that their first bath be delayed.

vertex: When a baby in utero is positioned head down.

What to do

Review these phrases, but don’t be afraid to ask questions when someone starts talking in terms (or recommends tests) you don’t understand. People love to feel smart and impart wisdom to others — so you’re giving them a gift by asking the questions.

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I’m over thirty-five, and when people refer to my pregnancy as geriatric I want to scream. How can I ask them to use a different term? And how can I shift my own beliefs around being an “old mom”?

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

Ugh. Whoever came up with the term geriatric pregnancy should be sentenced to a month of watching nothing but infomercials. I mean really,

I can’t think of a better term to make a woman feel like her body is ill equipped to carry a healthy pregnancy. While science has shown us that as women (and men!) age, their fertility declines and rates for various special circumstances increase, it’s absurd to make every pregnant woman who is thirty-five or older join the Geriatric Pregnancy Club. In many ways, factors such as lifestyle, physical and mental health, and genetics play a much bigger role than age in how a woman’s body handles pregnancy. If you rock a healthy lifestyle, you likely have a much better chance of having a thriving pregnancy than a twenty-five-year-old who smokes, drinks, and thinks healthy eating is getting sliced strawberries on top of a funnel cake.

Understanding the offensive nature of the term geriatric pregnancy, many now slap the label advanced maternal age (AMA) on pregnant women thirty-five or older. But that’s not much better. Why do we need to label these women at all? Why can’t care providers just look at each pregnant woman as a unique human? Why can’t we look at her personal and family medical history, current health, and other personalized factors to determine what testing she should have and what circumstances she might be at risk for, instead of automatically treating her as a geriatric, and therefore high-risk patient?

To be fair, many care providers do treat women thirty-five or older in this customized manner, understanding that just because she’s been on Earth for a set number of rotations doesn’t mean she needs to see a high- risk doctor, get that amniocentesis, and schedule a C-section (something three of my clients were told they should have, simply because they were in their early forties). These are the care providers you want to find, primarily because if you’re seen by a care provider who perceives you as high risk only because of your age, you might have a higher chance of receiving unneeded interventions because their misguided perceptions color their recommendations.

More and more research is also showing that women of AMA aren’t actually at much higher risk for many of the special circumstances often attached to “geriatric pregnancies” than their younger counterparts. For example, a study published in Scientific Reports found that pregnant women over the age of thirty-four had only a slightly increased risk for gestational diabetes mellitus and hypertensive disorders than younger women. These researchers also found no increased risk of postpartum hemorrhage, preterm birth, low APGAR scores, or NICU admission for the babies of AMA women. And according to a study published in the journal Human Reproduction, women aged eighteen to thirty-four had a stillbirth rate of 0.47%, while women between thirty-five and forty had only a slightly higher stillbirth rate, at 0.61%.

So enough with the derogatory labels. It’s time for a change.

What to do

Minimize the anxiety that’s often produced by all the chatter about a geriatric pregnancy by trying the following:

  • Find a care provider who doesn’t make you feel like a dusty china doll. There are a ton of amazing care providers who also roll their eyes at the term geriatric pregnancy. Put in the effort to find one. Ask friends and family members (especially those who had a baby after the age of thirty-four) for recommendations, and have a consult with your top choices. Ask them what their views are on women having babies after thirty-four, then hire the care provider who makes you feel most empowered about your ability to have a healthy pregnancy and birth experience, regardless of your age.
  • Ask for a reframe. If the care provider you eventually choose or someone who works with them drops the term geriatric pregnancy, or even advanced maternal age, when referring to your unique pregnancy, ask them to stop, and tell them why. For example, if these terms replace your confidence and trust in your body with fear and doubt, explain that to your care provider. You can tell them you’re fine hearing about the tests and precautions they recommend (unless of course you’re not), but you’d like to keep labels out of the discussion.
  • Remember that you’re a one-of-a-kind woman, not a statistic. Viva the cliché “Age is just a number.” It truly is just a number and means very little when it comes to how healthy your pregnancy will be. For example, my client Ava had her first baby in her early twenties, when she was a self-proclaimed “fast food addict.” She felt bloated, tired, and “fuzzy minded” during that pregnancy, which ended in an emergency C-section because of pre-eclampsia. When her thirties began, she cleaned up her lifestyle, and she became pregnant again at thirty-three. She loved this pregnancy, which came with ample energy, mental clarity, and no special circumstances. She had a complication-free vaginal birth after cesarean (VBAC). I saw pictures that proved she also looked younger in her thirties than she had in her twenties. So if all the lame geriatric labels are getting to you, remember that how you feel is much more important than the date on your birth certificate.
  • Work your plan for healthy eating and exercise. Taking those prenatal vitamins and omega-3 supplements; loading up on fruits, veggies, and other nutritious fare; drinking lots of water; moving your body; and sleeping at least seven or eight hours a night will do wonders in helping you have a healthy pregnancy.
  • Be curious about all the recommended tests. When you reach the age of thirty-five, care providers often recommend a heap of tests. If you feel good about all of them, great. But if you feel unsure about what is actually necessary, ask questions until you feel satisfied with the quality and clarity of the information you’re receiving. In addition, doing your own research can fortify you with information that may have been left out because of your care provider’s biases. However, make sure your resources are reliable. Studies published in peer-reviewed journals are a good place to start, and many can easily be found online.

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I succumbed to sushi and a glass of wine. Am I the worst pregnant lady ever?

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

No way, mama. While I certainly wouldn’t advise downing alcohol and raw fish on the regular without your care provider’s go-ahead, that fish with a side of red wine can actually help reduce anxiety. A plant compound found in red wine, resveratrol, creates anxiety-soothing effects by blocking the expression of an enzyme that controls stress in the brain.

And then there’s the sushi. A study published in the peer-reviewed journal PLoS One found that pregnant women who ate oily fish high in long-chain essential n-3 polyunsaturated fatty acids (PUFA) and docosahexaenoic acid (DHA) had lower levels of anxiety than their vegetarian peers, as these compounds are essential for optimal neurological function and impact mood changes. The study also reported that because baby is taking many of those happy compounds, the mom can easily become depleted, meaning she really needs to stay on top of her fish intake. Two to three servings of low-mercury, fatty fish each week is recommended.

With all that said, there are still concerns about drinking too much alcohol and eating fish raw. So what’s safe, and what should be avoided? Concerning alcohol, there is no evidence proving light consumption (up to two glasses a week) is harmful to the fetus. But because heavy drinking can be incredibly harmful, many care providers recommend abstaining “just in case.” Essentially, the light-drinking-while-pregnant question is still a bit of a grey area, but almost any care provider will tell you that having a few (very spread out) glasses of wine during your pregnancy shouldn’t be an issue.

Now let’s debunk the belief that raw fish is the enemy of a healthy pregnancy.

  • A primary fear about raw fish is that it will expose you to parasites. However, most fish is flash frozen before shipment, which kills parasites.
  • If salmon is your fish of choice, it’s likely farmed instead of wild, making it much less susceptible to parasites.
  • A study published in Obstetrics & Gynecology reported “sushi that was prepared in a clean and reputable establishment is unlikely to pose a risk to the pregnancy.”
    What you want to stay away from, more than that salmon roll at your local sushi spot, are fish dishes (cooked or not) that are high in mercury. King mackerel, marlin, swordfish, tilefish, ahi tuna, and bigeye tuna are all fishies to steer clear of.

According to a study published in Clinical Microbiology Reviews, most seafood-related illnesses are caused by shellfish, not fish.

What to do

If you’re mourning the loss of your vino and rainbow rolls, talk with your care provider about what would be safe for you to consume in your unique situation. You might find that because of certain special circumstances, it’s best for you to stay away from alcohol and raw fish most of the time. But if you’re having a healthy pregnancy, your care provider may surprise you by giving the go-ahead for a glass of wine and some sashimi once a week, for example. The answer you get will likely depend on the research the care provider has been exposed to and how conservative they are. If they give you an answer that feels off, don’t hesitate to dig deeper, asking them about their reasoning for the answer they provide. And if you really want to get a breadth of opinions, reach out to other care providers — making sure to throw some midwives into the mix.

If you’re cleared for intermittent treats, make sure to select the healthiest options. For example, if you can have wine from time to time, opt for an organic brand. Regarding sushi, only go to restaurants that provide super-fresh fish and have glowing reviews. Many cities have a public grading system for restaurants, helping patrons know which eateries passed their food and hygiene inspection with flying colors.

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I sometimes open my mouth to talk and a burp comes out instead. Why? And what’s up with my constant constipation and uncontrollable farting? Is there a way to minimize all this gas? Or to at least feel less embarrassed when it happens?

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

Thanks to progesterone, your intestines relax during pregnancy, making digestion less efficient and increasing the time fecal matter stays in the intestines by up to 30 percent. The pressure of the uterus on the abdominal cavity also slows digestion. This can all cause constipation, which leads to a buildup of gas that can burst out your northern or southern orifices — sometimes smelling like sulfur. Female gas actually tends to smell more sulfur-y than man-gas because our farts have a higher concentration of hydrogen sulfide. Adding to our lady-luck is the fact that even if we’re not constipated, those relaxed bowels make it tricky to control gas leaks.

During my pregnancy naps, I was often awakened by belly-rumbling sulfur toots so smelly I would sometimes lose my lunch. Who says pregnancy isn’t glamorous?

While all the gas can make you blush, it also has some benefits:

  • It’s a sign you’re staying on top of your fruits and veggies.
  • The slow moves of your intestines allow more time for your body to absorb nutrients from food.
  • Farting and burping in front of your partner — or other loved ones — can be a strangely bonding experience, as it’s an ultimate sign of comfort.
  • Letting it rip with abandon actually makes your kisser more desirable, as holding in farts can make the breath stink.

What to do

Despite the benefits of passing gas, having too much of it gurgling around can be uncomfortable. The primary way to lessen that discomfort is revving up digestion. There are numerous ways to do that:

  • Move it or snooze it. A stagnant body usually leads to sleepy bowels. Get things going by talking to your care provider about an exercise plan that’s safe for your unique circumstances. Getting in thirty minutes of exercise every day is often enough to keep the intestines chugging along at a gas-minimizing rate.
  • Investigate your diet. If you notice that your gassiness intensifies after eating certain foods, consider eliminating them from your diet, or at least decreasing your intake. Foods that are especially gas-inducing include broccoli, cabbage, Brussels sprouts, artichokes, asparagus, onions, lentils, pork, fried foods, and artificial sweeteners. Many people also experience gas after consuming dairy or gluten. To support this recon mission, keep a food journal for a week, recording which meals made you burp or fart. Also know that you may experience more gassiness after taking your prenatal vitamin.
  • Soften your stools. Hard fecal matter leads to constipation, which leads to all the fun I’ve been outlining. Prevent brown bricks and pebbles from forming in your intestines by drinking plenty of water and consuming twenty-five to thirty grams of fiber every day, as fiber infuses the intestines with water. Prunes, bananas, figs, flax and chia seeds, blackberries, avocados, leafy greens, pears, and apples are all fiber-full. Fiber supplements can also provide a quick fix. Because I’m a lady blessed with lazy bowels with or without a bun in the oven, I start every day with prunes and Metamucil. My morning sex appeal is almost too much to handle.
  • Chew your food. As one cause of gas is bacteria in the large intestine breaking down food that wasn’t fully digested by enzymes in the stomach, adding to your chew count can lower your burp and fart count. Aim for chewing each bite of soft foods at least ten times, and denser foods at least thirty times.

In addition, slowing down your chewing (and drinking) and minimizing talking while eating can help limit the amount of air you swallow.

  • Eat smaller meals. Noshing on six small meals, instead of three big ones, spreads out the load your digestive system has to work through, minimizing backlog.
  • Sleep on your left side. This position aids digestion, helping you wake up ready to poo.
  • Say yes to the muumuu. Staying away from tight clothing — especially articles that squeeze the waist — allows your bowels to pulsate without restriction. In addition, loose clothing can reduce discomfort from bloating.
  • Filtered panties. That’s right folks, filtered panties are a thing, and a thing that can alleviate fear when feeling a big one coming on and thinking, “Will it, or will it not, be a stinker?” If you’re worried about the sound: A trick I often utilize is pretending like I’m talking to someone on my cell phone and letting out a laugh as I simultaneously let out the toot. You’re welcome.
  • Air freshener. If you’re still concerned with the smell after donning those filtered panties, do as I did and carry around an on-the-go bottle of an essential oil air freshener.
  • Seek professional care. If you experience constipation or abdominal pain for more than a week or feel like you’re rarely able to have a complete bowel movement, alert your care provider.

Let it be known that even if your bowels are always on their A-game, you’re still going to burp and fart, sometimes without warning. While it can feel embarrassing, know that it matters to you way more than it does to other people. Sure, others may clock your toot or belch, but they’ll likely spend only a second considering it, thinking, “Oh, so-and-so just farted/burped. But who cares? They’re pregnant.” Even when you’re not pregnant, who cares? We all do it. It’s been found that, on average, many people produce four pints of gas and fart up to twenty times every day.

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My various body odors and breath have gotten out of control. Is that normal? What’s a safe way to mask the stinks?

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

This smelliness is totally normal, but as I’m sure you’re tired of hearing from me, you should still tell your care provider just in case it’s an indicator of a special circumstance. But it’s probably related to the following pregnancy phenomena:

Dragon breath: Progesterone can impact the slant between your esophagus and stomach, causing smelly gastric juices to bubble up. In addition, many women develop pregnancy rhinitis (fancy term for a chronic stuffy nose), which can lead to mouth breathing, which dries out the saliva that staves off the buildup of pungent bacteria. Underarm funk: The increase in your basal metabolic rate causes an increase in your blood supply and body temperature, prompting sweat glands to go into overdrive.

Shift in vaginal fragrance: This is caused by a change in the vagina’s pH balance, which produces a sweet scent that’s often compared to the aromas of glue or dough. Sometimes an odd smell can be created by a yeast infection, which is often accompanied by redness, itching, burning, or strange discharge. If you have bacterial vaginosis, a fishy, ammonia-like aroma will waft about.

What to do

Know that you’re probably the only person who thinks you’re stinky. Because your nose is seriously sensitive to smell during pregnancy, the aromas floating up from your mouth, pits, and vagina are exaggerated by your smell receptor. However, we don’t want you gagging over your odors. Try out the following to soothe the stench:

  1. Do hygiene on the go. Keep organic, unscented feminine hygiene wipes to freshen up your vagina and armpits when you feel the moisture collecting. In addition, always have organic deodorant on hand. And since food stuck in the teeth and bacteria on the tongue can get stinky, store dental floss and a tongue scraper in your bag.
  1. Shower on the regular. Start your day with a shower that ends with a cool rinse, so you don’t start sweating before you’re done toweling off. If you find yourself sweaty, sticky, and stinky later in the day, don’t be shy about taking shower deux.
  1. Use natural antibacterial products. After showering, minimize a buildup of bacteria by wiping an apple cider vinegar toner (mix one part apple cider vinegar with two parts filtered water) on areas that collect sweat. And as honey, coconut oil, cinnamon, and cloves also have antibacterial properties, using body oil or lotion infused with these ingredients can minimize unpleasant odors.

In addition, friction removes bacteria — so use a coconut sugar scrub once a week. To make, melt one-half cup coconut oil in the microwave for about forty-five seconds, or until completely melted. Then, mix in one cup white sugar and transfer mixture into a mason jar.

  1. Wash clothes with distilled white vinegar. Pour a half cup of distilled white vinegar into your washing machine during the rinse cycle, as this liquid is great at deodorizing clothes.
  1. Drink water. As a dry mouth is a mega-manufacturer of bad breath, drink water on the regular. Add to the freshness by mixing in a few sprigs of mint and a squeeze of lemon.
  1. Snack out the stink. Noshing on leafy greens, celery, cucumbers, pears, apples, pineapple, cherries, melons, citrus fruits, parsley, basil, and spirulina (stick it in a smoothie to mask its taste) can help erase funky breath. In addition, staying away from too much garlic, onion, and curry reduces your pungency.
  1. Avoid scented products. As tempting as it is to mask smells with perfumed lotions and sprays, many chemically produced scents can irritate skin. If you really want to conceal the scent, mix one drop of organic lavender, rose, ylang ylang, grapefruit, sweet orange, or lemongrass essential oil with one teaspoon of a carrier oil like almond or jojoba oil, and rub on pulse points.

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Why am I sweating so much?

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

During my third trimester I would frequently awake to a pillow so drenched with sweat it was squishy. (And it made all the squishy sounds.) My night sweats and, heck, my all-day sweats were out of control. I looked, smelled, and felt like a Swamp Mama. It was really sexy.

Not surprisingly, it’s believed the intense sweating many women experience during pregnancy is due to the spike in estrogen and progesterone. (Those buggers seem to tinker with everything.) In addition, an increase in body temperature and blood flow to the skin contributes to the pregnancy glow, or for ladies like me, the pregnancy drench.

What to do

Let you care provider know. Although the sweats are likely just a side effect of growing a human, it’s wise to rule out circumstances like infection or thyroid issues. After you’ve determined all is well (besides the whole waking up in a swimming pool thing), minimize your excessive glisten by trying the following:

  • Exercise. It seems counterintuitive, but whether you’re pregnant or not, exercise has been found to reduce sweatiness (at least after the exercise).
  • Stay hydrated. While drinking water won’t make you sweat less, it will minimize overheating. It also helps you replace all the fluids you’re losing, which is crucial, as those fluids impact amniotic fluid levels, blood volume, new tissue production, nutrient delivery, digestion, and removal of wastes and toxins (bye, constipation). Hydration is crucial.

To ensure your sweating doesn’t impact your vitality, shoot for drinking your body weight in ounces every day. For example, a woman who weighs 140 pounds would drink 70 ounces every day. It’s a lot. But if you’re a sweating-overachiever, the extra fluids will be worth the effort. If your care provider is concerned about the electrolytes you’re losing via sweat, consider getting some of your fluids from coconut water and noshing on bananas, watermelon, and avocado.

You can also put a dash of pink Himalayan sea salt in your water.

  • Be cool in the bedroom. Minimize night sweats by lowering your thermostat to around 65 degrees Fahrenheit, turning on a fan, having a cup of cold water by the bed, and sleeping in sheets and pajamas made with breathable natural fibers like organic cotton, linen, or bamboo. (Percale is another cool option for sheets.) In addition, have an extra pair of pj’s and a clean sheet you can lay on top of your half of the soiled sheet at the ready, in case you still wake up soaked in the middle of the night.
  • Wear loose, breathable clothing. Nothing inspires sweat glands like a tight polyester dress or some snug rayon pants (hello, sweaty crotch). Do yourself a favor and swap the tight for the flowy, and the impermeable for the breathable. And just like the pj’s mentioned above, look for duds made with organic cotton, linen, or bamboo.
  • Powder your undies and thighs. You can prevent the heat rash or chafing that can be caused by an abundance of moisture in your nether regions by sprinkling organic talc-free powder (or corn starch!) in your undies and dabbing some on your thighs before putting on your bottoms. While there’s no evidence that talc-free powder in the vaginal area is harmful, it’s still wise to check with your care provider before your inaugural sprinkle.
  • Carry a folding fan. Look like the chic lady you are by keeping a folding fan in your purse and whipping that baby out whenever you’re feeling flushed.

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My boobs are so itchy I feel like sticking sandpaper in my bra. Why are they itchy, and how can I soothe them?

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

If you walked through a Target parking lot in Los Angeles, summer of 2012, and saw a pregnant woman with her hand down her shirt and a “scratching that itch” face . . . that was me. (Target was my spot for napping and boob itching before making the hour-long drive home from work.) My breasts — nipples especially — became so insatiably itchy during my last trimester that I was itching my upper privates anytime I wasn’t in public. When I was home, I slathered cream all over them and walked around topless. It wasn’t cute.

There are numerous reasons for the tickling-teats phenomenon:

  • Hormones: Those dang hormones. As they build, they can create increasingly itchy skin, especially in the bosom.

  • Stretching: As if the visual of stretch marks weren’t irritating enough, stretch marks also exaggerate itchiness, as they cause the skin to dry out. Talk about adding insult to injury!

  • Eczema: The most evil of all itchy-booby culprits is pregnancy-induced eczema. This skin condition can make you feel like a body’s worth of chicken pox is condensed on your boobs. Not cool.

  • Prurigo of pregnancy: As the immune system adjusts to all the changes pregnancy throws at it, itchy, bugbite-like bumps, called prurigo, might appear on the skin.

  • PUPPP. Pruritic urticarial papules and plaques of pregnancy (say that five times fast) can cause bumps or hive-like rashes anywhere from the stomach to the boobs. If the sight of it weren’t fun enough, it’s also itchy. It will go away after pregnancy.

  • Intertrigo. Essentially, this is just an underboob rash caused by the three amigos heat, moisture, and friction.

  • Yeast infection. While yeast infections usually just party in your pants, they occasionally make trips up north, especially during pregnancy. Its party favors are usually dry, flaky skin and possibly bright red nips. If you suspect this is what’s going on, contact your care provider.

What to do

Stick that sandpaper in your bra. Just kidding. There are kinder ways to calm the itch:

  • Drink more water. Consuming your body weight in ounces of water (e.g., if you’re 140 pounds, strive for 70 ounces of water) every day will soothe many of these skin ailments, in addition to clearing up clogged bowels and a slew of other pregnancy annoyances. While this water recommendation is higher than most, it takes into account increased sweating, vomiting, and those days when you forget your water bottle.

  • Consider your boob hammock. A too-tight bra or one made of synthetic material could aggravate itchiness. Opt for a bra that’s done away with underwire and dye and can grow with your expanding melons. You can even start wearing nursing bras early, as they’re often mega-comfortable. In addition, make sure your bras are made with natural fibers like cotton or bamboo, which is more comfortable than it sounds.

  • Butter up your boobs. Alleviate the itch by applying shea or cocoa butter, lanolin cream, or jojoba or olive oil. Heck, straight-up butter would even help. Keep your anti-itch agent of choice in your purse so you can slather on the go. (Target parking lots are excellent for this activity.)

  • Don’t itch. I hate typing that because I hate when people tell me that. But alas, people are right. While it’s heavenly in the moment, scratching often intensifies the itchies and can make skin so raw you’re then itchy and in pain. Instead of scratching, pull out that boob butter.

  • Spring for organic, unscented detergent and skin products. As the chemicals in detergent, body wash, and lotion can all intensify the itch, switch to products that are organic and unscented.

  • Humidify. Because dry air almost always exaggerates itchiness, moisten the air by placing a humidifier in your bedroom and any other room where you spend ample time. There are amazing portable humidifiers (about the size of a water bottle) that help ensure you’re never without a dewy draft.

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I’ve turned into Sasquatch. Why am I so hairy?

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

My tummy, upper lip, back, and bum took to growing extra hair (à la an elderly man) during pregnancy. And it wasn’t peach fuzz…it was dark, shockingly long hairs. Eric once caught me mid–tummy shave. Not cute. Unsurprisingly, an increase in hormones are to blame, specifically androgen and, wait for it, wait for it…estrogen! These hormones not only induce hair growth but also prevent hair from shedding. This is a big reason your locks become so lustrous — the hundred or so strands that typically shed each day stay put when you’re growing a baby. An increase in your metabolism and blood circulation also play a part in all this, as they keep the hair pumped up with nutrients. Regarding the darkening of body hair, this is caused by the extra melanin — a pigment that impacts the color of hair, skin, and eyes — your body makes during pregnancy.

Androgens, primarily composed of testosterone and androstenedione, are a main cause of hair growth during pregnancy in places usually reserved for male hair growth. They’ve been nicknamed “male hormones” because — while they’re present in both men and women — men typically have higher levels of them. In the female body, most androgens are converted into estrogens. Androgens were likely to blame for the coarse, curly, and black nipple hair my friend Chelsea reported during her pregnancy. She said she had more of it than her husband. I took her word for it.

In rare cases, excessive body hair can be a sign of hyperandrogenism, which is an overproduction of androgens. This condition can cause high blood pressure, acne, weight loss, and other not-great side effects. If you feel your body hair is out of control, let your care provider know.

What to do

If all the hair really bugs you, go ahead and shave. Hair removal products aren’t recommended, as the chemicals leach into the skin. And while waxing is safe, it usually isn’t advised because hot wax can irritate extra-sensitive pregnant skin. If the hair only kind of irks you, consider making peace with it and saving yourself major time in the shower. You can really make friends with it by rubbing almond or jojoba oil all over after showering, softening the hair and minimizing the development of stretch marks. And take heart in the knowledge that your Sasquatch traits will almost entirely disappear by six months after birth.

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Why does it look like a crimson, white-capped mountain range has sprung up on my face?

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

Throughout my pregnancy, topographical maps of the Sierra Nevadas would pop up along my jaw and the edge of my nose. Everest even made an appearance once. I felt like a prepubescent boy. And I’m not alone. Many of the mamas I work with come into childbirth prep classes horrified that the clear, dewy skin they’d worked so hard to maintain had reverted to red, bumpy chaos. The main reason for this is…wait for it… wait for it…you guessed it! Hormones! Increases in the hormone andro- gen can incite acne, as it causes oil glands to become overeager producers.

The good news is that for most women this condition will resolve after childbirth, when androgen levels drop. And hey, girl, throughout it all, remember that you are a gorgeous-baby-making goddess, regardless of what your skin is up to.

What to do

Combat that acne with the following:

  • Be hypervigilant about skin care. Wash with an organic facial cleanser — made specifically for acne — every morning and evening, and after heavy sweating.

  • Avoid washing too often, as this can actually cause more oil to develop.

  • After washing your face, use an organic antiacne toner. You can also make toner with one part raw, unfiltered apple cider vinegar and three parts distilled water. Follow this with an organic moisturizer that doesn’t contain retinol. Some effective moisturizers made specifically for acne include ingredients like raw shea butter, aloe vera, and manuka honey.

  • Wash your hair regularly, and keep it out of your face. Oily hair rubbing on your face could exacerbate acne.

  • Use the speaker feature, or headphones, when talking on your phone, as the screen is often covered in oil and dirt. Cell phones are way grodier than they look.

  • Staying on the theme of keeping gross stuff off your face, wash your pillowcase once or twice a week. On a side note, experts (aka, my grandmother) believe silk pillowcases reduce the development of wrinkles.

  • If the acne is out of control and it’s stressing you out, ask your care provider for a dermatologist referral.

  • While it’s tempting to use medication or chemical-laden treatments, these often aren’t advisable for pregnant women. Many experts also advise against topical treatments containing salicylic acid.

  • Wear makeup only when you feel it’s absolutely necessary. And make sure you’re using oil-free products.

  • Drink plenty of water, and avoid refined sugar and processed foods.

  • And here’s the one that is near impossible for me — do not pop those suckers. While it’s one of the most satisfying feelings in the world, it could leave scars.

Why are there dark spots all over my face?

You have what’s called melasma (aka “the pregnancy mask”), which is caused by an elevation in progesterone that prompts pigmentation levels to increase. This results in dark, discolored patches on the skin, and it’s incredibly common in pregnant women. The good news is, it isn’t accompanied by other symptoms and isn’t dangerous for you or baby. It should fade after childbirth, when progesterone levels drop.

What to do

Check in with your care provider to confirm the patches aren’t a sign of another skin condition. After melasma is diagnosed, apply organic zinc oxide sunscreen every morning, and reapply as needed, as sun exposure can darken the patches. You can also avoid excess sun by becoming a hat lady and using your melasma as an excuse to skip that hike in favor of a cozy book-reading sesh in bed.

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I’ve heard so many women talk about loving their pregnant body, but I can’t stand mine. I can barely look in the mirror, and I feel so unsexy. My body shame is even making me resent my baby. Is there something wrong with me?

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

With a culture that has historically valued a flat stomach and slim thighs above all else, it’s so normal for pregnant women to feel uncomfortable and unattractive as their body shifts. Even women who never had body issues can have physical insecurities triggered during pregnancy.

The cause of much of this insecurity is the speed at which the changes are happening. We barely have time to integrate with what’s happening. It’s like, bam! — one morning we wake up and it looks like someone drew a line down our belly with a brown Sharpie. Then bam! — our fingers are too pudgy for our rings and our nose has gotten wider and squishier. And oh look — now our favorite clothes don’t fit, parts of our body we didn’t think would bulge are bulging, and our feet feel like they were injected with Play-Doh. And the changes don’t stop for at least twelve months. I mean, come on! Who wouldn’t be thrown by these almost constant shifts in appearance?

If you’re thinking, “Um, those ladies who are always waxing lyrical about their pregnant bodies don’t seem bothered by the same changes I’m experiencing,” I hear you. But while those I’ve-never-felt-so-radiant wenches (just kidding, I’m just jealous!) probably aren’t lying, I can al- most guarantee they have moments when they look in the mirror and feel a jolt of insecurity when they notice how wide their hips have become or see the fresh stretch marks on their thighs. It can be a shock for anyone — even if they’re not talking about it.

But this shock can feel really big if you, like me, have struggled with body image. When I was in high school, I was convinced that if I were just skinny enough, everything I ever wanted to happen would happen — like my skinny body would be my fairy godmother. So in pursuit of this totally logical dream I would starve, then binge, starve, then binge. After lots of therapy I got it under control and began loving my body (most of the time)…but then I conceived Hudson.

When I began showing, all I could focus on was the spreading and softening of the faint outline of abs I had worked so hard for, and my butt, which had always been a pancake, becoming a lumpy pancake. I felt like the most unsavory pregnant lady in the history of pregnant ladies. This led me to believe Eric would never ever want to have sex with me again. He tried everything to convince me otherwise, but nothing worked. I felt horny (because pregnancy hormones can cause mega-arousal) but didn’t act on it because I was sure my body was incapable of inspiring lust and would probably horrify Eric if he saw it naked.

This all made me feel discouraged and resentful. Especially resentful. I was resentful that my husband got to have a baby without dealing with any physical changes or feeling like he’d lost his sex appeal. I was also resentful that I was giving up what felt like every fiber of my body and desirability for my baby.

While I didn’t feel too bad about resenting my husband (I mean re- ally, why can’t nature make them feel a few contractions?), I hated that the shock of my body changing made me feel even a tinge of resentment against my baby. That I could feel anything but total love for him devas- tated me. So, yeah, a majority of my first trimester was spent in a sexless pit of resentment and guilt. Fun, right?! But mamas, I got out.

Bolstered by the brighter perspective brought on by the body image–enhancing tools of working out, therapy, and the weird stand-naked-in-front-of-a-mirror exercise I outline below, I finally realized that unconditional love for my child can live in harmony with a splash of resentment and a sprinkle of annoyance. Thoughts of our children are not always going to cause hearts to pop out of our eyes — and that’s okay.

You will save yourself a world of self-inflicted emotional torture later down the road by giving yourself grace now for having feelings about your baby that aren’t all rosy. (Of course, if those thoughts turn violent in any way, alert your medical care provider.) If you’re feeling irked that baby’s making your skin ripple with stretch marks and your sexy time turn into “just rub my feet” time, it’s all good. You’re not alone. You’re part of a tribe of strong, radiant, multilayered women also feeling so many feels about their body and baby.

What to do

While training your mind to sprinkle grace over the whole range of emotions about how baby is impacting your body image and sensuality, give yourself physiological support by talking with your care provider about starting (or continuing) an exercise program. Exercise not only strengthens the body for birth but also releases endorphins that elevate your mood and help you see yourself in a more attractive, sexy-time glow. Up the exercise benefits by being active outside, as the combination of fresh air, vitamin D, and movement is magic.

In addition to discovering a movement plan that works for you, try this:

  • Eat mindfully. Think about what you’re eating, as certain foods can exaggerate the anxiety and depression sometimes triggered by body image stressors, while others can enhance your energy and mood. Soda and other high-sugar drinks, pretty much anything with high- fructose corn syrup, white bread, too much coffee, and fried foods are major culprits when it comes to making you feel blah. On the flip side, whole grains; chickpeas; Brazil nuts; eggs; omega-3 fatty acids; foods high in antioxidants, like berries; and probiotic-rich nosh, such as yogurt and kefir, can all help your mind and body smile. Make sure your diet supports any special circumstances you might have by running it by your care provider.
  • Get naked in front of a mirror. Release body shame and up your feelings of sexiness by standing naked in front of a mirror and finding one area of your body that you love. After you find that area (and it can be as small as your lips or a smooth patch of skin at the base of your neck), really focus on it. Allow yourself to fill with thoughts about how beautiful that area is and how appreciative you are that it’s nourished by blood and oxygen and all the other miraculous functions of the body. Each time you do this exercise, find a new area to focus on.

The point is to start training the mind to shift focus from the parts of our body we don’t like — the parts we usually obsess over — and realize that our body is actually covered in beauty. Know that this exercise can feel super uncomfortable in the beginning, as the act of immediately homing in on cellulite or extra padding is ingrained in us. But if you commit to pushing past the discomfort and the inclination to body-shame, you’ll slowly move into a space of adoration for your body that can create a whole new body. Pretty cool!

Seek therapy. For those who have struggled with eating disorders or exercise addiction, pregnancy might reignite old thought patterns. Give yourself the customized emotional nourishment you deserve by finding a therapist you trust and connect with. A good therapist can offer wonderful support for integrating with your changing body and figuring out how to fall in love with it, or at least come to terms with it. They can also help you work through the feelings toward your baby these changes might trigger.

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My discharge is grossing me out. Why is there so much of it? Is it ever a sign of a problem?

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

One of my childbirth prep class mamas once told me she felt like she had a bottle of “drippy glue” leaking out of her vagina. “It’s everywhere down there — all the time. I go through like ten pair of underwear a day. WTF?”

I’ll tell you what I told her: Vagina-glue is a sure sign your child will be an arts and crafts savant. Just kidding. But for real, this is an incredibly normal byproduct of pregnancy, and it has a fun name! Leukorrhea. Okay, maybe not so fun.

This abundance of goo is caused by an elevation in estrogen, which increases the amount of blood pumping to the pelvis area, which stimulates the mucous membranes, which makes your vagina a discharge factory. It can be icky, but it serves many purposes for the vagina, such as wiping away dead cells, helping its bacteria levels find equilibrium, and guarding the birth canal from infection.

While leukorrhea is usually thin, odorless, a little sticky, and clear or white, its color can range from green, yellow, pink, or red, to white, brown, or gray, depending on what’s going on within your body.

Here’s a discharge color guide:

  • Clear to white: This is what normal discharge usually looks like.
  • Green or yellow: These hues could signal the presence of the STD chlamydia or trichomoniasis.
  • Pink: A bit of pink discharge in early pregnancy could appear when the embryo implants in the uterus. When you’re nearing your due date, thick gobs of clear discharge tinged with pink or red could occur when your mucous plug dislodges in preparation for birth — this is also called bloody show.
  • Red: Tinges of red in discharge can be normal in early or late pregnancy, because of the implantation and mucous plug mentioned above. A touch of red discharge may also appear after sex. However, if you experience so much red that it’s more blood than “red discharge,” reach out to your care provider immediately, as this could be a sign of a complication.
  • Brown: Brown discharge is common in early pregnancy, when old blood is clearing out of the uterus. Alert your care provider if you experience dark brown discharge, as this could be a sign of miscarriage, ectopic pregnancy, or an issue with the placenta.
  • Gray: The vaginal infection bacterial vaginosis could cause gray discharge. It’s caused by a bacterial imbalance in the vagina that can be rebalanced with antibiotics.

In addition to color, the odor, consistency, and accompanying symptoms of discharge could be signs that something is off:

  • Fishy: In addition to gray discharge, a fishy odor is a common calling card of bacterial vaginosis.
  • Cottage cheese: If food aversions haven’t already put you off cottage cheese, know that the vagina equivalent of this dairy dish may appear on your toilet paper if you have a yeast infection.
  • Itching or burning: Another joy of a yeast infection is itching, burning, an inflamed vulva, or my favorite, all of the above!

If you experience discharge that indicates an infection or other issue, tell your care provider. While you’re likely qualified to diagnose a yeast infection, for example, it’s still best to get the green light before using over-the-counter or homemade treatments.

What to do

Because pregnancy doesn’t need any help being uncomfortable, here are a few ways to minimize the wet and yucky feeling of normal discharge in your unders, and the bevy of discomforts caused by not-normal discharge:

  • Wear unscented, organic cotton panty liners. These are a safe way to prevent discharge from soaking through your panties and making you feel like you wet yourself a little.
  • Don breathable cotton undergarments. Beyond being comfortable, not-too-tight underwear made from a breathable fabric like cotton helps prevent excess moisture — which is like a breeding ground for yeast infection–inducing bacteria.
  • Say no to tampons and douching. Beyond a penis, your fingers, a sex toy, or your care provider’s vaginal exam devices, nothing should be going up your vagina during pregnancy. As tempting as it can be to use a tampon to thwart your discharge’s descent, tampons can introduce harmful bacteria. And you don’t want to douche, as it could disrupt the balance of microorganisms in your vagina and potentially cause bacterial vaginosis.
  • Use unscented personal care products. As the chemicals used for many scented products can disrupt the sensitive vaginal ecosystem, resist the temptation to purchase perfumed toilet paper, soaps, oils, or anything else that might touch your vagina.
  • Honor the wiping rule. When we were potty trained, many of us were taught to wipe front to back, to prevent fecal matter from entering the vagina. This is especially important during pregnancy, as not abiding by this golden rule could lead to a urinary tract infection (UTI).
  • Get those probiotics. Eating unsweetened yogurt, kefir, sauerkraut, and other probiotic-rich foods infuses the vagina with healthy bacteria, helping to prevent unpleasantries like yeast infections and bacterial vaginosis.
  • Avoid sugar. As yeast loves sugar, eating too much of the sweet stuff can cause an overabundance of yeast in the vagina, which leads to… you know.

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My vagina occasionally feels like a bolt of lightning is hitting it. What’s up with that? How can I make it stop?

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

Well, my friend, you are experiencing what’s aptly called lightning crotch. You sometimes feel like you’re getting an electric punch to the crotch

because baby is pressing on or kicking a nerve, or their head is dropping down in preparation for B-Day and pressing on nerves around the cervix. Because of this, lightning crotch (so fun to type!) often occurs in the third trimester.

These bolts of ouch can also be caused by round ligament pain, which happens when the ligaments that support your pelvis and uterus stretch too far and too fast because of an influx of the hormone relaxin. While lightning crotch could be a sign that your body is preparing for labor, it’s not usually a symptom of early labor.

What to do

Make sure you’re getting enough magnesium, as this mineral is essential for nerve function. To discover if you have a deficiency, ask your care provider to order a magnesium RBC blood test. If you are deficient, ask them about the best ways to get the recommended dose of 350–360 mg of magnesium per day. They’ll likely recommend a supplement or eating more magnesium-rich foods, like almonds, spinach, chard, avocados, bananas, and pumpkin seeds.

In addition, spinal manipulation and myofascial release by a chiropractor trained to work with pregnant women, as well as acupuncture, could reduce nerve pain. But get the go-ahead from your care provider before seeking these treatments.

Beyond magnesium and bodywork, you can minimize the discomfort of what one of my friends lovingly refers to as “electro puss” by whipping out those pain-relieving techniques you’re learning in childbirth prep class. For example, taking deep breaths, changing positions to get baby off your nerves, and relaxing your body can alleviate those jolts of pain. In addition, wearing a belly support garment could potentially lift baby off the nerve, or nerves, they occasionally press on.

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Why does my vagina smell weird?

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

Because my husband Eric and I have no boundaries, I would fill him in on the various scents my vagina would emit during pregnancy. He loved it. Some days it would be Scent of Asparagus. Others would be Cabbage with a Splash of Dirty Socks, and on the really special days I got to enjoy the aroma of Expired Fish with Undertones of Ammonia. (I should patent these scents before someone tries to steal them out from under me.)

Luckily, Eric had no idea what I was talking about, because only my nose was lucky enough to pick up the scents. I had developed something called hyperosmia, which is a heightened sense of smell (the worst superpower ever). This increased nasal sensitivity meant I picked up every fragrance my vagina was dropping. Asking the smart medical people I know about these smells revealed that (most of the time) they don’t actually emanate out of the interior of the vagina; instead they are primarily caused by leftover urine in and around the vulva. While these leftovers don’t have much of an aroma when you’re not pregnant, pregnancy pee can take on strong scents for any of the following reasons:

  • Dehydration: When you’re dehydrated, urine will be more concentrated, meaning its aroma will also be more concentrated. More water = less stinky pee. This is an amazing motivator to stay hydrated if I’ve ever smelled one.
  • Diet: When you’re pregnant, it’s not just asparagus that stinks up your flow — Brussels sprouts, garlic, and onions also do a number on your Vagina Eau de Parfum. I craved all of these. Brussels sprouts barbequed with maple syrup, sautéed onions on top of chicken potpies, and garlic in everything. No wonder oral sex wasn’t a thing during my pregnancy. Other foods that can tinker with urine include broccoli, cauliflower, curry, fish, and cumin.
  • Vitamins and supplements: Vitamin B6, calcium, and vitamin D can all make urine smell fishy. Because most prenatal vitamins contain all three, you can expect slightly (or not so slightly) fishy pee.

In addition to all of the above, the increased blood supply during pregnancy can impact the pH balance of your vagina, sometimes causing it to become more acidic. You’ll likely also experience more discharge; this shouldn’t have much of a smell, but when mixed with urine it might take on a more pungent odor.

What to do

Tell your care provider. While a fragrant vagina is often caused by the issues above, it can also be a sign of a yeast infection, urinary tract infection, bacterial vaginosis, sexually transmitted disease, or other issues. While I understand the embarrassment that comes with a smelly vagina, your care provider has smelled it all and will just be glad you’re comfortable enough asking whether you should be concerned. After you have the clean bill of health, try the following to deodorize your petunia:

  • Wipe well. Kill the number one culprit of vagina stink, leftover urine, by wiping with unscented, organic cotton intimate wet wipes.
  • Wear organic cotton underwear. The sweaty crotch we talked about in the last question can contribute to vaginal odors. By wearing breathable cotton panties you can minimize nether-region odors.
  • Drink apple cider vinegar. Because this type of vinegar makes your urine a bit more alkaline, it also makes it smell better, as more acidic urine smells more like ammonia. After checking with your care provider, aim for mixing one to two tablespoons of apple cider vinegar into your smoothie or juice, up to two times a day.
  • Use essential oils. While I can almost guarantee that no one else can smell your vagina, you can keep it from bothering you by rubbing two to three drops of an essential oil — mixed with a carrier oil like jojoba or almond oil — into your inner thighs, being sure not to get it on the vagina. Use only mild oils that are safe to use on the skin, like lavender, frankincense, or sandalwood. With the exception of these oils, stay away from all scented feminine hygiene products, as they could cause irritation.

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My vulva is so swollen you can see it through my pants. Why is it like that, and what can I do about it?

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

Been there. I even nicknamed myself Mama Moose Knuckle when I was pregnant. I was so embarrassed by my bulging vulva that I swapped my beloved yoga pants for sweats and skirts — until I discovered why the bulge was there, and that almost every other preggo lady was also hiding a puffy moose knuckle. Get this — to support the uterus during pregnancy, your blood volume increases by nearly 50 percent. This is caused by an elevation of the hormones estrogen and progesterone. In addition, as the uterus enlarges, it can block the flow of blood, intensifying swelling in the vulva and legs.

For many women, this surge of fresh blood can up your libido and create an almost constant state of arousal. After all, blood also rushes to the vulva and introitus (the lower area of the vagina), and it causes swelling when the body is preparing to orgasm. I’ll trade my stretchy-pants for that any day.

However, if you’re experiencing pain, burning, or redness instead of pleasurable pulsations, check in with your care provider, as this could be a sign of infection, certain skin disorders, or low estrogen levels. In addition to the swelling, you might discover a web of varicose veins creeping across your vulva. Yay. These are also caused by the abundance of blood and will likely go away a few weeks after birth.

Another fun change this extra blood may cause is a darkening of the skin covering the labia. The skin could also develop a bluish or purplish tint. But as your blood volume returns to normal after birth, the coloring and swelling should minimize, or completely go away.

What to do

If you’re one of the lucky ones experiencing throbs of bliss, relish it. But if you’re not, check in with your care provider to ensure the discomfort isn’t a sign of a special circumstance that requires attention. Then, try the following:

  • Soothe the ouch. Slip back into comfort by applying a cold compress, elevating your hips, and wearing a compression garment (after getting the go-ahead from your care provider). To minimize varicose vein annoyance, take a warm bath, lie on your left side, and elevate your feet. Light exercise can also do wonders for many vaginal issues, as long as you remove that moist underwear and shower as soon as you’re done.
  • Buy the right undies. Lessen excess irritation by using 100 percent organic cotton, Goldilocks panties — not too loose and not too tight. And for the love of your crotch, skip the thongs.
  • Wear loose lower-duds. Opt for roomy bottoms, as the friction from tight pants or skirts can increase discomfort — or constantly distract you with stimulation. (No judgment if you’re intrigued by that idea!) Loose clothing also hides the bulge if you find it embarrassing. However, you don’t need to be embarrassed. For example, a mom in one of my classes had the superpower of finding the chicest fitted maternity jeans. These jeans showed off everything — her toned legs, juicy booty. . . and enlarged vulva. But she didn’t care, saying, “It’s a product of this amazing process that’s happening inside me, and I have no desire to hide it. And I get a kick out of seeing people’s faces when their eyes land on it.”

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