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.
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.
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.
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.
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.
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.”
As long as you don’t have a medical condition that creates a high risk for miscarriage, preterm labor, or bleeding (confirm this with your care provider), you’re all clear to orgasm to your vagina’s content. Heck, you might even find yourself reveling in multiple orgasms, as they can be more intense and easier to come by during pregnancy.
Regarding the rush of blood, it could actually benefit baby, as it sends more oxygen to the uterus. And the uterine contractions that occur during orgasm are like a massage for baby, while the surge of oxytocin fills both of you with happy feels.
What to do
If your pregnancy is free of special circumstances, orgasm away. If you’re unsure whether you’re at risk for a circumstance that could be triggered by sex or orgasm, check in with your care provider before heading to Pleasure Town.
It’s also important to follow your instincts when it comes to sex and pleasuring yourself. If a position feels uncomfortable, move out of it, and if you’d prefer to skip penetration in favor of foreplay, speak up. And hey, girl, don’t forget to take advantage of your alone time.
Although sex is an essential component of conception (at least most of the time — love you, IVF!), I initially found postconception sex awkward, as I got all up in my head about baby being right there. I prayed he wouldn’t start kicking during sex and tried to avoid wild rocking motions. I wasn’t a lot of fun between the sheets that first trimester. Eric was even more unsettled, worrying about his penis poking the baby. We were missing the ingredients for a juicy sex life, until we learned something super helpful . . .
Babies have no idea what their parents are doing! They’re floating in their warm fluid, pretty oblivious to what’s happening around them. And sure, at around eighteen weeks’ gestation, baby begins to hear sounds outside the womb, but they have no frame of reference for moaning or dirty talk. To them, it’s all jumbled sounds. Regarding the penis-poke phobia, male partners need not worry, as the mucous plug securely lodged in the cervix prevents anything from getting into the uterus. And then there’s those back and forth motions: baby might actually love this, as it creates a gentle sway in the womb that could help them get some sleep. And then, if you’re the lucky duck who reaches orgasm, the flood of endorphins and rhythmic pulsations in the uterus soothes baby even more.
Yet, despite all the goodness prenatal sex can bring for all involved, it can still be strange to feel the little one move, or to suddenly start thinking of baby names when you’re getting frisky. And the physical logistics of sex once your belly has bloomed can make it tricky to get baby thoughts out and bow-chicka-bow-wow vibes in. But because sex is such a wonderful way to maintain intimacy with your partner and enhance your mental and emotional health, we need to get you past these blocks.
What to do
Before you engage in sex, remind yourself and your partner of everything mentioned above. The baby doesn’t know what’s happening, couldn’t care less about the sounds and motions, and has no idea that there’s a penis afoot.
Something else that helps is making the sex so good — so in-the- present-moment-mind-blowingly-wow — that there’s little room left for self-conscious baby brooding. Sprinkle some sexy fairy-dust on your libido by getting creative. Seek fresh inspiration in reading erotic stories together, investing in some new toys, taking your time with foreplay, or brainstorming other ways to get the juices flowing. For example, I never thought dirty talk was my thing until a need to spice things up exposed me to its naughty wonders in my second trimester. Suddenly I was so consumed by lust I had no awareness for anything but pleasure. “Baby who?”
Tip: If you’re experiencing fatigue, get some nooky in the morning when your energy is likely at its peak.
If the logistics of sex are tripping you up (for example, maybe penetration is uncomfortable, or you can’t find a user-friendly position), try out mutual masturbation or a pose that’s suited for pregnancy, like doggy style, spooning, standing, seated, or cowgirl. Yee haw, y’all!
With that said, if all you want to do is hold a trash bin in front of your face and nibble saltines, don’t feel pressured to have sex. Your number one priority is taking care of your needs, so if sex isn’t currently in your cards, don’t beat yourself up. If your partner is yearning for hanky-panky, remind them that you love them and are turned on by them, and that your lack of desire for sex isn’t personal — it’s just not a good time. Then, when you’re feeling better, you can check in with yourself to see if you’re ready to engage in a pants-off horizontal (or vertical) dance-off.
Tip: If you’ve passed your due date and are trying to get things going, have a roll in that hay, as the hormone prostaglandin that’s present in semen can stimulate the cervix and cause contractions. And the rest of you can rest at ease, knowing that sex shouldn’t send a woman having a healthy pregnancy into preterm labor.
Do not, I repeat, do not deprive yourself of the deliciousness of masturbation during pregnancy. Because of the increased blood flow to the vagina I keep talking about, the surge of progesterone and estrogen upping your vaginal secretions, and uber sensitive breasts and nipples, your body is ripe for the pleasuring. Beyond being a totally normal activity during pregnancy, masturbation can actually elevate your health by soothing stress through a release of endorphins, improving blood flow, minimizing pregnancy pains, and helping you slip into a restful sleep. Baby also reaps rewards, as they can be comforted by the rhythmic uterine contractions triggered by orgasm.
It’s important to remember that growing a baby does not cancel out your sexuality. You’re still a sexual being who needs and deserves various forms of pleasure. However, as you explore your sexuality during pregnancy, you might find that different things turn you on. For example, I have a heterosexual friend who told me in whispers that one of the only things that turned her on during pregnancy were erotic stories about lesbian encounters. She said she wasn’t attracted to women but found the stories so sexy during pregnancy. After she had the baby, I asked if the stories were still her thing. “Not really,” she said. “I finally like my husband’s penis again!”
If you prefer sex to masturbation but find that intercourse is uncomfortable, or have a partner who can’t get over being so close to baby’s temporary home, consider mutual masturbation. This allows you to share intimacy with your partner while bypassing everyone’s discomfort.
Fun Fact: The beloved G-spot often becomes more accessible during pregnancy. And did you know you also have an A-spot and a U-spot? The A-spot is located above the cervix (so don’t go there during pregnancy), and the U-spot encircles the urethral opening (go there).
In regard to baby being right there while the deed is being done, know that they have no idea what you’re doing. They’re busy floating in a warm waterbed and breathing in amniotic fluid. They couldn’t care less what you’re doing.
What to do
Masturbate! Find a comfortable, private space, pull out your inspiration materials or tools of choice, and go to town — downtown.
If you have a hard time reaching that special spot, invest in a vibrator or dildo — just make sure they’re clean before use by washing them with soap and water.
Don’t be shy about exploring various areas of your body — for example, those plump breasts.
Before you begin the fun, minimize the chance of scratches during fervent rubbing by cutting and filing your nails.
If thoughts of baby triggering a flood of shame come up during masturbation, remind yourself that you’re doing nothing wrong. It’s healthy and natural. You can also close your eyes and envision floating away to another realm where only you exist — we’ll call it Pleasure Town.
Note: If you have special circumstances, such as a risk of preterm labor, placenta previa, or uterine infections, confirm with your care provider that masturbation is a safe choice. And if you’re embarrassed asking about this, know that they’ll likely be relieved you trust them enough to ask this personal question, and that this is likely far from the strangest question they’ve received.
Heck, yes. When I was pregnant I had sex dreams about the guy that’s always eating sandwiches outside our grocery store, the mysterious library clerk with dreadlocks, and some ex-boyfriends for good measure. Sometimes these were not-so-dreamy encounters, and I’d be trying to lock doors to stop the sex. I would wake up feeling relieved it hadn’t actually happened, but also ashamed my mind had gone there. Other times, the dreams were dreamy, and I’d wake up in solidarity with preteen boys who need to sleep with tissue by their bed. I’ve heard women report sex dreams that involved family members, and even animals. Yup. Most of these women blushed as they whispered how turned on/embarrassed they were by these dreams. So you can be sure that however strange your sex dreams, and whatever your reaction to them may be, there’s someone out there who has had a stranger one, and a similar response.
I also encourage you to really let this sink in: Our dreams don’t make us miscreants unfit for motherhood. We don’t need to shame our poor brain for the random stuff it cooks up when we’re dozing, because those thoughts in no way mean we actually have a desire to engage in the acts playing out behind our eyelids, even if we wake up throbbing in all the fun ways.
Dreams should not be taken literally but instead viewed as representations of more emotional aspects of our life. For example, sexual dreams about people who aren’t your partner are believed to represent breaking away from your old life as you near motherhood. And dreams about women, even if you’re with a woman, are thought to symbolize feelings about your shifting body and identity.
Many of us actually have these bizarre dreams even when we’re not pregnant — we just don’t remember them. As you might have discovered, your sleep is much lighter during pregnancy, especially when your bladder is waking you every five minutes to pee out a few drops. Because of this light sleep, you remember more of your dreams. In addition, women have increased blood flow to the genitals and an influx of estrogen that ups vaginal secretions during pregnancy. These factors combine to make sex a common idea floating in your subconscious mind, and intense arousal a common response. Consider yourself lucky.
What to do
If you want to dive into the fascinating practice of dissecting your dreams, write them down, or make a voice memo when you wake up — even if it’s the middle of the night. Then, take time later to examine the contents of the dream on your own, or with a therapist if you really want to get into it. Because dreams aren’t a science, feel free to create meanings that feel good to you and that support the exploration of the changes you’re experiencing. If you’re still feeling uneasy about your mind-movies after this process, listen to this recording, which helps reduce the many forms of shame that crop up during pregnancy and motherhood: yourserenelife.wordpress.com/releasing-shame/.
Most of the messages society gives us about childbirth boil down to, “It will be the most painful experience of your life — you’ll hate your partner — you’ll probably poop — and your vagina will never be the same.” So, yeah, it’s pretty hard to trust that anything short of narcotics will get you through.
When I was pregnant, I religiously practiced HypnoBirthing techniques and told everyone who asked that I believed this method would work. But I was doubtful, like really doubtful. Even while preaching its benefits, I would think, “How is a bit of breathing and meditation going to get me through the whole pushing-a-human-through-my-vagina thing without screaming for drugs?” But despite the doubt, I kept practicing. I kept asking, “Well . . . what if? What if this actually works?”
Watching HypnoBirthing birth videos actually chipped away at my doubt more than any other aspect of preparation. Witnessing these women have intense experiences with calm, and without drugs, helped me hold on to that “What if?”: “If they can do it, what if I can too?” And then I went into labor. Holy guacamole, was it the most intense emotional and physical experience I’d ever had! But the childbirth prep techniques worked. I didn’t use them all, but certain ones came to me at different times. It was like my body and subconscious mind were in cahoots to get me through the experience. I would be wondering what the heck to do, and all of a sudden an answer would come. “Keep doing your surge breaths…Sit on the birth ball and swirl your hips…Have someone press on your back . . . Tell Eric to stop sleeping because it’s filling you with rage-envy. . .” The answers kept coming and held me in the space of knowing I could get through it. I did ask for an epidural, but everyone ignored me and I forgot about it when the next contraction came.
With all that said, my birth could have played out very differently, even with the same amount of preparation. I had a cervix that seemed happy to open, a uterus that really wanted to get the baby out, and care providers who didn’t push intervention. I say this because I’d never want a woman to feel like she failed if she’s vigilant about childbirth preparation but ends up needing interventions she hadn’t planned on. And sometimes we change our mind during birth. We decide an epidural is the best thing for us, or that Pitocin is essential to get things going. None of that means all the work you put into childbirth preparation was a waste.
There is a common misconception that childbirth preparation classes, especially those more focused on unmedicated birth, have the sole purpose of getting you that unmedicated birth. I believe all childbirth preparation classes — at least those focused more on calm and empowerment than fear — help you do the following:
Foster a greater bond with your baby during pregnancy.
Develop a deeper understanding of your body and the process of birth.
Receive tools to stay calm and focused whether you’re having an unmedicated birth, a medicated birth, or a cesarean birth.
Feel empowered to guide your birth journey, instead of feeling like you’re at the mercy of others.
You don’t have to have complete faith that the class you’re in will get you an unmedicated birth. You just have to remind yourself that you’re doing yourself and baby a huge service by putting thought and preparation into your birth experience, even though you have no idea how it will unfold.
What to do
Find a childbirth preparation method and a teacher you resonate with, as all methods and teachers are not created equal. You’ll have a much better experience if you put time and effort into researching the various methods available and call up teachers you’re considering. I recommend calling or video chat because it’s easier to get an accurate read on someone when you’re speaking with them. If you prefer online classes, look for a free introduction video you can watch before committing. You can find my on- line course here: udemy.com/course/childbirth-preparation-a-complete -guide-for-pregnant-women/.
Once you find the course for you, fully commit. Try all the techniques they recommend and continue practicing those that resonate with you. And remember, you don’t need to believe that everything you’re doing will guarantee an unmedicated birth. All you have to believe is that all this preparation will serve an important purpose, even if you don’t know exactly what that is.
Nope. There are plenty of women who stiffen at the sight of kids but are still great mamas. You’re allowed both. And if it’s any comfort, I naively thought the fact that I love kids would make motherhood a breeze. I was mistaken.
For those who find comfort in a controlled environment where social norms are followed, kids can be jarring enigmas. If you’re one of these people, you might feel like you’re missing a part of the brain that allows you to relate to the littles, which could understandably make you uncomfortable interacting with them. And there is nothing wrong with feeling this way. We all have different things that make us tick and trigger discomfort. If kids are one of your discomfort triggers, it doesn’t mean you’re a monster, it means you’re a human who finds it hard to relate to people who seem to be in their own world half the time, and who poop their pants.
Something that will have your back (and heart) as you get to know both your child and who you are as a mother is oxytocin, the “love hormone” or “social glue” that helps humans attach to their babies, even if that attachment takes a while. When you engage in common acts of mothering like feeding, holding, cooing, and smelling that yummy baby head, the pituitary gland releases oxytocin, which reinforces nurturing. So the more you nurture, the better you feel. And as you’re reveling in this feel-good hormone, your baby will be doing the same. This love juice doesn’t make you start loving all the babies, but it’ll make you really like your own (at least most of the time).
If you notice a lack of pleasure when interacting with baby, your body might not be producing adequate levels of oxytocin. As this could be a sign of postpartum depression — which is not your fault — check in with your care provider to ensure you receive quality support.
In addition to oxytocin, there’s also the little thing where motherhood cracks you open. It shakes up all your preconceived notions and turns you into a new version of your pre-pregnancy self. This new version might still find other kids irritating, but it will have a new skill set that helps you care for and relate to your little human. You’ll also develop deeper empathy for the kid-crew as you gain insight into why they do what they do. For example, after you have a baby and hear another baby crying, you might find that you’re no longer irked by the sound but instead recognize it as a request for a clean diaper or some boob. Realizing how much parenthood changes you can be equal parts overwhelming and fascinating.
The most drastic motherhood change I’ve seen took place in my friend, whom I’ll call Clarissa. When a kid would run up to her, babbling about kid stuff, Clarissa used to recoil. She would give them a tight smile and excuse herself. The few times I saw her hold a baby, they would start crying — one time Clarissa started crying! So I was shocked when she became pregnant. Yes, kids freaked her out, but she said that because she and her partner came from small families they wanted people to hang out with as they grew old. Fair enough. But because her desire to have a baby was inspired by thoughts of what life would be like when the child was an adult, she had serious doubts and anxieties about her ability to care for a baby. She was so sure early motherhood would be awful that she asked her doctor to preemptively prescribe antidepressants. But she never needed them. When the baby was born, a switch flipped and her maternal skills turned on. She still finds other kids intolerable but adores her own. Her partner is in charge of “mommy and me” gatherings and kid parties, and Clarissa takes the reigns at home. It works for them.
That maternal skills and all-consuming-love switch might not immediately flip for you, and that’s okay. Even women who adore kids sometimes find it difficult to tap into mom mode. Be gentle with yourself, ask for support (professional support if you’re really feeling blue), keep nurturing that baby even when it feels uncomfortable, and take care of your own needs, as they’re still essential.
What to do
Remember that each mother and baby have their own way of relating. While these relationships may look similar on the outside, every mother and baby duo has a customized thing going. And you will find your thing as you navigate parenthood. You and your baby, and the rest of your tribe, will figure out the care systems and types of bonding that work best for you. It might not fall into place immediately, but continuing to follow your intuition regarding what feels right for you and your family will help you eventually find an individualized system that works. And don’t worry if your system looks totally different from what other families are doing. All that matters is that you figure out a way of life that gives everyone involved the opportunities to be happy, healthy, and fulfilled.
Tip: Because it can feel really strange (and a little boring) to talk to a human who can’t speak, begin practicing by talking to your baby while they’re in the womb. As you practice this skill, know that you don’t have to speak in simple sentences, or in a baby voice. Feel free to read aloud from the newspaper, sing along to your favorite opera, or talk to your belly about your thoughts on climate change. The point is to expose baby to your voice and language, so you might as well talk about things that interest you. This exercise will peel away one of the many layers of newness you’ll experience during early motherhood, helping you feel a little more prepared for the unknown.
My husband Eric and I had just had sex, and I was going pee. I wiped, and froze. There was bright red blood on the toilet paper. I was ten weeks along, so according to a study published in British Medical Journal I had about a 9 percent chance of miscarrying. I know this because I immediately used my shaking hands to look up miscarriage stats. Then I did what any normal woman would do and called my mom while crying so hard I was snorting. She’s an RN and always does a spectacular job of under-reacting to most physical ailments. The first thing out of her mouth was, “Blood is not a definite sign you’re miscarrying.” Because we have no boundaries, I told her the blood came after sex. She assured me the blood was likely coming from my cervix, which bleeds more easily during pregnancy because blood vessels are developing in the area. Because of her aforementioned under-reacting, I still made an emergency appointment with my OB, who seconded everything Mom said. I was fine.
So while it’s never a bad idea to check in with your care provider if you experience vaginal bleeding, you don’t need to panic like I did. Beyond sex, there are many reasons why a bit of blood may flow out as your body moves through all these wild changes. For one, it’s common to have light to medium bleeding as the embryo is implanting in the uterine lining, about ten to fourteen days after fertilization. In addition, the cervix goes through a process called “cervical remodeling” that includes softening, ripening, dilation, and postpartum repair. The softening begins in the first trimester and can cause bleeding in some women; the ripening begins a few weeks or days before you go into labor; and the dilating and postpartum repair stages are self-explanatory. Additional causes of bleeding include a vaginal exam and excessive exercise.
To assure you even more that bleeding is pretty normal, I’ll cite a study, published in Pediatric and Perinatal Epidemiology, that found that 22 percent of women experience vaginal bleeding during pregnancy — and many of these go on to have healthy babies, even those that had some heavy bleeding. The study also reported slightly higher rates of bleeding in women of advanced maternal age, those with passive smoking exposure, or women who have had a prior preterm birth or multiple miscarriages or induced abortions.
While I’m here to uplift and not to freak you out, I’d be remiss if I didn’t mention the more alarming causes of vaginal bleeding, which include miscarriage, ectopic pregnancy, placenta previa (when the placenta covers part, or all, of the cervix), placental abruption (when the placenta separates from the uterus), and early labor. But know that these are much less common than the other mentioned causes of bleeding.
What to do
If your trips to the bathroom are shrouded in fear, take five long and slow breaths before sitting on the toilet. These breaths help to pull you out of fight-flight-freeze and allow calm, rational thoughts to return. You can also say an affirmation, like “I am on the exact path to motherhood I’m meant to be on” or “My self and my baby are glowing with health.” Say whatever you need to return to a space of trust.
Then, if blood does appear when you wipe, repeat the process — five deep breaths and repetition of your affirmation of choice. Next, take note of the color and amount of blood, and check to see if any clots or tissue is present. If there is enough bleeding to require absorption, use a pad — never a tampon. Finally, give your care provider a ring to talk through the possible explanations for the bleeding, and then decide whether you need to be checked. All the while, keep breathing and reminding yourself of all the nonthreatening causes for a bit of vaginal bleeding.
After you’ve received the all-clear from your care provider, they might still recommend the following: Netflix-ing and chilling, drinking more water, propping up your feet, backing off physical activity, and not lifting anything over ten pounds.
Anxiety Release Tool: To enhance that deep breathing and affirmation practice, try the tapping technique EFT, which stands for Emotional Freedom Technique. This can reset any fearful, chaotic energy running through your body. Instructions can be found here: yourserenelife.wordpress.com/eft/
I can’t imagine a tragedy greater than the loss of a child. From the incredibly brave women I’ve worked with who have navigated this heartbreak and from experiencing it myself, I have learned how common it is for fear to encase the heart after loss. Although the conception of a rainbow baby, a baby conceived after a pregnancy loss, is a joyous discovery for many women, it also marks the beginning of a fraught experience. An experience that’s a swirl of guilt, hope, anxiety, healing, and fear that the cruelty of loss will strike again. And then there’s the stress of being stressed: you know stress isn’t good for pregnancy, but you just can’t shake the stress that stems from your trauma. It can feel like an impossible situation.
But here’s a stat that can hopefully soothe some of those nerves. According to a study published in the Journal of Human Reproductive Sciences, only about 2 percent of women will have a repeat miscarriage (pregnancy loss before twenty weeks’ gestation) — most go on to have a healthy pregnancy after the initial loss. In regard to stillbirth (pregnancy loss after twenty weeks’ gestation), a study published in the British Medical Journal found that while women who have had a stillbirth have a higher chance of experiencing another one, the likelihood of this occurrence is rare.
And now for the murkier component of this question, the emotions. Some women feel like they’re turning their back on the child they lost by allowing themselves to be happy and hopeful about the new baby they’re carrying. But you have every right to let joy bubble to the top of your swirl of emotions. And when you keep making the choice, over and over again, to allow yourself to feel positive emotions — even if it’s just glimmers of those emotions — you begin teaching your brain (and heart) that it’s able and allowed to move forward, and you begin to realize that moving forward doesn’t mean leaving your angel baby behind. Throughout it all, keep reminding yourself that your angel baby will always be in your heart, even on days when you don’t think about the loss.
What to do
Find a care provider who is vigilant about helping you understand (as much as possible) what happened in your last pregnancy and is confident about how to support you through this one. This type of care can help you relax a bit more into pregnancy. If you had a stillbirth, consider hiring a maternal-fetal medicine specialist (MFM).
In addition, ask for more prenatal visits if you feel anxious something will happen in the interim. A family member of mine who experienced a stillbirth requested a prenatal visit every two weeks during the first two trimesters of her next pregnancy, and a visit every week in the third trimester. And don’t be afraid to check in if you feel like something is off. Soothing your fears is more important than not calling your care provider too often.
Is there anything else that can help prevent a subsequent pregnancy loss? Maybe. According to the aforementioned study published in the Journal of Human Reproductive Sciences, there are various factors that could potentially help you avoid another pregnancy loss, if your initial loss was unexplained. And a study published in Australian and New Zealand Journal of Obstetrics and Gynaecology found that 50 percent of miscarriages are unexplained. But many of those are caused by genetic abnormalities, which can’t be avoided unless preimplantation genetic testing (PGT) is utilized during an in vitro fertilization (IVF) cycle.
Because there’s some debate about the most effective strategies for preventing pregnancy loss, talk with your care provider about whether the following interventions could be useful for your unique situation. Keep in mind that because research is ongoing with many of these treatments, your care provider might not be comfortable recommending them.
Folic acid: Stay on top of taking your 400 mg of folic acid daily, as it helps prevent major birth defects in the baby’s brain and spine.
Emotional support: Seeking support from a therapist can help you move through the unique fears attached to your pregnancy. In addition, utilizing alternative support (after your care provider gives you the go-ahead) like acupuncture or hypnotherapy could alleviate stress. You can also use the following link to access a guided meditation I made for women wanting to experience more joy in their rainbow baby pregnancy: yourserenelife.wordpress.com/rainbow-baby/.
The norms: Promote a healthy pregnancy by eating a nutrient-rich diet, exercising regularly, taking your prenatal vitamin, and staying away from no-nos like alcohol, cigarettes, and illicit drugs.
Environmental factors: Limit exposure to harmful products like mercury, solvents, paint thinners, pesticides, and heavy metals. Talk with your care provider about other hazards to avoid.
Chronic conditions: If you have chronic health circumstances such as diabetes, high blood pressure, or other ailments, make a plan with your care provider about how to stay on top of treatment.
Sleeping on your side: Because sleeping on your back could impact the flow of blood and oxygen to the baby, sleeping on your side is the safest option. A pregnancy pillow does wonders for making this comfortable.
Aspirin: Some believe that taking a daily baby aspirin can help prevent pregnancy loss in women with high levels of inflammation. But do not take aspirin without explicit instructions from your care provider.
Progesterone: In some cases, progesterone can help prevent miscarriage in women who experience bleeding in the first trimester.
Low molecular weight heparin (LMWH): The use of LMWH has sometimes been found to help minimize the chance of pregnancy loss.
Human chorionic gonadotrophin (hCG): Because hCG plays a critical
role in the establishment of a pregnancy, it’s believed that hCG injections might help prevent early pregnancy loss.
Steroids: The steroid prednisolone has been found to reduce the amount of a type of cell called uterine natural killer (uNK). Women who have had recurrent miscarriages often have elevated levels of uNK.
Intravenous intralipid solution: Much like prednisolone, intravenous intralipid solution therapy helps prevent natural killer cells from attacking a fetus. While not all women are candidates for this treatment, it’s often beneficial for those with endometriosis, autoimmune disorders, connective tissue disorders, or rheumatoid arthritis, as these women are more likely to have elevated levels of active natural killer cells.
Immunoglobulins: This is a type of antibody made by the immune system to battle bacteria, viruses, and other not-nice invaders. Injections of immunoglobulin are especially needed for immune-deficient patients, in addition to those with a negative blood type. While controversial, immunoglobulin therapy is sometimes used to help prevent pregnancy loss for a woman who has experienced recurrent miscarriages.
With all that said, I want to stress how important it is to avoid blaming yourself for your loss. While there are many ways we can promote a healthy pregnancy, a loss is often caused by circumstances out of our control. Give yourself credit for all you’re doing to nurture your well-being, and do everything possible to release guilt and adopt trust in your body’s ability to move through this pregnancy with ease.
If you’re having a hard time enjoying this pregnancy because you’re steeped in grief, it might be supportive to find new ways to honor your child who has passed. For example, instead of viewing your grief as the prime way to honor them, you can plant a memorial tree that you regularly meditate by, or write letters to the child. Whatever practice you’re drawn to can help you connect to that child, assuring you they’ll never be forgotten while also maintaining enough emotional space to give loving focus to your current pregnancy. Of course, you’ll still have moments of regret, anger, and sorrow, but they’ll no longer be the main channels of connection with your child who has passed on. You’ll now have a new channel that fosters emotional relief and evolution.
Let me tell you a story. I had already picked out outfits for her first Christ- mas, beach day, and birthday in my head. We had made a long list of girl names, and no boy names because we didn’t have to — we were sure we were having a girl. But no. At the twenty-week ultrasound the tech smiled and pointed, “Oh look, there’s his little turtle head!” No joke. There was a turtlehead inside of me. I bit down on the inside of my cheek, but the tears still came. Eric was shocked. I immediately felt detached from my baby. I had been connecting to the idea of a girl. I had been thinking about how I would parent a girl. I had been wanting a girl.
Eric had to go to work, so I was left alone to sob in bed. To mourn the baby girl I wasn’t having. Waves of disbelief washed over me. And then it happened. The guilt struck. I still had a healthy baby inside me. A sweet little boy whose parents were devastated he was not a she. I started crying again, apologizing over and over again to my boy.
When the tears stopped and rational thinking returned, I realized the sex of my child wouldn’t change the way I connect to them. It wouldn’t change the way I parent them. It wouldn’t change the fact that I was going to put them in ridiculous outfits. And heck, I didn’t know how I would connect with or parent them, regardless of their sex, because I hadn’t met them. I didn’t even know what the baby’s gender would actually be. If it had been a girl, maybe she would have identified as a boy, or as neither. Same for my boy. I just didn’t know. The only thing I did know was that I would love them completely. Whatever the sex, whatever the gender, whatever the personality, they were my child and I was beyond blessed they had chosen me.
But even after my realizations, it took a few days before we were ready to share the news. I didn’t want there to be even a tinge of disappointment in our voices when we said, “We’re having a boy!” (We practiced saying it at the same time but could never get in sync.)
So I feel you, mama. It throws us for a loop when we find out we’re having a baby who doesn’t have the sex we’d hoped for. And I don’t buy it when people say, “I don’t care what the sex is, I just want a healthy baby.” I believe every person expecting a baby has a sex they’re rooting for, even if it’s just a tiny bit and at a subconscious level. And there’s nothing wrong with that. Maybe you have two boys and desperately want a girl. Or maybe you grew up in a household of only women and want the experience of raising a boy. Whatever your reasoning, it’s totally understandable. You get to wish for a certain sex. And when it doesn’t come true, you get to mourn. You get to freak out. You get to wish the ultrasound tech got it wrong. And then you get to move past the regret and find peace.
What to do
Be upset. Get to a private place and cry. Or scream, “What the [bleep]!” Don’t hold back; let your honest emotions and thoughts flow. Write a letter about how friggin’ upset you are and rip it up. Then, begin stepping toward acceptance, and even joy, by trying the following:
Remember that you’re growing a unique human. As I mentioned before, no mother has any idea who her baby will be, or what gender they’ll identify as. Even if the sex had been the one you hoped for, your baby probably wouldn’t have perfectly fit into the visions you had of raising a boy or girl. Begin connecting to baby as the wholly unique person they’ll be- come by listening to the meditation at this link: yourserenelife.word- press.com/babys-gender/.
Explore the reasons you wanted a certain sex. As you envisioned your life with a boy or girl pre-ultrasound, you likely had fantasies of going on certain outings with your girl or boy, maybe guiding them through milestones or connecting over a shared love of literature, pop culture, or whatever your thing is. Write it all down. Then look over those dreams with a new lens — a lens that will help you realize that just because you’re having a child that isn’t the sex you had hoped for, doesn’t mean you can’t do the same things with them. The only exceptions I can think of are teaching a boy to not get urine everywhere and to put the seat down, and guiding a girl through her first menstrual cycles. Beyond that, there’s really no bonding experience you can have only with a boy, or a girl.
Write a letter to the baby. If guilt over your disappointment hits, write a letter to your baby explaining how much you love them. Gush over how excited you are. Do whatever you need to do to fill your womb with love as you explore your feelings on the page.
Know that your disappointment will fade, but it may take a while. For many, the disappointment after That Ultrasound will dissolve in a few days, after you get used to your new reality. However, some mothers may feel lingering regret until they deliver their baby. But when you’re finally holding your baby in your arms, you’ll be shocked you ever wanted anyone who wasn’t that exact child.
You do. But while the thought of that conversation probably makes you cringe, you have every right to feel no shame about sharing this information. According to the Centers for Disease Control (CDC), there were 2,457,118 reported cases of STDs in the United States in 2018 — and many go unreported. That’s a lot of people. And I can guarantee all those folks aren’t irresponsible miscreants. People contract STDs. It happens. It’s something that should obviously be avoided as much as possible through safe sex practices, but despite our best efforts they still occur all the time. This is especially true when we’re teens and more prone to in-the-moment “I can’t find a condom, but whatever” behavior. And if we contract something like herpes — an STD that can never be erased from the body — we have to deal with those super-normal, yet unfortunate, teen-decisions forever.
Note: Most care providers recommend testing for human immuno- deficiency virus (HIV), hepatitis B, chlamydia, and syphilis during the first prenatal visit.
Although your care provider will provide the most up-to-date in- formation on how your STD could impact pregnancy and what the best course of action will be, here’s the lowdown on STD risk factors and the STDs that pose the greatest threat during pregnancy:
Can pass to the fetus during delivery: Without certain medications, chlamydia, gonorrhea, genital herpes, and cytomegalovirus (CMV) can be passed from mother to infant as baby moves through the birth canal.
Can infect the fetus during pregnancy: Syphilis, HIV, and CMV can pass to the fetus.
Pregnancy loss: Syphilis, gonorrhea, HIV, and herpes can all increase the chance of pregnancy loss if left untreated.
Chlamydia: This STD can increase the risk of preterm labor, and eye infections or pneumonia in the baby.
Gonorrhea: Eye infections, pneumonia, or infections of the joints or blood in the baby can be caused by gonorrhea.
Syphilis. Syphilis can cause a slew of serious issues for mother and baby, which is why it’s often treated with antibiotics during pregnancy.
Genital herpes: Herpes exposure during delivery could lead to problems in baby, like brain damage. Women who have been diagnosed with herpes but don’t have active sores will be given medication to prevent an outbreak during delivery. Those with active sores will receive a C-section.
Hepatitis B: As hepatitis can cause serious liver complications, the baby of a woman with this STD will receive the hepatitis B vaccine within twelve hours of birth, in addition to a treatment, called immune globulin, that helps prevent a chronic hepatitis infection. Some women might also receive antiviral therapy during the third trimester.
CMV: Cytomegalovirus is a common virus (related to herpes) that often goes undetected. Serious illness could occur if it’s passed on to the baby. It’s usually managed by giving the mother antiviral medications.
HIV/AIDS: This STD is often managed by giving the baby the medication zidovudine for four to six weeks after birth. In addition, the mother will likely be advised to continue her standard medication regime during pregnancy. A C-section is often recommended if there’s an elevated amount of HIV present in the body in the third trimester.
While these risks sound scary, many can be prevented if your care provider knows about your STD as soon as possible and gets you the necessary care.
What to do
Remind yourself that you’re not the first pregnant woman to tell her care provider she has an STD. Many women have come before you. Then re- mind yourself that your care provider is legally obligated to zip it when it comes to everything you tell them — no one else (beyond members of their staff with the clearance to see your chart) will find out, unless you tell them. And because preparation often does wonders for minimizing nerves, think through how you’ll tell them the news. As you do this, your head might be filled with visions of your care provider looking at you in horror, or shaking their head in disappointment while making that annoying “tsk tsk” sound. I can almost guarantee they’ll do none of the above.
Something else to consider is that you might have omitted this information in numerous prior visits. For example, I’ve worked with women who have seen their OB-GYN for years, and because of (undeserved!) shame, never told them about their STD. In all cases, the women received treatment for their STDs at a Planned Parenthood. Fast forward to their pregnancies — now they not only had to tell a person they saw as an authority figure that they had an STD, but also had to let it slip that they had been holding back key medical info for quite some time.
If you’re in the same predicament, you might feel the amplified anxiety and embarrassment these women all reported. However, it’s important to know that — just like the millions of people who also have STDs — there are likely also hundreds of thousands of other humans who have felt too embarrassed to share this info with their primary care physician. In addition to knowing that you’re not alone, know that if your care provider is worth their salt, they won’t bring up the fact that you’ve been keeping this from them. They’ll simply mark the info in your chart and discuss how it will be managed. Just another special circumstance. No biggie.
This is one of the most frequent questions I receive. As our culture sets doctors up to be authority figures (something that can be comforting in many cases), we often feel like we’re stuck with the first person we receive treatment from after we pee on the stick. Most of the time, that person is the OB we started going to because our insurance covered it or a few friends recommended them. But then we start learning about pregnancy and childbirth and might find we’re feeling less aligned with that OB — feeling less comfortable asking questions or expressing how we want to navigate pregnancy and childbirth. Under normal circumstances, we would find a new care provider, but discomfort at the thought of firing the person who’s been administering those lovely Paps for so long can seem more than our pregnant emotions can handle, especially when we’re nearing the end of pregnancy. But the alternative is often a birth experience that is a far cry from what we actually want.
In addition, most of us feel incredibly vulnerable during pregnancy, so when we have a care provider talking with great authority on what we should do, we wonder if we’ll be doing ourselves or our baby a disservice if we change care providers. So we stick with them. But this decision is often based on fear rather than on a genuine desire to receive care from the person in question. It’s also important to note that some care providers present opinions as fact. They state their views on induction, for example, as gospel, making some women feel silly for having a differing opinion. If you conduct the care provider interviews recommended in the following pages, you’ll find that almost every candidate will have a slight (or significant) difference of opinion on almost all pregnancy and childbirth topics. In many cases, a lot of what they say is based on their personal experiences, not on science-based research.
I have a birth story packed with disappointing moments because I didn’t feel comfortable being open with my care provider. At the time, I didn’t have the courage to find a new one. When I discovered a fertilized egg had landed in my uterus, I went straight to the lady who had given me a painful endometrial biopsy the year before. She was an authoritative grandma type and a high-risk OB. I knew nothing about pregnancy and childbirth and figured it would be good to have a doctor who was well trained in everything that could go wrong. What I soon learned was that she seemed to always be looking for something to go wrong.
I started feeling unsure of my body and my ability to make decisions, and I rarely shared my thoughts on what I wanted my birth to look like. The one time I summoned some courage and told her I didn’t want to be induced and didn’t want an epidural, she just stared at me. Fast forward to labor. I had not developed any special circumstances that warranted the watchful eye of a high-risk doctor, so I was primarily left under the care of the L&D nurses, who were happy to let me birth without intervention. Things were moving along fine when my doctor came in and decided to break my water. There was no medical indication for this — she just wanted to speed things up. And of course, I didn’t talk back. So that happened . . . and soon after I was ready to push. I began trying out positions I learned in my birthing class and did a combination of deep breathing and pushing to avoid the burst-a-blood-vessel, high-octane pushing commonly recommended in hospitals. My doctor stood in the corner and watched skeptically for about ten minutes before telling me to put my feet in the metal stirrups and push the way she wanted me to push. Three exhausting hours later Hudson was born. We were healthy, and I had my unmedicated birth, but I didn’t feel empowered. I felt like I had been railroaded.
Looking back, I recognize my doctor wasn’t “bad,” she just wasn’t the right fit for me. I wish someone had told me what I’m about to tell you . . .
What to do
If you’re not jiving with your current care provider, find a new one. I can guarantee you won’t be the first person to move on from them, and you won’t be last. I can also (almost) guarantee they won’t be offended. They have plenty of patients and likely prefer those who happily follow their suggestions, not someone who seems hesitant about their care. So really, you’re doing both of you a favor. To find a care provider you gel with, consider the following:
Conduct interviews. These interviews can be done fairly quickly, and sometimes over the phone. You can usually find good suggestions for candidates by asking friends or family members who had the type of birth you’re hoping for, or your childbirth preparation educator.
Meet with your top choices. After the initial interviews, have consults with three or four of your favorites, sharing the type of birth you want and paying attention to how they respond. If they seem like they could maybe, possibly support what you want, they might not be a good fit. If they’re enthusiastic about your birth preferences and talk about things you can do to set yourself up for your ideal birth — if they make you feel like they’ll be your champion — they might be a really great fit.
Check in with your gut. The most important indicator that someone is the right care provider for you is feeling instinctually comfortable with them and excited at the prospect of receiving support and guidance from them. They should be someone you feel you could trust, ask anything of, and tell anything to.
This process can be done at any point during your pregnancy, even a few weeks before your due date. I know a midwife who started caring for a mother the day she went into labor. I also know a woman who had a breech baby and one week before her due date decided to switch from a doctor who was insisting she have a cesarean birth to a care provider who performed breech deliveries.
Above all, you deserve to have a care provider who makes you feel empowered, safe, and capable. And you have every right to hire and fire as many care providers as you need until you find that golden match.
“I hate all of them,” my client Shelly said. “First it was just all the people that aren’t pregnant and can bend over, and poop, and eat more than crackers. And then I started hating all the pregnant women too. They all glow more than me, yet sweat less. There’s no way they’re as scared, or angry, or tired as me. And then there’s my husband — he really sucks. I hate that! I hate all of them, but I can’t stop it. And…and…and…” Shelly went on for a while. I felt for her. She was taking my childbirth prep class and had stayed behind to talk.
Shelly said the moments of excessive annoyance began almost as soon as she peed on the stick. But the rage didn’t fully blossom until the beginning of her third trimester. She couldn’t tolerate being in public because she couldn’t hold her tongue — she couldn’t stop her eyes from giving away how dumb she thought everyone was. “I got a foot massage last week and asked the woman if she was trying to do a bad job. I could barely feel her hands, but still, I was such a bitch. She teared up. I’m not usually like this. Before I became pregnant I was that person who struck up conversations with strangers in the checkout line. I would leave waiters big tips even if they did a horrible job. I think I’m possessed,” she said. She was possessed. But not by the Spawn of Satan, just by the Hormones from Hell — and a few other pregnancy demons.
What Shelley experienced was an extreme version of the mood shifts many women have during pregnancy. The changes in estrogen and progesterone throw your neurotransmitters — the chemicals in the brain that help regulate your mood— for a loop. Like a giant, nauseating roller coaster loop. In addition to the hormones, the fatigue, the stress of pre- paring for a new baby, and the changes to your metabolism contribute to the whole “other people are insufferable” thing. While this is all normal, it doesn’t feel great, and each time you see red it can cause a surge of the stress hormones epinephrine, cortisol, and adrenaline, in addition to a constriction of blood vessels.
A study published in the Journal of Obstetrics and Gynaecology found that pregnant women with chronic high levels of anger had high levels of cortisol and adrenaline, in addition to low dopamine and serotonin levels, and that these women tended to have babies with high cortisol and low dopamine levels. These babies also had issues with sleep, orientation, and motor maturity after birth. The good news is there’s a lot you can do to minimize the spike in these rage hormones, as well as the dips in your happy hormones.
What to do
Avoid other people. Seriously. While I’ll get to ways to manage your irritation when you have to be around other humans, I want to stress your right to honor your needs — even if those needs include being a hermit for a few weeks. Maybe your irritable mood is a much-needed invitation to step out of the social scene and spend more time connecting with your baby — a person who, at the moment, cannot talk back and demands nothing of you (beyond most of your nutrients).
If you’ve always felt like you’d rather stare at a blank wall than interact with other humans, this may be a sign of social anxiety, chronic depression, or other common conditions, which might be something you can explore with the support of a mental health specialist. But if this is a state of being that popped up with pregnancy, it’ll likely subside after baby comes and the hormones chill. So instead of stressing about other people stressing you out, give yourself permission to avoid people as much as possible. Give yourself permission to retreat in ways like these:
Pop on your headphones when you’re at work (or anywhere) so people aren’t tempted to talk to you.
Tell your partner you need alone time and slip into bed with a good book or the remote.
Pull the pregnancy card when friends ask you to go out, or an invite to a family gathering arrives.
If any of your people are offended, be straight up. Tell them pregnancy hormones are making you exceedingly irritable, so you’d rather avoid people than be mean to them. You can also remind them (and yourself) that you’ll be back to your more social self after your hormones regain equilibrium. Until then, just send your regrets. #SorryNotSorry
However, there will be times when you just can’t avoid interacting with fellow earthlings. To make those situations less infuriating, try the following:
Discover what relaxes you, then do it. Analyze all the activities you engage in, or want to engage in, and pinpoint what makes you the most relaxed. For example, maybe a walk every morning, a nap in the afternoon, or a massage once a week pushes your reset button. Or maybe your thing is binging on Dr. Pimple Popper or knitting baby booties. Or whatever. Just do what soothes you at least once a day, as this will fill you with a greater capacity to deal with irritants when you have to leave your bubble.
Follow the healthy norms. I know eating nutritious food and not being a total couch potato is talked about ad nauseam, but it’s for good reason. These activities help combat the factors that can make you susceptible to anger and irritation, like fatigue, headaches, and bloating, while also pumping you full of endorphins.
Walk away. When someone triggers you and you feel a red-hot response on the tip of your tongue, swallow it and walk away. Go some- where private (the bathroom or car are my favorite choices), and let your rage spill out there. Say everything you wanted to say to that person. Bang your fists. Let it out. This helps avoid the escalation of interactions that don’t need to escalate, and prevents you from saying something you’ll later regret. If you need to return to that person, wait until your anger has subsided so you can engage from a calm space.
Pull the pregnancy card. If those red-hot words spill from your mouth and you wish you could shove them back in, blame it on the baby. “I am so sorry I said that. These hormones are out of control.” However, if that person deserved those red-hot words, skip the excuse, and as the singer Lizzo would say, do a hair toss and walk your fine self out the door.
Intentionally rage. Release your inner pressure cooker on your terms by finding activities that allow you to express your anger without hurting anyone. For example, I’ve been known to scream into pillows, pound said pillows, or write a scathing letter to someone I’m mad at, then burn it. Find your thing, then do it as often as needed.
Practice nostril breathing. Most people hold their breath when they get mad. Pull yourself out of this state by practicing the very strange, yet effective, technique of nostril breathing, also called the “subtle energy clearing breathing technique.” To do this, close your right nostril with your thumb, then take a deep inhale through your left nostril. Next, close your left nostril with your finger, then exhale through your right nostril, and then inhale through your right nostril. Now close the right nostril, and exhale through your left nostril. That’s one cycle. For optimal results, do it for five minutes. It may sound confusing, but it gets easier with practice.
Safety Note: Stop this breathing technique if you begin feeling lightheaded.
Practice muscle release. In addition to holding their breath, people tense their muscles when they’re mad. So when you feel anger coursing through your muscles, counteract it by envisioning a warm, euphoria-inducing liquid being poured into the top of your head and flowing down through every muscle, nerve, and cell in your body until it reaches your toes. Track this liquid as it slowly moves through you, feeling your muscles relax as the euphoria moves through them. Keep repeating this visualization until you feel the anger subside.
Nope. That decision is super personal, and you can do whatever you like with it. In the age of oversharing, some people feel it’s their right to know all your business, which can make you feel pressure to share it all — even the aspects of yourself you want to hold close. This can even result in you feeling like you’re lying or inauthentic if you’re not completely open about your journey to conception. I don’t want that for you. I want you to feel free to choose who you do and do not share this intimate information with, and to know that you’re not less-than if you don’t feel like shouting it from the rooftops.
You might also still be processing how you feel about using a donor. Maybe you’re exploring what it’s like to be pregnant with a child who is not biologically related to you. Or maybe you’re supporting your partner through that journey. It can muddy the emotional waters to share information you’re still unpacking.
On the other hand, you might also be yearning for a few special people to talk with about your donor decision — a few people who won’t judge or ask insensitive questions. Creating this carefully curated group can give you a pillow of support when you do tell people who might not be as understanding as they should (for example, uptight parents or in- laws) and your child, when they’re old enough to understand.
What to do
Think long and hard about the people you trust implicitly. The people who never raise their eyebrows when you tell them something deeply personal. The people who have your back no matter what. Make a list of names. If you have a partner, make this list with them. Then do the following:
Tell those people. I recommend having a private meetup with each of the individuals on your list, where you share your exciting news. You can also request that they don’t share this information with others until you give the go-ahead.
Request support. If you’re struggling with emotions around your genetic connection to the child or are nervous about telling certain people, ask your core group if they’d be willing to support you through this process. They’ll likely appreciate you being up front with your needs and will probably jump into action to make you feel held.
With this team of ride-or-die confidants in place, move on to phase three…telling the family members you’re not excited to tell.
Having the tricky talks. Before we dive into this, I want to note that it’s not absolutely necessary to tell anyone — even family members. I cover how to share this information with family because many women feel it’s easier to tell them than to try and preserve the secret. But of course, whatever choice intuitively feels right for your unique situation is the right one.
If you choose to share your decision to use a donor with the family, make a loose script for what you will say, writing down any information you’re willing to provide and what you’re keeping to yourself. You can also create a script for what to say if they ask questions you don’t want to answer or are judgmental. For example, if they start hammering you about why you used a donor instead of doing X, Y, or Z, clearly tell them that you’re not there to discuss your reasoning and have no obligation to do so. Express that you’re telling them out of courtesy and do not need them to agree with your decision. State that you’ve shared every- thing you’re willing to share, and request that they find a way to support you. This might seem harsh, but I want you to remember that you don’t need their approval. You’re an adult who is following the path to parenthood that is right for you and, if applicable, your partner.
If you’re really nervous about having these conversations, ask someone from your support group to accompany you so they can back you up, or pull you out if the situation gets toxic.
You are a champion for moving through the intense journey of conceiving with the support of a donor. It’s a long road, and you deserve to be honored for your commitment to bring a new life into this world. Don’t let anyone dim your light.
A friendship can get tricky when one friend’s pain intersects with another’s joy. The emotions experienced by someone facing infertility, miscarriage, or stillbirth can be truly understood only by those who have navigated the same sorrow — it cuts deep and can feel like a cruel joke. I speak from experience, as I’ve had a miscarriage.
While every woman who experiences this painful journey will do so in her own way, a common thread is feeling frustration, desolation, and even resentment when they see babies and pregnant bellies, or hear about the healthy pregnancies of their loved ones. Being around pregnancy can be so triggering. Because of this, it’s fair to feel nervous about sharing your amazing news with someone who will understandably see it as a reminder of what they don’t have. It’s not a fun conversation. But it has to happen.
While it’s normal to want to hide this information because you don’t want to cause pain, you’ll actually cause more by hiding it. I have a close friend (we’ll call her Megan) who experienced a late-term stillbirth that rocked her world. I was devastated when I heard about her loss — so I can’t even begin to piece together how she felt — and still feels. Then one of Megan’s friends (we’ll call her Anna) became pregnant, and had a get-together where she shared the news with all their mutual friends. Anna did not invite Megan. Sharing the news with Megan was left to her husband, who heard about the pregnancy secondhand, and this made Megan feel that a secret was being kept, like Anna would rather hide than face Megan’s pain. She felt betrayed. If Anna could have pushed past her discomfort, they would have had a potent opportunity to connect, as one of the main things Megan wanted was for people to be willing to talk to her about her child who had passed. To be willing to hear about her pain. She wanted people to not be scared of her story and her grief.
So in some ways, the situation you’re in with your friend is a gift. It’s an opening, an opportunity to let her know you’re there for her no matter how uncomfortable her emotions and life circumstances make you feel. While initially uncomfortable, this conversation could be one of the most unifying and transformational encounters you’ll ever have. It will force you to summon your strength and compassion, and connect with another human in a raw, deeply authentic way.
What to do
To start, don’t post anything on social media or have a big pregnancy announcement party until you’ve spoken to your friend. News travels fast in the age of instant information, so hold it close. Then consider the following:
Make a plan for when and where you’ll tell her. First, think of a day and time that will give both of you plenty of time to talk and allow room for decompression before either of you step into another activity. Next, figure out a private, safe space for her to freely express whatever emotions might arise. (Her house might be a good choice.)
Figure out how you’ll tell her. To get started, write down some ideas about how to deliver the news. For example, you can preface the news by telling her you’re fine with any reaction she has, as this can make her feel safe to express sadness or frustration if that comes up. In addition, knowing that you didn’t come into the conversation with expectations about how she should respond will likely make her feel emotionally held.
You can also write a reminder to remain neutral when you tell her you’re pregnant. While it’s natural to want to gush about how happy you are and share all the details, know that such a reaction might exaggerate her pain.
Below is an opener I helped a client write. You obviously don’t have to say this verbatim, but it can provide a starting-off point. You also don’t have to walk into the convo with the script, but it’s helpful to review it beforehand to ensure you don’t forget the most important points.
If you feel your friend would rather receive the news via email, compose a letter along the lines of what’s written below, and end with an invitation to talk whenever she feels ready.
Sample Script for Informing a Sensitive Friend
“I want to start by saying how much I love you and appreciate our friendship. Before I jump into my news I also want you to know I have no expectations about your reaction — you should feel safe to express whatever comes up. With that said, I want you to be one of the first people to know that I’m pregnant. [Pause for reaction.] I can’t even begin to understand what you must be going through, but I want you to know I’m always here for you. I promise we absolutely do not have to talk about my pregnancy when we hang out. You are an amazing woman, and it’s an honor to know you.”
• Determine how to manage your emotions. An important aspect of preparing for this talk is recording ideas (see energetic shield exercise in the following pages) about how you’ll man- age your own emotions or triggers if she doesn’t seem happy for you. She’s moving through a challenging experience, and it’s natural for her to not be excited about your news. Her reaction is not personal — it does not mean she doesn’t love you or thinks you don’t deserve to become a mother.
Actively listen. After you’ve said your piece, allow her to lead the conversation, and practice active listening. Avoid going into details about your pregnancy, like due date and birth plans, unless she asks, and for the love of uteruses, do not offer any advice on conceiving or drop fertility platitudes. “Everything happens for a reason,” “It will happen for you when the time is right,” and other such sayings are not helpful.
Protect yourself. Something else to consider as you plan for this conversation is that your fears could be triggered. For ex- ample, if your friend experienced a miscarriage or stillbirth and wants to talk about it, you could begin wondering if the same will happen to you.
To protect yourself, create an invisible shield before you meet by closing your eyes and envisioning a golden light around you. Allow this light to represent energetic protection from whatever your friend says. Remind yourself that this conversation is for her, and that all you need to do is be there for her — you don’t need to absorb her pain or fear. When I went through this exercise with a client she asked if it was selfish, saying, “Shouldn’t I be willing to feel her pain and really go there with her?” The thing is, “going there” with her sucks energy away from your ability to support her. If you spiral into the what-ifs of your own journey, you’ll have little concentration, or even willingness, left for nurturing her. In addition, gifting yourself this energetic protection can pre- vent you from becoming defensive or angry if her response is hurtful.
Keep reaching out. After you have the talk, avoid the temptation to ghost her. It’s normal to want to hang only with people who lift your mood and are cool talking about baby stuff 24/7, but continuing to give friendship-TLC to her can be good for both of you — she feels supported, and you’re reminded of what a solid friend you are. (Just don’t talk baby unless she’s the one bringing it up.) With that said, she might request space from you. She might find it’s just too hard being around you during your pregnancy and that she needs to take a step back. While you want to honor her choice, it doesn’t hurt to continue checking in on her occasionally, letting her know you’re thinking of her and are there if she ever needs anything.