9 unexpected things you should know about pregnancy

We reveal some of the lesser-known facts around pregnancy and birth.

It’s supposed to be the most natural thing on earth, yet not everything about birth and pregnancy is straightforward, and certain aspects are not widely known. There are those unexpected little things that older women have forgotten about and your friends just don’t want to tell you. We asked Dr Bernie Potgieter, a Johannesburg-based gynaecologist and obstetrician, to explain some of them.

1. The trans-vaginal ultrasound

“When I went for my eight-week scan, the doctor pulled a condom over this long, vibrator-looking instrument, covered it with KY jelly and inserted it down below. I was so shocked, I couldn’t speak!” Natalie, PE

“Yes, having a trans-vaginal ultrasound the first time can be quite a shock, but the pros far outweigh the cons. However, it provides a far more detailed image in early pregnancy than a trans-abdominal ultrasound, and even more so in overweight patients,” says Dr Potgieter. “It won’t harm the foetus or mother, and it’s hardly ever needed after 12 weeks, except in certain high-risk pregnancies.”

ALSO SEE: Everything you need to know about ultrasounds

2. The internal examination

“I had some idea of what the 38-week examination would be about, but it was still quite a shock. My partner was there with me, and he felt so uncomfortable!” Lerato, Durbanville

For those patients opting for vaginal delivery, an internal examination is done at 38 weeks to assess whether the pelvis is suitably and adequately sized to allow the baby to pass through. Yes, it can be a little uncomfortable and invasive, but fortunately it isn’t a long procedure. Before you go for your examination, discuss it with your partner so that he can decide whether he would want to be present or rather sit that one out and attend the next one.

3. Haemorrhoids

“It was quite a shock when I realised I’d developed piles. My poor hubby had to go and buy some Preparation H for me, without even knowing what it was for – but like a true star, he did, and even rubbed it on!” Helen*, Magoebaskloof

Piles, or haemorrhoids, develop for two reasons in pregnancy: pressure by the low presenting part (head) of the baby; and constipation. “That’s why you should treat constipation as soon as you notice it,” says Dr Potgieter. “Piles should also be treated at onset. If neglected, it can lead to thrombosis, which requires surgical removal.”

ALSO SEE: Dealing with constipation and 4 other pregnancy niggles sorted

4. Perineum massages

“My gynae suggested that my husband massage my perineum throughout the third trimester. Is this beneficial?” Maryannne*, Howick

If the vagina doesn’t stretch enough during birth, the perineum can tear or might need to be cut – a procedure called an episiotomy. The perineum is the tissue between the vagina and the anus, and consists of muscles that form the pelvic floor. Massaging the perineum is a great way to minimise the incidence of tears and episiotomies for first-time moms, but there’s very little benefit in future pregnancies, according to Dr Potgieter.

5. Leaking breasts before birth

“I’d expected some leakage after Sam was born, but not before! Thank goodness for scarves – they’ve saved me from so many embarrassing situations!” Donna-Lee*, Ballito

If you’re suddenly noticing wet spots on your shirts before your little one is even born, don’t worry – it’s perfectly normal. If you don’t want to depend on scarves, you can also get breast pads specially designed to hide these “accidents”.

6. Enemas before birth

“I’d never had an enema before. It was a horrible feeling and I felt very invaded and embarrassed. Nothing about pregnancy was a shock after that!” Helena*, Johannesburg

Having an enema makes life easier for the mom-to-be during pregnancy. Most expectant women are constipated, so the rectum, which is located right behind the vagina, can be filled with hard stool that can form an obstruction to the descending head of the baby. When the baby is pushed out, so is the stool, which can be quite embarrassing to some patients – hence the need for an enema.

7. An outside uterus

“I had a last-minute C-section. I was not in a happy place to begin with, and then the doctor literally flipped my uterus out of my body, after Toni was taken out, to clean it and stitch it up.” Diane*, Bryanston

After the baby is removed, the uterus can be sewn up outside or inside the abdomen. “Which approach is used depends largely on the personal preference of the surgeon. If you’re worried about this, talk to your doctor well before the baby is due, to make sure you’re on the same page.”

8. Bleeding after birth

“After my C-section, I had what resembled a heavy period for a few weeks. Is this normal?” Naledi*, Rustenburg

Although the postpartum discharge may last up to six weeks, the bleeding should be almost gone after two weeks. “Any heavy bleeding with clots after the first few hours should be regarded as abnormal and should be reported to the nursing staff,” warns Dr Potgieter. “Heavy bleeding can be due to the uterus not contracting well, tearing in the general tract, or pieces of retained placenta.”

ALSO SEE: Your period after baby – what to expect

9. Shaving down there

“My doctor asked me to shave ‘down there’ the day before my C-section was scheduled. Since I couldn’t reach, my partner had to do it for me.” Praneshka*, Cape Town

Shaving your pubic hair before a Caesarean is a matter of being practical, explains Dr Potgieter. “As the incision we make is usually very low, we prefer the area to be shaved so that we can see what we’re doing. The cut needs to be very neat, and when we suture, it’s easier and more hygienic if the area is clean-shaven. Shaving prevents hair from getting into the abdomen during surgery. It also makes it easier to keep the area clean after the delivery, until it’s healed.”

*Names have been changed.

Originally published in December 2010

 

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