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Worries During Delivery
Q. I hope I'm not the only one to have a bowel movement during labor. During my first pregnancy I arrived in the delivery room and threw up and shit all over the place. I was so embarrassed the next day– I couldn't look the doctor in the face. I was too afraid to ask any of my friends if they had anything like that happen to them. With my next pregnancy the same thing happened and I was equally mortified. Now, fifteen years later, I am pregnant again. I am consumed with the fear that I am going to take a dump or fart with fifteen people staring at me. My Lamaze instructor said that years ago they used to give enemas to pregnant women, but don't anymore. I would gladly have an enema than go through such embarrassment. Has anyone else had a similar experience?
-Laura, New York
A. Don't worry. You are not alone! Involuntary passage of gas, urine and feces happens to nearly everyone during delivery. Some more (quantity-wise) than others. I guess it depends on how long you've been in labor, what the contents of your guts are, and if you've had an enema or not. (See the other "pooping on the table" question for more details.)
Q. I am now 20 weeks pregnant with my second child. My question is, how do I avoid any feces from coming out while pushing my baby? It happened to me when I was pushing my first baby. The baby came out and so did some of my feces. It was SO EMBARRASSING!
-Fauziyah, New York
A. Women with long labors usually do have one small advantage– diarrhea and plenty of time to empty out the bowels, while women with short labors sometimes find themselves pooping on the delivery table. Don't worry, most doctors and nurses have seen this many times before and are quite used to it.
The only thing I can think of to possibly avoid this situation is to give yourself a warm water enema to clean out your bowels before heading off to the hospital. Or, ask your attending nurse to give you one.
Twenty years ago it was common practice to give women enemas during labor. I suspect this no longer occurs today because women are more embarrassed to have the enema than to poop on the table!
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Q. Do I have to shave my privates when I am pregnant?
A. There is no reason to shave during pregnancy unless you have a preference for it.
As far as shaving for the birth, it used to be common practice for women's pubic hair to be shaved prior to delivering because doctors thought that eliminating the hair would decrease chances of infection. However, statistics showed that there were actually more instances of infection reported from shaving than not shaving. These days, the most common practice seems to involve swabbing the crotch area in antiseptic before the birth.
Usually, the only time shaving is required is when you have a caesarian birth, as I did with my first child. They didn’t shave very much, though—just a little off the top.
Q. What is the proper way to remove a sedated GYN patient from the stirrups after surgery? Are there any dangers of back injuries?
A. Since I am not a medical professional, I cannot tell you if there is a "procedure" to follow in this case. I will tell you that when I had my Cesarean the nurse just lifted my legs out of the stirrups and placed them down on the table after surgery, as the spinal block did not allow me mobility in my lower body. I've never heard of anyone incurring a back injury as a result of being removed from the stirrups, but I guess it could happen. Heck, a house could fall on you, too!
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Q. This is my second pregnancy. When I had my daughter, I suffered a second degree tear. How likely is this to happen again?
A. Of course many factors come into play, but I think your chances of a second tear are significantly less. Once your vaginal muscles and tissues have been stretched (from childbirth), they “give” a lot easier the next time around. However, if your second child is much larger than your first or the baby comes out breech or with shoulder dystocia, then your chances for tearing again do increase.
You might discuss your concerns with your doctor to see if there are any preventative measures you can take to avoid tearing. For instance, if you gained a lot of weight with the first (over 45lbs.), then you might try to gain less weight with this pregnancy. Less weight gain usually makes for a smaller baby and easier delivery.
Q. I am pregnant with my third child. My first (a girl) was born at 5 lbs. and my second (a boy) at 7lbs. With my second, the baby had shoulder dystocia, where his head was born and then the shoulders got stuck. This was very scary for everyone in the room. What are the chances of this happening again?
A. You may be at risk for another episode of shoulder dystocia if you have gestational diabetes, a history of large infants (which you do not), are of large maternal size, have a prolonged gestation or if the second stage of delivery is prolonged. If you have one or more of these risk factors, your doctor will probably monitor you closely as delivery time comes nearer. If your baby is large and/or late, you may be scheduled for a C-section to put the odds in favor of a healthy delivery.
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Q. I am six months pregnant, and I am an incredibly modest person. I was wondering if there's any way to remain at least slightly covered during my delivery? I am horrified at the thought of having everything out there for all to see, especially in front of my husband!
A. I, too, remember being quite concerned during my first pregnancy about the fact that many people were going to be staring at my crotch, possibly for hours, during the labor and delivery. I imagined being extremely humiliated and embarrassed. Well, I am happy to report that this did not happen and has never happened to anyone I know, no matter how modest they might have been. During labor in the hospital with all of the nurses and doctors examining you, modesty will be the furthest thing from your mind. Maybe labor releases some kind of anti-inhibition chemical. Or maybe it's the intensity of contractions that distract you.
I know it seems hardly comforting now, but believe me that when the time comes, you won't care one little bit.
Q. My uterus quit working after I was fully dilated with my seventh child. I did not realize I was that far along, but after about an hour and-a-half I suggested to the doctor that perhaps I should try to push the baby out myself. After I started pushing, my uterus started again. Is this common? Is there anything I can do about it now that I am expecting my eighth child? Will it happen again?
A. I don't think, after full dilation, a stalled uterus is all that common. I know I've never heard of it before. Maybe your uterus thought you had already delivered the baby. Maybe it just needed a little rest. Regardless of what happened, your mother's intuition told you what to do – you decided to push. That's all your body needed to wake up and realize that there was more work to be done.
It probably won't happen again, but if your contractions do cease during labor, you and your doctor or midwife should still closely monitor your dilation in case you need to give your uterus another kick-start.
No matter what complications may arise during labor and delivery, you should listen to your own intuition. After all, you are very experienced in the subject of childbirth.
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Q. I am a little worried due to the position of my cervix. It has always faced the back wall of my vagina. I am trying to conceive, but I am afraid that the birth is going to cause a fistula or at least be a very difficult delivery. How varied are cervix positions? Is there a name for this?
A. In most cases, a woman's uterus is positioned straight up. Sometimes the ligaments and tendons that hold the uterus in place will shorten or lengthen causing it to tilt. An anteverted uterus tilts forward toward the abdominal wall and a retroverted uterus (as in your case) tilts back towards the rectum. Whether it is tilting forward or back, a tilted uterus usually presents no problem during pregnancy. The uterus tends to straighten itself out by the second trimester as it grows and fills your lower body cavity.
In some cases, however, the uterus does not reposition. As it enlarges, it continues to push towards the back. Eventually, the baby runs out of room to grow and premature labor could occur.
You should mention your condition to your doctor if she/he is not already aware of it, so the position of your uterus can be more closely monitored. The worst case scenario is that you may require a device called a pessary that can be inserted into your vagina to help correct the backward tilting.
Q. The first time I had sex I started bleeding. The blood soaked through my jeans within five minutes. I went to the bathroom and tried to make it stop. It was coming out like I was peeing blood. I went to the ER and by that time there were blood clots coming out. I went into the OR and when I woke up, I had no idea what happened. The doctor that did the stitches told my mom that I tore on my left wall. What happened? How can you bleed that much from down there? I'm pregnant and I'm scared it will reopen in labor and it will happen again.
A. It sounds as if you had a tear in your vaginal wall, which can bleed quite a bit (as you found out). The vagina is surrounded by many large veins and arteries that could have been severed.
Now that you are pregnant, you should mention your previous tear to your OB/GYN so that he or she will be able to monitor the condition of this possibly weakened area. If your doctor thinks there may a risk of the prior tear becoming a problem during delivery, then you may be scheduled for a C-section. Just having your doctor aware of a potential problem beforehand is a huge advantage.
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