What They Don't Tell You About Pregnancy, Labour and Postpartum!

What They Don't Tell You About Pregnancy, Labour and Postpartum!
Nikki C is wearing the 'Evolve Bra' and the 'Aspire Top' in neo.

When I was pregnant with my first son, every time I met with a mum, I’d find something out about labour, pregnancy or the early weeks postpartum that I had NO idea about previously. Things like raw and bleeding nipples from nursing, the fact areolas and the pregnancy line (linea nigra) on your stomach darkens so your baby can find its way to your breast when it arrives (I know right?!). I learnt that milk comes out of more than one hole (LOL!). I was constantly being told new things, and when I had my baby...oh lordy...did I find out a thing or two then as well! Ummmm...I have to give birth to the placenta? What?! No one told me that!

Was I just a giant ignoramus, or are there lots of things many mums-to-be just don’t pick up on until they’re faced with it? Turns out...I’m not entirely an ignoramus...in fact, many of us get a heck of a shock when we are confronted with the realities of this journey. Recently I asked members of the Cadenshae Facebook group what they never knew about pregnancy, labour and postpartum until after the fact…AND THERE WERE A LOT OF UNKNOWNS! I wasn’t alone. Thank goodness.

So much of the information shared I STILL had no clue about and I’ve had two babies and am constantly surrounded by fellow mothers! There were a number of things highlighted that many women felt others should be made more aware of...hence this blog. At Cadenshae we want to inform any pregnant woman out there on the things you don’t always hear about, but should know about! 

Oh and just before we get stuck in, I want to point out that I’m not trying to ‘scare’ anyone. A lot of the things below I didn’t experience, and many of the things below you won’t experience either...but you just might endure maybe three or four of them...and if you’re more clued up on those three or four things, then I think that has got to be a good thing. Knowledge is power. Understanding something takes away the fear...we’re not trying to terrify, we’re trying to prepare and educate you (and in doing so, I’ve definitely educated myself)!

So, read on, learn up...you’ve totally got this!

WHAT YOU PROBABLY DIDN’T KNOW ABOUT PREGNANCY:

Michelle is wearing the 'Evolve Bra' and the 'Classic Maternity Leggings' in black.

1. For some, sex is pretty special (more so in the early days when your belly isn’t too large!) as your bits and pieces are extra sensitive...everything is heightened. I’ll leave it at that.
2. Perineal massage. This is when you (or your lucky partner!) massages the area between your vagina and anus (perineal), in order to stretch and better prepare it for labour...sheesh!
3. Exercising in your first trimester can increase the size of your placenta, meaning your baby has an increased supply of nutrition. Get movin’ mama!
4. It’s rare, but some women experience extreme saliva build up in their mouths! It’s a strange one and most often reported by women who also have morning sickness.
5. Due to hormonal changes in your body, your hair might become quite thick and luscious during pregnancy...but then fall out post birth. Dumb.
6. Relaxin (a hormone you release in pregnancy to prepare your body for labour) can cause your feet to go up a size. This could be permanent!
7. You may become iron deficient during pregnancy and be given tablets to combat this. Just so you know, iron tablets make your poop BLACK.
8. Pregnancy can cause you to get varicose veins around the outer surface of your vulva (does anyone else find that word quite...intense?). It’s due to the extra blood volume in the pelvic region and the associated decrease in how quickly your blood flows from your lower body to your heart. Fun.
9. While your skin stretches and grows to accommodate baby and milk, your skin can get incredibly itchy and dry (I had this big time, not cool).
10. Continuing on the topic of itching...PUPPP (pruritic urticarial papules and plaques of pregnancy) is a super itchy rash that appears in stretch marks on the stomach during late pregnancy. 
11. We’re not done scratching yet! Cholestasis of pregnancy is a liver condition that triggers intense itching, but without a rash. Itching usually occurs on the hands and feet.
12. It’s best to sleep on your left side during pregnancy. Why? Because your liver is on the right side of your abdomen, lying on your left side helps keep the uterus off that large organ. Sleeping on the left side also improves circulation to the heart and allows for the best blood flow to the fetus, uterus, and kidneys.
13. Round ligament pain is a sharp or jabbing pain often felt in the lower belly or groin area on one or both sides. It’s most often felt during the second trimester (around week 17 specifically). Several thick ligaments surround and support your uterus as it grows, one of them is called the round ligament. As your baby and womb grow, the round ligament stretches, causing pain. I had this and to be honest I was so scared, I thought I was losing my baby. It was week 17...googled and immediately felt better. It was such an intense pain and something I WISHED I knew earlier in order to stop the plethora of tears and worry I felt before researching!
14. Leg cramps are super common. We’ve actually written a whole blog about this which includes information on Symphysis Pubis Dysfunction (SPD). Click here for more information.  
15. Nearly a third of women will experience restless legs syndrome (RLS) when pregnant. People who have restless legs syndrome describe it as an itchy, pulling, burning, creepy-crawly feeling that gives them an overwhelming urge to move their legs. Once they move their legs, the feeling often subsides.
16. Hot feet! I had this one...bad! Hot feet at night during the third trimester is quite common and is the pits! It’s caused by increased pressure on the feet (due to weight gain) which causes swelling.
17. I never knew this until just recently, and I think it’s amazing. Some women can actually harvest their colostrum before giving birth. From about week 36 women can produce colostrum which can be hand expressed and then frozen to use at a later date if needed. Women who have diabetes are encouraged to do this because a baby born to a diabetic mother is at risk of low blood sugar after birth. Receiving extra colostrum at this time can help a baby’s blood sugar level to stabilise. Frozen colostrum is also handy for those babies who may find it hard to breastfeed, e.g. babies with cleft lip and/or palate, or a neurological or cardiac condition. How good right?
18. Hyperemesis gravidarum (HG - what the Duchess of Cambridge gets) is an extremely severe type of nausea during pregnancy. Symptoms include nausea, feeling faint or dizzy when standing and persistent vomiting. This condition can require hospitalisation with patients receiving IV fluids and anti-nausea medications. For those that get this, the pregnancy journey is so, so rough...hats off to you ladies.
19. Pregnancy Rhinitis. Do you have a blocked nose that doesn’t seem to go away? The cause of this condition isn't really clear, however it’s probably caused by hormonal changes...those damn hormones again!
20. The placenta attaches to the wall of your uterus, and its position can be anywhere — front, back, right, or left. If the placenta attaches to the back of the uterus, it's known as a posterior placenta. If it attaches to the front of the uterus, it's called an anterior placenta. Both types are common. With a posterior placenta, mothers may feel stronger movements and kicks of the baby earlier on during their pregnancy.
21. Have you ever experienced a sudden sharp pain deep inside your crotch? Like an electric shock, maybe with some burning, pins and needles, or stinging? If the answer is yes, then you’ve experienced what's known as ‘lightning crotch.’ This uncomfortable pelvic pain is common during late pregnancy, and hits without warning. The pain from ‘lightning crotch’ should last just a few seconds.
22. Pregnancy can make the blood vessels in your nose expand, and your increased blood supply puts more pressure on those vessels, causing them to rupture. That's why nosebleeds are common during pregnancy – 20% of pregnant women get them.
23. Some studies have shown pregnancy carpal tunnel syndrome can affect around 60 percent of mums-to-be. Expecting women (especially those who work at computers) may begin to notice an uncomfortable tingling, pain, burning and numbness in the wrists, hands and fingers. Though it's usually associated with work that requires repetitive motion such as typing or sewing, carpal tunnel can strike any pregnant woman.
24. 'Cheeseburger crotch.' Yep..it’s a thing. ‘Cheeseburger crotch’ refers to the swollen vagina during pregnancy...someone at some point thought a swollen vagina looked like a cheeseburger. So there ya go...McDonald's anyone?
25. Hip pain. I had this big time...all to do with the relaxin hormone once again. Changes in posture and a heavier uterus may also contribute to the ache. As you get closer to your due date, your baby will change the position in your uterus, which will hopefully reduce the discomfort.

WHAT YOU PROBABLY DIDN’T KNOW ABOUT LABOUR:

Nikki C gave birth to Billie in the 'Smoothie Crop Bra' in black/confetti.

1. Have you heard of a mucus plug? Sounds so lovely doesn’t it? A mucus plug is commonly referred to as a ‘show’ and can be one of the first indications that you're in labour. The mucus plug accumulates at the cervix during pregnancy and when the cervix begins to open, the mucus is released. It may be clear, pink, or slightly bloody and can be quite hefty in size - around two tablespoons worth of ‘matter.’
2. It’s common to vomit during labour or soon after, due to all that adrenalin surging through your body. I remember my midwife saying, ‘Ellen, do you feel sick...’ and then I vomited everywhere...just as she brought it up. Loved it.
3. Did you know a squat position during labour increases the pelvic diameter by 30%! That’s 30% more room for the baby to move through...you DO NOT HAVE TO BIRTH ON YOUR BACK!
4. Back labour pains...you don’t hear about these often, and it was a shock to me as I experienced back labour pains. They were FAR more intense than my uterine contractions. Back labour is an intense pain experienced in the lower back. It usually happens when a baby is positioned with his head down toward your cervix but is facing forward, toward your stomach. Your tailbone is literally moving out of the way. The vast majority of babies turn to face backwards on their own before their mums are ready to deliver. It hurts. 
5. The groan you make when you’re ready to push is something utterly animalistic and can not be mimicked once you’re out of it. You literally sound like a cow.
6. It’s pretty common to poo during labour, don’t worry about it...I can tell you now, you just won't care when you’re in the throes! It's normal and your nurses and midwives will deal with it. Don’t stress about it! They’ve seen it ALL before!
7. Inductions can last for four days...
8. The ‘ring of fire.’ You’ll get why it's called this when you experience it for yourself. The ‘ring of fire’ is when the labia and perineum (the area between the vagina and rectum) reach the point of maximum stretch. It’s called the ‘ring of fire’ because of the burning sensation felt as the mother's tissues stretch around the baby's head. It’s a real humdinger!
8. It’s pretty common to tear during childbirth, but you may not be aware of the different ‘degrees.’ First degree tears are small and usually heal naturally. Second degree tears affect the muscles of the perineum and the skin, these usually require stitches. A third degree tear extends away from the vaginal wall towards the perineum to the anal sphincter (another one of those ‘intense’ words!) and will require stitches. And finally, a fourth degree tear extends to the anal canal and rectum...definitely requiring stitches. Yay.

WHAT YOU PROBABLY DIDN’T KNOW ABOUT POSTPARTUM:

Nikki C is wearing the 'Bamboo Long Sleeve Top' in peacock.

1. As mentioned above...once you’ve had your baby, it’s not over. Just as things start to calm down, you’ll have to give birth to your placenta. You will experience a few more contractions to do this. These contractions may not be as intense as those you had when you gave birth to your baby, but you still have some work to do! 
2. Also, sometimes medical professionals might try and help you get the placenta out if it’s ‘stuck.’  They ‘massage’ your belly to do this, but just be wary, it’s not like a massage, massage - it’s more like they’re trying to rearrange your insides.
3. The placenta detaching is what tells your body to produce more milk...‘baby is here!’ So if you have a little bit of your placenta remaining inside you (it will need to be removed) you may have trouble with your supply. If you’re thinking of making your placenta into a pill form, or eating it, keep this in mind too, it could affect your milk supply as your body thinks it's still there...
4. It takes 4-6 weeks just for your placenta wound to heal postpartum after a vaginal delivery...and the wound can be the size of a dinner plate. So take it easy...they say not to do too much during the first six weeks for good reason.
5. Be aware of a prolapsed uterus. A prolapsed uterus occurs when the pelvic muscles and ligaments that support the uterus weaken to the point where they no longer support it. This condition is common with vaginal births, but women who have never given birth can also develop a prolapsed uterus. In severe cases surgery will be required.
6. Shivering post birth or postpartum chills may relate to fluid or heat loss and hormonal changes in your body after you give birth, vaginal or caesarean section.
7. If you have torn and had stitches, your first ‘wee’ after birth can be incredibly painful. It’s a good idea to have some ‘Ural’ sachets on board as they neutralise your urine and can ease the sting. Also, you could pee in the shower and use the shower head to wash away the urine, or you could use a water bottle to spray on the area as you urinate in the toilet. 
8. You might want to make your first shower after birth just a warm one, not a stinking hot one. Temperatures that are too high could cause you to faint.
9. After pains. This one took me by surprise and was awful to be fair. ‘After pains’ occur when your uterus is contracting back to its normal size. It can happen for a week or two after birth. Breastfeeding can bring on the pains as nursing your baby sends messages to your brain saying ‘the baby is definitely here...the uterus can go back to normal now!’ This was probably the one that was the most shocking to me as a new mum. Have a hot water bottle and some painkillers on hand...you’ve been warned!
10. Night sweats! So many women spoke about this. You might wake up completely drenched in sweat due to postpartum ‘night sweats.’ Your pregnancy hormones are the culprits here again, as they instruct your body to rid itself of all those extra fluids it was using to nourish your baby. Lots of perspiration is completely normal in the weeks following birth.
11. If you don’t ‘fall in love’ with your baby straight away, don’t worry. It’s common. You’ve been through a lot both mentally and physically and your hormones are all over the show. Don’t stress, you’re still a fantastic mother, and it will happen, give it time.
12. Hemorrhoids (swollen veins in your rectum) and anal fissures (a small tear in the skin that lines the anus) are extremely common post birth. Get some ointment to help with this.
13. Just on this line of thought...your first poo post birth will be scary. You may feel like everything is about to fall out...it’s not. Just breathe.
14. You may experience incredibly swollen feet after birth. Mine were massive. It’s all due to the extra fluids you’re carrying. They will go down in a few days. 
15. You may bleed for about 4-6 weeks post birth.
16. Many women won’t get their periods for a long time...especially if breastfeeding.
17. When you do get your period, the first one may be quite heavy and you may experience heavier periods than ever before from here on out now you’re a mother. Yay.
18. Midwives can contradict each other. I experienced this and found it very confusing. Just understand that like all mothers, midwives have their own way of doing things. Listen to them, take what you will from each and do things your way.
19. Vaginismus can be caused by childbirth. It’s a condition involving a muscle spasm in the pelvic floor muscles. It can make it painful, difficult, or impossible to have sexual intercourse, to undergo a gynaecological exam, and to insert a tampon.
20. You can get postpartum preeclampsia. It's rare, but can occur when you have high blood pressure and excess protein in your urine post birth. Good to know.
21. Shoulder tip pain is a common (but a mostly neglected consequence) of a c-section and can be extremely painful. The pain is described as sharp, deep and referred, and usually begins intra-operatively and continues for 2-3 days post surgery. The cause of the pain is due to trapped air, a sub-diaphragmatic clot or peritoneal irritation. Heat massage and drinking hot water or tea with fresh lemon can help relieve the pain. Painkillers help too!
22. Trapped gas and constipation is another not-so-friendly side-effect of a c-section. It can take a few hours or days after your c-section for your bowel to start working again. This can be very painful.
23. Women can feel phantom fetus-like kicks for up to 28 years after giving birth. WHAT?! New research has found that 40% of women feel phantom fetal kicks after giving birth and that the sensation persisted for an average of 6.8 years following delivery. Whoa, intense!
24. Postnatal Post Traumatic Stress Disorder (PN PTSD) is a real thing. PTSD is the term for a set of normal reactions to a traumatic, scary or bad experience. Unfortunately for some, giving birth can also be a traumatic experience. To learn more on this, click here.
25. Your baby’s first poo will be black, thick and sticky. It’s called the ‘meconium poop.’ Meconium is composed of materials ingested by baby while in your uterus. It’s funky, just beware and get your partner to do the first change! ;)
26. Tongue-ties...know about this and ask your baby to be checked immediately if you suspect something is wrong and if they're not latching onto your breast properly. Tongue-tie is when a baby has an unusually short, thick or tight band of tissue (lingual frenulum) that tethers the bottom of the tongue's tip to the floor of the mouth. This can make it hard for a baby to latch and can cause a lot of damage to the mother’s nipples if not picked up early enough. Tongue-tie can be treated with a quick surgical cut to release the frenulum (frenotomy).
27. You and baby may have to learn how to breastfeed, it doesn’t always come naturally. 
28. Blocked milk ducts and mastitis. Your milk ducts can become blocked which is painful, but harmless. However, sometimes these blocked ducts become infected, resulting in mastitis. Mastitis, or inflammation of the breast, is common in women who’re breastfeeding. The incidence has been reported as 20% in the first six months after birth. Mastitis can be caused by obstruction, infection and/or allergy. Early symptoms of mastitis will feel like the flu, with many women experiencing shivers and aches. Some mothers who do not have any early signs of a blocked duct may get mastitis out of the blue. The breast will be sore like it is with a blocked duct, only more painful. It is usually red, swollen and hot. The skin may be shiny and there may be red streaks. You may feel quite unwell. One of the causes of mastitis is restricted milk flow, which may be a result of too much pressure on a part of the breast. If a breastfeeding woman wears a bra that doesn't fit well - thus placing consistent pressure on the breast tissue - this can lead to blocked ducts and potentially mastitis. Cadenshae bras help to prevent mastitis as they do not restrict the breast or have underwires placing extra pressure on the tissue. Just saying! ;)
29. Just on this one too...you can book into a women’s health physio for ‘ultrasound therapy,’ to help clear blocked milk ducts. I didn’t know about this until now, but I will take this one on board for baby number three for sure! 
30. Cluster feeding. This can be a full-on time for breastfeeding mothers, so lean on your village for support. Cluster feeding is when babies feed closer together in order to build up the mother’s milk supply. Your baby will be pretty much attached to you while this happens, hence you need more support.
31. Babies can lactate too! Even baby boys! Those hormones again...it’s called neonatal milk, or ‘witch’s milk’ and is secreted from the breasts of some newborns. Neonatal milk secretion is considered a normal physiological occurrence and no treatment is necessary. Also, because babies can lactate, they can also get mastitis...madness!
32. Baby girls can get a wee period! About one in 10 baby girls will have ‘a small amount of menstrual blood’ between their 4th and 14th day of life. This mini period is not uncommon and doesn't last long. It will generally not appear again until puberty. Again, all those hormones are wreaking havoc!
33. Some babies may vomit up mucus/blood postpartum. If you see some red flecks or pink-tinged newborn vomit, the source is most likely maternal blood. The blood came from you, either by the baby swallowing blood during the birth process or from your breasts or nipples during breastfeeding.
34. You may very well wake up in the middle of night convinced you’re sleeping on your baby or suffocating it, then quickly rummage through the sheets trying to find your baby. I experienced this and neither of our babies ever slept in our bed! You’re so consumed by this small child that it’s extremely common to wake up in a frenzy like this. It all comes down to normal motherhood anxiety and should go away in a few weeks’ time. Just like any massive life change, you’ll most likely dream about it, plus you’re already sleep deprived from multiple wakes a night, so your mind is playing little tricks on you! 
35. When sleeping, babies are to be placed on their backs to help prevent SIDS (sudden infant death syndrome), and because of that, more and more babies are now developing ‘flat spots’ on their heads. This is because they may prefer a particular side to sleep on, or they don’t yet have the strength to be able to regularly move their heads from side-to-side. To learn how to prevent flat spots, click here.
36. Here’s another condition I had absolutely no idea about until now. Dysphoric Milk Ejection Reflex (D-MER). It’s an abrupt emotional ‘drop’ that occurs in some women just before they release their milk, and continues for a few minutes. The negative feelings range in severity from wistfulness to self-loathing, and appear to have a physiological cause. Clinicians can support women with D-MER in several ways; often, however simply knowing that it is a recognised phenomenon makes the condition tolerable. 
37. And here’s yet another one I had no clue about! Raynaud’s phenomenon in nipples. Breastfeeding women with Raynaud’s phenomenon experience debilitating nipple pain that usually follows feeding (although it can occur during feeds) and may last for hours. When the warm mouth of the baby comes off the breast, the face of the nipple, or part of the nipple, will blanch white and burning pain begins. The nipple can go through several colour changes (white, blue, red) and the entire breast may throb. Ouch! Gosh we women go through a lot!
38. If you have inverted nipples and breastfeed, your baby can suck them out. My babies got my inverted nipple out for good! Hooray!
39. Not all women produce enough milk, and some have an oversupply.
40. Your boobs may leak and you may need lots of breast pads. Be prepared for drenched pjs and sheets in the morning if your baby sleeps through a feed!

Sheesh, what a collection of warnings, information, experiences and knowledge! Just one more from me though...I was completely unaware of how deeply troubled and affected I would be every time I saw a hurt, abused or sick child on the news, a T.V. programme or on the movies. Even baby animals! Fictional or real, human or animal, my heart just breaks if they're in pain! I am more deeply moved by negative things relating to children than ever before. Be wary of that one...you’ll soon find yourself crying at the drop of a hat...motherhood...it changes you all right.

There will be things we have missed out, no doubt, but I feel this is a pretty good foundation of information. Knowing a little bit about all of the above alongside what you’ll naturally research, your antenatal classes and the advice you’ll receive (wanted or not!) from family and friends...you should be pretty well covered in terms of ‘what to expect when you’re expecting...’

Go well mamas...you can do this.

Written by Ellen Chisholm.

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