We’ve all been there—yes, even me, a midwife. Sitting on that cold exam table donning a paper gown, stirrups looming in front of us and the doctor or midwife says, “Any questions?”
Um, yes? Two thousand questions, actually.
But instead we just say, “Nope, I think I’m good!”
Sometimes the idea of asking about the things we really want to know about feels too uncomfortable—primarily because our society has ingrained in us the idea that anything to do with the reproductive system is taboo, secret or even bad.
There is much I can say on that but for now, just remember that while you may feel uncomfortable talking about this, gynecologists, midwives, and women’s health nurse practitioners spend their entire day talking about it.
Seriously. We found this stuff so fascinating that we decided to spend our lives learning about, discussing, looking at and answering questions about it. So please, please don’t ever hesitate to ask.
But until you do, here the answers to some of your top gynecological questions:
1. "I’m not pregnant... but I SWEAR I can feel a baby moving in there sometimes. Is that normal?”
It is—they’re called phantom kicks or phantom movements, and while there’s no confirmed medical reason they happen, many women report feeling them.
Once you’ve felt true fetal movement, it’s believed that you become more sensitive to sensation in or around your uterus, and therefore pick up on feelings you previously wouldn’t have. You may be experience gas or rumbling in your intestines or some uterine irritability.
It can be pretty disconcerting, for sure. Some women enjoy it, while some get sad—especially if they have experienced a pregnancy or infant loss. Please don’t hesitate to reach out to a therapist if you’re struggling. You are definitely not alone.
2. “What’s the deal with these hemorrhoids?”
Hemorrhoids are swollen veins in your rectum or anus, that can protrude, bleed and cause discomfort. They are especially common during and after pregnancy. Constipation during pregnancy (and after) can also lead to hemorrhoids, especially if you are straining to have a bowel movement.
Hemorrhoids are generally not a cause for concern, but certainly reach out to your provider if they’re causing you discomfort, are large or bleeding a lot.
3. “I am about to give birth, and I will be so embarrassed if I poop while I push. Does that really happen?”
Okay, so... yes, it does. As the baby is moving down past your rectum, and as you push, often times some stool (poop) does come out.
But here’s the thing—IT IS SO TOTALLY FINE! I promise.
The nurses and doctor or midwife in the room barely even notice it. If anything, we get excited when it happens because it means that you’re doing a great job pushing and that the baby will be here very soon. We’ll just clean it away real quick and move on to the main event—you being a goddess mama giving birth to your baby.
I have attended a lot of births, and never once have I ever been involved in a conversation about whether or not someone pooped during labor. It’s just normal and no big deal. And, you’ll be so busy thinking about pushing and meeting your baby that you probably won’t notice either.
4. “When is vaginal discharge normal, and when should I be worried?”
Vaginal discharge is normal and healthy, and exists for a few reasons:
- It helps carry away dead cells and keeps the vagina clean.
- It helps carry semen up through the cervix around ovulation to increase the chances of getting pregnant.
You may notice that right after your period, your have very little or no vaginal discharge. It will then start up, but be dry and sticky. As you approach ovulation, it will get wetter until it has an egg white consistency (this is usually your time of peak fertility), and it will then taper off again until you get your period.
Healthy vaginal discharge is clear to white and has a sort of sour smell.
Possible signs that the discharge is not healthy include:
- Yellow or green in color
- Chunky, like cottage cheese
- Fish-like odor
- Itching, pain or discomfort in or around your vaginal area
- Lesions or bumps on or around your vagina
- Anything else that makes your nervous
5. “What’s the best way to keep my vagina clean?”
Soap and water. That’s it!
Douching is a method of cleaning the inside of the vagina, usually by squirting a store-bought mixture of water and vinegar into the vagina. It is almost never recommended.
Most of the things that women want to clean out of their vaginas—discharge and odor—are supposed to be there. They are normal and healthy parts of your body and don’t need to be washed away.
Vaginas maintain a delicate balance of good bacteria and acidity—douching kills this good bacteria and changes the pH, which increases the risk of developing infections, like yeast infections. Douching can also transfer bacteria further into the body, increasing the chances of pelvic inflammatory disease and sexually transmitted infections.
The best way to clean your vagina is simply with soap and water, and only on the outside. The vaginal area can be very sensitive, and using cleaners with lots of fragrances and chemical and cause discomfort, itching and infection.
6. “Every time I [cough/sneeze/laugh/do a jumping jack] I pee. Is there anything I can do about that?”
Oh, incontinence. The gift of motherhood you would rather turn down. Unfortunately, it’s super common. Researchers report that 3 to 17% of women experience moderate to severe incontinence, but from a talking-to-real-women perspective, I’d put the number closer to about 99%.
Being pregnant, giving birth and simply aging can make the pelvic floor weaker, which can lead to the inability to hold urine in, especially during anything that applies extra pressure (like laughing and jumping).
Treatment can be difficult. Many women try Kegel exercises, a tightening of the pelvic floor muscles, to help improve strength. Our friends at Yarlap have designed a device to reestablish pelvic floor muscle control—you insert it into your vagina for 20 minutes a day and it does the work of Kegels for you. Um, yes, please! ?? (Psst—use code MOTHERLY for $25 off.)
Also, know that there are pelvic floor physical therapists who can help you. You don’t have to just live with it if you don’t want to.
7. “I’ve lost interest in sex—is there anything I can do to find it?”
Almost everyone—men and women—go through periods in their lives where they have lower libidos and less sexual desires. So you are not alone. And it can be totally natural. There are so many reasons people can experience a decreased love of sex:
- Exhaustion and fatigue (hello, parents)
- Stress (hello again, parents)
- Hormone changes related to pregnancy, breastfeeding and birth (and once again, hello, parents)
It is kind of a wonder that new parents ever want to have sex with all of these factors!
Alcohol, tobacco, street and prescription medications and medical problems can also contribute to a decreased libido, so it is important to speak with your medical provider about it to make sure something more serious isn’t going on.
Beyond that, try not to pressure yourself—that stress usually only makes it worse.
That said, sometimes as parents, it’s really hard (read: impossible) to be spontaneous like you used to be, so if you need to schedule it in, do so. Just make a date for “us time”—if that turns into going to sleep at 8 p.m. together, great. If it turns into going to bed but not sleeping ? great as well.
Make sure to use lubrication, especially if you’ve recently had a baby or are breastfeeding, as the hormones can make vaginal dryness an issue.
Don’t underestimate the power of foreplay—yes, you are busy and time is limited, but a little foreplay can go a long way in terms of getting the heat levels rising.
And talk to each other. Good communication is so vital, and you’ll probably feel closer and more connected by doing it.
8. “Should I shave or wax my pubic hair before a pelvic exam?”
Certainly not for our sake!
Pubic hair exists for a number of reasons—warmth, protection from dirt and bugs and such going into places they shouldn’t, and pheromone trapping—pheromones being one’s scent that attracts just the right mate so that we produce offspring that are more likely to survive and further the species (pubic hair might be responsible for evolution, who knew?)
In this day and age, when there is less of a threat of the aforementioned bug problem, pubic hair may not as important as it once was. People choose to leave it, style it or remove. This is, of course, a very personal decision, though there are some risks with hair removal including burns, abrasions, ingrown hairs and infections.
Now that you are a pubic hair expert, I will tell you that your GYN or midwife doesn’t even notice it, really. We do somewhere between 5 and 20 vaginal exams a day, so we are simply unfazed by it. If you feel more comfortable removing your pubic hair, certainly go for it, but please don’t worry about being embarrassed by it or anything like that. It’s normal and healthy.