Pregnancy is a time of immense change in the human body – and with it comes a swath of symptoms and worries that mothers-to-be may be embarrassed or just scared to talk about. It’s tough to up and ask a doctor or a friend about baby bump size, “pregnancy brain,” bowel movements during labour, or how vaginas change after birth, to name just a few topics.
So INSIDER rounded up expert answers to some common questions about pregnancy, birth, and the postpartum period. Read on for answers.
1. What are the early signs of pregnancy — and when will I notice them?
The most common sign of pregnancy is a missing period, but you might also experience nausea, heartburn, constipation, tiredness, or breast tenderness,Dr. Talitha L. Bruney, medical director of OB-GYN at the Comprehensive Family Care Center,Montefiore Health System, told INSIDER.
“These can occur within the first six to eight weeks of pregnancy,” she added.
2. What are the odds of a false positive or a false negative on a pregnancy test?
At-home pregnancy tests work by detecting the hormone human chorionic gonadotropin (HCG) in your urine, Bruney explained. That hormone is only released when you’re pregnant.
In very uncommon cases, a miscarriage, some cancers, or certain medications may create a false positive result, she said, but most of the time, a positive result means you’re pregnant.
“It’s very unlikely to have a false positive,” Bruney said. “But all positive tests should be confirmed at a doctor’s office.”
False negatives are far more common, she added, because many women test too early. All pregnancy tests are most accurate when you take them after a missed period, according to Planned Parenthood. If you take one before a missed period, you’ll get less reliable results.
3. Is it possible to be pregnant and not know it?
In July, INSIDER reported on a Michigan woman who gave birth to a healthy baby boy – but claimed she didn’t know she was pregnant until she was in labour. Kelly Yakich told CBS affiliate WNEM that she had no baby bump, no pregnancy symptoms, and felt no fetal movement whatsoever.
For most people, pregnancy’s physical changes are all but impossible to ignore, Dr. Mary Jane Minkin, clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, previously told INSIDER.
But she added that it is possible to miss a pregnancy. The simplest and most common explanation is “a sense of denial,” she said, though there could be physical reasons a growing baby is hard to detect.
A bump could be less noticeable in a person who is heavier or in a person whose uterus sits deep inside the pelvis, according to Minkin. The position of the placenta – the organ that develops in the uterus to deliver oxygen and nutrients to a foetus – could also make a difference.
“When the placenta sits in the front part of the uterus – what we call an anterior placenta – it does blunt some of the [fetal] activity,” Minkin said.
Chalk it up as another reason to take pregnancy tests after a missed period, when they’re more accurate.
4. Is it really that dangerous to get pregnant after 35?
Women are born with a fixed amount of eggs in their ovaries and, as they get older, they’re left with fewer eggs that are more likely to have genetic abnormalities. This is why a woman’s fertility decreases with age. This decline starts around age 30 and speeds up in the mid-30s, according to the American College of Obstetricians and Gynecologists (ACOG).
When women get pregnant in their late 30s or 40s, there’s a higher risk for certain complications, including birth defects, miscarriage, stillbirth, multiple pregnancy (like twins or triplets), the ACOG website adds. Bruney explained that older women also have a higher risk of diabetes and high blood pressure in pregnancy.
This doesn’t mean that every person who gets pregnant after 35 will experience these problems. Bruney said she’s seen plenty of women around 35 or slightly older who have uncomplicated pregnancies.
But, statistically speaking, you are less likely to get pregnant and more likely to have certain issues if you get pregnant past 35.
5. Is it safe to exercise during pregnancy?
“For regular healthy women who are having a low-risk pregnancy, exercise is actually recommended,” Bruney said.
The Centres for Disease Control and Prevention (CDC) recommends that pregnant women get 150 minutes of moderate-intensity aerobic exercise (like brisk walking) every week. That breaks down to 30 minutes, five times a week.
Staying active during pregnancy has some benefits, too: It can reduce back pain, ease constipation, and may lower risk of gestational diabetes, preeclampsia, and cesarean delivery, according to the ACOG.
But there are some exceptions. People with certain health conditions or pregnancy complications should not work out while pregnant, the ACOG website adds. It’s best to ask your obstetrician about exercise at an early prenatal visit.
And those who haven’t been active – either in a while or ever – should take it slow.
“If you’ve not been to a gym in 10 years, [pregnancy] is not the time to start aggressive exercise,” Bruney said. Instead, the ACOG recommends starting with as little as five minutes of exercise daily, then working up from there.
6. What’s the deal with eating fish during pregnancy?
Some fish are contaminated with mercury, a heavy metal that’s been linked to birth defects. On the other hand, many fish are also packed with healthy omega-3 fatty acids, which may be important in promoting your baby’s brain health, according to the ACOG.
The bottom line: You can still eat fish while pregnant, but don’t overdo it.
“Two to three servings of fish week is absolutely fine, but you want to do everything in moderation,” Bruney said.
She also suggested avoiding bigger fish like shark, swordfish, king mackerel, and marlin. (Here’s a more complete guide to mercury levels in common fish.)
“The big fish are usually the more concerning fish because they tend to have higher levels of mercury in them,” she said. And finally, the ACOG says that pregnant women should not eat any raw fish. It may cause food poisoning, which poses serious risks to a baby.
7. Can I drink caffeine while pregnant?
Lots of studies have investigated a possible link between caffeine and a higher risk of miscarriage, but the results are unclear, according to the ACOG.
8. Do I really get to eat for two during pregnancy?
The phrase “eating for two” implies that you get to take in double the calories you normally ingest. It’s true that a normal-weight person should gain 25 to 35 pounds during a healthy pregnancy, but you don’t need many extra calories to accomplish this.
In fact, during the first trimester, you don’t need any extra calories, according to the US Academy of Nutrition and Dietetics (AND). During the second trimester, you need about an additional 340 calories a day, and in the third trimester you need roughly 450 additional calories a day, the AND adds.
9. Is it safe to fly while pregnant?
Travelling by plane every once in a while is generally safe for many mothers-to-be, according to the ACOG. Recent studies suggest that there’s no increase in negative pregnancy outcomes for “occasional air travellers.”
But air travel isn’t recommended for those who have pregnancy-related or general health complications that could be worsened by flying or that could require emergency treatment. The ACOG recommends scheduling an appointment with your OB-GYN before planning a trip to ensure your travel is as safe as possible.
You may also need to keep your due date in mind, since some airlines restrict travel after 36 weeks of pregnancy.
When on a plane, the ACOG recommends booking an aisle seat so you can easily get up to stretch every two hours or so. (Regular breaks to move and stretch help reduce the risk of getting dangerous blood clots.) The organisation also recommends wearing your seat belt at all times when seated.
10. Why do some people have really small baby bumps?
Baby bumps are often at the center of heated online debate. One famous example is Sarah Stage, also known as the “six-pack mum.” She’s been subject to intense scrutiny over her comparatively small, muscular stomach during both her pregnancies.
As Bruney put it: “People always have opinions about other people’s baby bumps.”
But there are lots of reasons bump size can vary, she explained. People who have a long torso or a uterus that tips backward in the body may end up with smaller bumps. Those who’ve had tummy tucks tend to carry small, too. Having more than one baby can also make a difference.
“A lot of women, their bellies protrude more when it’s their second or third pregnancy,” Bruney said. “The abdominal muscles are just not as strong.”
11. Is an ultrasound the only way to find out the baby’s sex?
There are plenty of old wives’ tales about how to determine a baby’s sex, but to get an accurate answer, you’ll want to see a doctor for testing.
Often, the baby’s sex is determined with an ultrasound between 18 and 20 weeks of pregnancy, according to the Mayo Clinic. This isn’t the primary reason ultrasounds are done, though. They’re used to evaluate a baby’s growth, check for birth defects, and more.
But Bruney said sex can also be revealed via tests used to screen for genetic disorders.
The non-invasive prenatal test (NIPT), done at eight to nine weeks, screens for some of those disorders and can determine a baby’s sex.
“This is a blood test on mum, because [there are] tiny fragments of baby’s DNA in mum’s blood,” Bruney said. “The issue is not all insurance pays for it, so some women have to pay out of pocket.”
There’s also a more invasive genetic screening test called amniocentesis, in which doctors collect a sample of fluid from the placenta that contains the baby’s DNA, she added.
These are more reliable than ultrasound when it comes to determining sex, Bruney said, but just as with ultrasound, these tests aren’t used solely for that purpose. Talk with your obstetrician to see which prenatal testing makes sense for you.
12. Is it dangerous for me to sleep on my back while pregnant?
Bruney explained that in the third trimester, when the uterus is its largest, major blood vessels on the back of the uterus can get compressed when a mum-to-be lies on her back. Some research suggests that the sleeping position is associated with stillbirth.
But Bruney said that plenty of pregnant women end up sleeping on their backs at some point during the night and are still fine.
“Clearly, women who lie on their backs do not all wake up with dead babies,” she said.
But if you can sleep comfortably on your side, it’s still considered the best, she said. Doing so can also alleviate pregnancy-related back pain, the ACOG adds.
13. Why does pregnancy cause gas and digestive issues?
It all comes down to hormones.
Pregnancy causes elevated levels of the hormone progesterone, which relaxes tissues all over your body, including your GI tract. This GI tract relaxation slows down the movement of your bowels, potentially causing gas, heartburn, and constipation, Bruney explained.
“It’s all because of the relaxation of the tissue,” she said. “It’s all the progesterone effect.”
14. Is it safe to get a flu shot when you’re pregnant?
Back in September 2017, a study published in the journal Vaccine discovered a potential connection between miscarriages and getting the flu shot in the first trimester of pregnancy.
But the single study didn’t prove that the vaccine causes miscarriages – and it didn’t change existing recommendations from experts.
The ACOG released a statement in response to the study, saying the organisation “continues to recommend that all women receive the influenza vaccine” and that the shot is “particularly important” during pregnancy.
One reason is that pregnant people are at a higher risk of dying and being hospitalized due to flu, according to the ACOG. Having the flu while pregnant also increases the risk of preterm labour and birth. Finally, when a mother gets the shot while she’s still pregnant, flu-fighting antibodies are transferred to her developing baby. These antibodies protect the baby from getting the flu until he or she is old enough to start getting vaccines.
15. Why do I feel so tired while pregnant?
The short answer is that it’s not easy to grow a baby.
“Pregnancy is a time when you’re building a whole entire person,” Bruney said. “[The body] is really undergoing a lot of changes to make all this new tissue from scratch. That is why women just feel so tired.”
16. Why am I having pregnancy cravings?
There are some theories that cravings are linked to hormonal changes or heightened senses during pregnancy, Bruney explained, but the truth is that we don’t really know why they happen.
“We have no idea the medical or scientific reason behind cravings,” she said. “There’s no clear reason.”
17. Is “pregnancy brain” real?
It seems to be, but scientists don’t know exactly why it happens.
“There seems to be some kind of change that occurs where women can have bouts of forgetfulness [during pregnancy],” Bruney said. “It’s a stressful time. Like any time in our lives when we are stressed and busy we may not be as productive. There’s no clear reason as to what actually happens. We think it’s really just the stress and excitement.”
18. Will I really have a bowel movement when I give birth?
Maybe, but it’s totally normal.
“The muscles you use to push a baby out are the same ones you use to have a bowel movement,” Bruney said.
In other words, if it happens, it means you’re pushing correctly.
19. Is there any way to prevent stretch marks?
Reddish stripes known as stretch marks may show up on your growing belly during pregnancy. Some pregnant women get them on their butts, breasts, or thighs, too, according to the ACOG.
But there’s not a whole lot you can do to prevent them. In 2015, a group of researchers looked at the existing evidence on topical treatments for pregnancy stretch marks. They concluded that reliable prevention methods are “scarce.”
Bruney said that avoiding excessive weight gain during pregnancy may help prevent stretch marks, but sometimes they’re just inevitable. Most stretch marks do fade after pregnancy, however, according to the ACOG.
20. Will my vagina always be different after delivery?
Bruney said that the way your vagina recovers after delivery depends on how it was before you gave birth. People at a healthy weight with strong pelvic floor muscles are more likely to “bounce back,” she explained.
But difficult deliveries,assisted deliveries (when doctors use a vacuum or forceps to help pull out a baby), and an episiotomy (an incision made just below the vaginal opening) can cause more vaginal trauma and longer recovery.
While recovering from childbirth can takes weeks or even months, the vagina is a highly elastic organ that’s made to expand and contract. Although doctors will be able to tell that you’ve had a vaginal delivery and your vagina may never be exactly the same, with time, it may look and feel very close to the way it was before you gave birth, according to What to Expect.
Pelvic floor exercises (also known as Kegels) can help the vagina and all your pelvic floor muscles rebound after birth. Here’s a step-by-step guide explaining how to do them.
21. When can I start having sex after giving birth?
Doctors used to recommend that women wait until after their six-month postpartum checkup before resuming sex, Bruney explained, but really, you can start whenever you feel ready.
“Women know when they are ready to resume sexual activity,” she said. “It’s up to them.”
- Read more:
- 1 in 20 pregnant women suffer from eating disorders – and it can affect them long after the baby is born
- People are ‘bump shaming’ Meghan Markle for getting bigger during pregnancy
- Hilary Duff ate her placenta in a ‘delightful’ smoothie after giving birth, but doctors think it’s a bad idea
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