A Guide to Pregnancy

Everything you want to know but are afraid to ask
Dr. Tiffany Bates of Novant Mintview / image courtesy of A Beautiful Mess Photography

Ah, pregnancy. One of the most beautiful and strangest experiences of your life. From the nausea and constant need to pee to the first flutters of movement from the tiny creature inside you, you quickly learn your body is not quite your own anymore.

Navigating pregnancy is unlike anything you’ll experience. I was lucky to have a sister who’s an OB-GYN, so I could go to her with all my crazy questions. But for those without that luxury, I’ve asked rockstar Novant Mintview OB-GYN Tiffany Bates a series of questions about pregnancy you might have been afraid to ask. Her answers have been edited for clarity and space.

*For additional questions about diet, exercise, sleep, and more, be sure to consult your doctor.

Q: What are your odds of experiencing nausea during pregnancy?

A: I would say a large majority of patients experience some degree of nausea. Nausea probably occurs 70% of the time, but not always with vomiting, too. And it may not stop after the first trimester. That’s a misconception. Although it is less common, there’s no guarantee the nausea is going to stop at 13 weeks.

Q: At what point should you stop the crackers and ginger ale or the grin-and-bear-it routine and say, “Doctor, please put me on Diclegis?”

A: There are definitely safe medications to take during pregnancy, but there’s also a lot of fear surrounding it. Some questions to ask yourself: Are you getting through your day just fine? Is the nausea manageable? If you just need ginger ale and crackers, great. If you’re miserable, you don’t have energy, can’t keep anything down, or you’re losing weight, you can certainly be on medication.

Q: What are some natural remedies mothers can use?

A: Ginger candy, sour candy, wearing sea-bands, constant snacking, water with lemon, lemon-lime Gatorade…all those natural things.

Q: What is diastasis recti and who can expect to get it?

A: With the uterus enlarging, you get a natural separation between your two rectus muscles in the midline of your abdomen. It’s very common. The severity is going to depend on a lot of factors: somebody’s innate tissue strength, their fascial strength, and how large their baby was, if they have one or two babies, and their core strength before pregnancy. All those factors make a big difference. But there’s not a lot you can do to prevent it. Afterwards, thankfully, we have therapy for it. Pelvic floor physical therapy is so helpful in correcting diastasis. Unfortunately, insurance coverage isn’t always great for that. Luckily there’s a lot of information on YouTube and Instagram about ways that women can help themselves without needing to go in, but if they have the opportunity, I think all women should be evaluated and learn how to correct it.

Q: Is age a factor as well?

A: Your tissue is probably a little different in your 20s than in your 40s, certainly, but I’ve got some wonderfully fit 40-year-olds before they’re pregnant as well. And some not-so-fit 20-year-olds, so I think it depends on how fit you are before. Genetics make a huge difference as well.

Q: I didn’t know the pelvic floor was related. I always thought the pelvic floor was mostly about not being able to hold your pee.

A: It’s all related because all of that tissue is connected through your fascia. So pelvic floor weakness, core strength—t’s all interrelated. Fixing one tends to help correct the other, and vice versa.

Q: Speaking of incontinence, does it help to do Kegel exercises while pregnant or is it better to do them afterward?

A: It can’t hurt. Maybe it’ll slow the progression of any problems that are probably going to happen anyway. I even have patients that go see a pelvic floor physical therapist during pregnancy, too, especially if they’re already suffering from some urinary incontinence. It can also help them learn how to push properly, with the correct muscles, and make that process a little more efficient—especially first-time moms—and make the recovery of the pelvic floor easier.

Q: How effective is physical therapy for women who do it post-pregnancy?

A: There can be severe cases that may not be amenable to just pelvic floor physical therapy alone. But in most cases, I have a lot of women who find great improvement just by going to pelvic floor PT.

Q: Do people still ask for the “dad stitch?”

A: It’s not done anymore. You better not say that today in the delivery room as a partner or as a father. You’ll probably have a not-so-nice response. The nerve of him asking immediately after delivery to tighten the vagina for his pleasure, right after she’s pushed out a child and gone through pregnancy for nine to 10 months?

Q: What’s the medical reason not to do it?

A: It increases the risk for painful sex for her and scar tissue development.

Q: What do you tell your patients about having sex during pregnancy? 

A: As long as the mom feels comfortable having sex, there’s no problem from a safety aspect. Oftentimes, if they have a male partner, the dad worries that it could hurt the baby, but it won’t.

Q: Is it OK to get bikini waxes during pregnancy?

A: Absolutely. Pubic hair removal—whether you wax or however you do it—is safe. Keep in mind, nobody cares how much or how little pubic hair you have when you’re coming into the delivery room. It doesn’t change anything for us. The vulva in pregnancy is a lot more sensitive, so be aware it might be more painful than before you were pregnant. Another thing, I know women have a challenge actually seeing their vulva later in pregnancy when they have the big belly. So just try to do it safely, whether you shave or whatever you do.

Q: Any other questions you get from patients that we haven’t covered?

A: What about pooping or peeing during delivery? That’s a fun question. It’s definitely a possibility. It’s really no big deal, and almost expected, honestly. I always tell women “If you’re pooping, you’re pushing correctly, because those processes require use of a lot of the same muscles to get the job done right.” Also, as the baby comes through the birth canal, the head will often push directly on the rectum and that will push any poop that’s there out, so it’s inevitable. If it’s going to happen, it’s going to happen. Nobody blinks an eye at it.