Is This Normal?

There are so many aches and pain during pregnancy.  At times it is hard to tell what it is concerning and what is not.  A huge question I have been asked lately is, “When should I  call my doctor? Is this normal?”  The thing about pregnancy is, so much is going on with your body and everyone is different.  You can not pinpoint a “norm” because what may be completely normal for one woman, could be concerning for another.

It is very rare that women fly through pregnancy with ease and never have a situation where calling the doctor is necessary.  If you are one of those women, I am jealous!  I managed to have kidney stones, pyelonephritis (kidney infection), hyperemesis, fluid leak at 27 weeks, the list goes on.  Like you, I questioned, when do I need to all the doctor?  I was always so worried about being an alarmist because so many things feel uncomfortable and are changing during pregnancy.

A rule of thumb is when in doubt, call your doctor or midwife.  You want to be safe than sorry.  I just want to educate you further so when you do call your doctor or midwife you have a bit more knowledge on what you may be calling about.  So many times I went in a nervous wreck when it was nothing or I would go in completely calm and end up at the hospital.  Here are some questionable times for women, normal or not, and when to call your doctor or midwife.

Bleeding:

Bleeding can happen in the first trimester and this is because of implantation of the fertilized egg in the lining of the uterus.  No matter what the circumstance, if you have bleeding always call your doctor or midwife.  Especially if it is associated by cramping.

Fluid Leak:

Any fluid leak is tricky because some women can experience some incontinence throughout the pregnancy.  Yup, you could pee yourself.  This can often be confused with thinking your water has broken.  In my own experience, I had some fluid and at first I didn’t really say anything, then I showed my mom and we called the doctor.  When I called the doctor, she said it was probably urine and not to be too concerned.  I called back and they were closed so I got the on-call doctor who brought me right in to the hospital.  I kept having nurses and doctors explain that sometimes you can pee during pregnancy but I knew this wasn’t pee.  They did 3 tests to see what was going on and test the fluid, turns out it was NOT pee...it was amniotic fluid.  The story goes on, but back to my point, it is difficult to tell so don’t hesitate to call your doctor or midwife.  If you feel you aren’t getting answers you must be your own advocate!

Frequent Urination:

It is totally normal to be running to the bathroom more than ever before.  The baby can be pressing on the bladder causing this.  It becomes a problem when you are urinating frequently and have pain, burning or any discomfort during urination.  Also, beware of a constant urge to go.  This could be from the baby’s position but could also be signs of a Urinary Tract Infection.  

Changes In Discharge:

You will find changes to vaginal discharge throughout your pregnancy.  Discharge is totally normal but watch out for any itching, burning or unusual odor that may be associated with the discharge.  Be sure to mention any changes to your doctor or midwife.

Depression:

Prenatal Depression is something that is sometimes over looked.  How blue is too blue?  Being uncomfortable and miserable during pregnancy is normal depending on your situation.  If you find you are lethargic, having excessive mood swings, uncontrollable crying, and constantly feeling hopeless, you need to make sure you address this with your doctor or midwife immediately.

Nausea/Vomiting:

Be sure to monitor your nausea/vomiting.  If you are finding there is no relief and it is getting worse, it most likely is not just morning sickness.  The predictable spurts of nausea and vomiting that can be relieved would be classified as morning sickness.  If you are finding nothing will help and it is all day and all night with no let up, it could be hyperemesis.  Talk to you doctor immediately to see what you can do to help stay hydrated and as healthy as possible through your pregnancy.

Swelling:

Having swelling during your pregnancy can be normal, but it can also be a sign of some serious complications.  During pregnancy, all the hormonal changes will cause some water retention and minor swelling.  If you find any sudden swelling in your hands, feet, and/or face accompanied by headaches and/or blurred vision call your doctor or midwife immediately!  These are signs of a serious complication called preeclampsia.  You may also hear the terms, gestational hypertension, pregnancy induced hypertension or toxemia.

Contractions:

A huge sign of labor, contractions.  How do you know when they are real or not?  I kept asking my mom throughout my pregnancy, how will I know?  Her response was always..”you’ll know.”  It could not be more true.  I was in what is call inactive labor for 2 weeks prior to delivery.  Inactive labor is when you are have true contractions but not dilating.  Some women experience Braxton Hicks contractions, which are practice contractions, prior to real labor.  The Braxton Hicks can be uncomfortable but definitely are not the real deal!  I had Braxton Hicks which were tightening and slightly uncomfortable.  When the real thing hit, I couldn’t even speak when I was in a contraction.  It is a tough call of knowing when to go and when to stay.  Timing your contractions is important.  Contractions in early labor last from 30 to 60 seconds and will be 5 to 10 minutes apart.  Let you doctor or midwife know and they will guide you.

These are some just instances where it is hard to tell what is normal or not.  I hope this gives you some more information.  As I said before, when in doubt do not hesitate to call your doctor or midwife.  You can never be too safe when it comes to pregnancy.  So much is unknown so it is normal to question things going on with your body.

What About Prenatal Depression?

        Morning y’all! I want to talk about something that seems to be swept under the rug, prenatal depression.  Prenatal depression was never mentioned to me through my pregnancy by any doctor or midwife.  I went to the doctor the day my son was born because I hadn’t felt any fetal movement for almost 24 hours, naturally I was a little anxious.  Being sick for 9 months with hyperemisis, little to no sleep and other health issues, 3 weeks away from my due date, you could say I was a little on edge.  I had huge dark circles under my eyes, I was a nervous wreck because no movement was far form the norm for my baby boy, and let’s not forget I had been throwing up everything I ate for 9 months.  I was on the table with my mom in the room getting an exam to see how far dilated I was, and my doctor asks me...”are you depressed?”  Now!? You ask me now when I am 3 weeks away from my due date and have been going through this for 9 months!  Mind you I was high risk so since 16 weeks gestation I had been at the doctor every 2 weeks for my prenatal visits.  Needless to say, I was not happy.  She followed that statement with...”I just want to make sure I am not missing anything.” Depressed I was not, ready for the pregnancy to be over, I was.  I am telling you this because it absolutely floored me that 3 weeks away from my due date after seeing me every 2 weeks for 9 months suffer I was asked this.  I was not upset that I was being asked if I was depressed, I was upset and shocked that I was being asked this so late in the game.  If the doctor wanted to make sure she wasn’t missing anything, she would have asked at the first signs of me seeming off to what she was normally used to, rather than letting it go for 9 months.

I feel it is so important that you be your own advocate and pay close attention to your body.  Talking to your partner about any changes you may be having is really helpful also because an outside perspective can always see things that perhaps you can’t.  There are a few reasons you may be at higher risk for prenatal depression.  It doesn’t necessarily mean you will experience it but some reasons it is a possibility are:

• complicated pregnancy

-bedrest

-genetic testing

-prior health issue

• history of depression or anxiety
• prior miscarriage
• financial and job concerns
• relationship problems
• unplanned pregnancy

If you fit any of the above, you are at risk for prenatal depression.  That is not to say that  you can’t have prenatal depression if these things haven’t happened to you  Also, just because these may describe you doesn’t mean you will have prenatal depression.  Some symptoms to look out for may be:

• emptiness or sadness
• irritability
• lack of sleep
• too much sleep
• lack of concentration
• guilt
• panic attacks

If you are experiencing any of these symptoms contact your doctor or midwife.  Make sure you talk to them about how you are feeling.  Emotional health is equally as important as your physical health during pregnancy.  Be your own advocate and make sure you express to your doctor or midwife exactly what is going on and how you are feeling.  Depression can be environmental in some cases.  Most of the time it is a biochemical condition so it can be difficult to avoid.  In those instances that the depression is environmental, there are a few ways you can help in preventing prenatal depression, such as:

• Spend time with your partner
• Talk to your partner or counselor about any fears or anxiety you may be having
• Yoga classes or some form of meditation
• Have a healthy and nutritious diet
• Try your best to get out of the house
• Pamper yourself

For women who do have prenatal depression, know you are absolutely not alone.  Make sure you speak to your doctor or midwife right away to work on some ways you can deal with this.  I hope this helps in letting you know it can happen and does for one in eight women.  Stay informed and keep yourself in the loop with what is going on with your own body.