Changes to the Body During Pregnancy

First, let me state that we will not review all of the astonishing changes the body goes through during pregnancy. For the purposes of this newsletter, we will solely focus on changes that impact sexual functioning. I also want to add that every pregnancy is different and the symptoms experienced during pregnancy vary wildly from person to person. Some women skate through pregnancy and swear it’s the best they have ever felt in their life. They feel full of energy and vitality. For my well-being, I choose to celebrate these stories from afar. My pregnant experience feels tantamount to having a never ending stomach flu, a 20 pound bowling ball on my bladder that creates random leakage especially during a spirited sneeze, hemorrhoids the size of grapes due to chronic constipation, and constant fatigue upon walking to the bathroom. In the spirit of full transparency and humility, let’s review some of the common changes that I and may other women have encountered during pregnancy.

1. Baby neosporin. Leukorrhea, affectionately known as baby neosporin, is vaginal discharge composed of a mucus-like substance containing cells from your body. While present in the vagina outside of pregnancy, Leukorrhea production can increase during pregnancy. It serves the purpose of keeping the membranes moist, clean and infection free. Leukorrhea can take the appearance of a thick, white milky substance. It can also leave a chalky stain in your underwear. It is generally mild in smell but, in my experience, differs from what you are accustomed to for your body.

2. Morning sickness. If ever there was a misleading name, it’s morning sickness. I suggest that this be renamed to waking sickness to allow for increased awareness that if you are awake, you may be sick. Some women, yours truly being one, are highly sensitive to the increase in pregnancy hormones. While most women experience some occasional nausea or vomiting, less than 2% will develop a condition known as Hyperemesis Gravidarum (HG). Common symptoms of are increased salivation, severe nausea, throwing up more than 3 times a day, weight loss, dehydration and fatigue. HG is commonly treated with both over the counter and prescribed medications. Some of the medications come with the added benefit of constipation.

3. Constipation. Another common problem during pregnancy is constipation especially if the mommy-to-be is taking antacids or other medications for nausea and vomiting. If you have never lived with chronic constipation, you may not know that a side effect is enough gas to inflate your own dirigible. Stool softeners and enemas may be recommended in this case.

4. Hemorrhoids. Hemorrhoids are another unexpected blessing of constipation. During my first pregnancy, I was mortified when my grapes of wrath appeared. Knowing that something was very wrong but being unable to assess the damage for myself, I begged my husband to inspect the damage. I will never forget his simple response, “Oh.” That’s all he said and all he had to say. To my chagrin, the embarrassment did not end when upon reaching out to my doctor’s answering service I had to provide a very detailed explanation of my presenting complaint to a kind gentleman. I still remember whispering the information into the phone somehow fearing that someone might overhear me. Hemorrhoids can be treated with stool softeners, medicated pads, and insertable creams. According to Dr. Victoria Butler, it is important to avoid straining on the toilet and practice deep diaphragmatic breathing to help relax the pelvic floor. This can prevent hemorrhoids from worsening as well as decrease risk for things like prolapse, diastasis recti and leakage.

5. Lightening crotch. Symphysis Pubis Dysfunction (SPD), the official name, refers to sharp, shooting pain through your vulva, anus or rectum. Some literature suggest that lightening crotch and SPD are the same while other sources describe them more as a spectrum with SPD being on the severe end. Either way, sudden shooting pain or chronic radiating pain in the nether regions is a less than desirable side effect of pregnancy. About 20% of new mommies will continue to have significant pelvic floor concerns following labor. If the pain is significant during or after pregnancy, a referral to a pelvic floor physical therapist may help to reduce your symptoms.

6. Everything hurts. Many pregnant women experience constant pain in their lower abdomen, low back and hips. This is likely a combination of hormonal changes that are relaxing muscles, joints and ligaments, an increase in weight, and an increase in pressure from the growing bundle of joy. A belly band, warm baths, stretching, light exercise, massage and Tylenol are all options for relief.

7. Contents under pressure. Heartburn during pregnancy is a surreal experience. It feels like the Devil himself is sticking a hot poker down your throat while simultaneously placing a vice grip around your stomach. You feel full, gurgly, burpy, tight and nauseous all at the same time. Moreover, you can forget about lying down if you have had anything to eat in the last three hours. Antacids, small meals and a bland diet are usually the best line of defense.

8. Leaky, achy boobs. Finally, leaky and achy tatas round out our list of delightful changes to the body during pregnancy. Also due to hormonal changes, it is not uncommon for the breasts to become so tinder that touch is painful especially to the nipple. It is also a strong likelihood that the nipples will change in size and shape and begin leaking colostrum. A supportive bra is really the only recourse for touchy tatas.

Recap of Topic: Changes to the Body During Pregnancy

Pregnancy is a time of wonder and awe. For many women, it is also a time of constant nausea, pain, discomfort and constipation. Changes to the body during pregnancy can have an impact on your sexual relationship with your partner. In the next section, we will look at ways to manage these changes with grace, humor and communication.

Impacts to Sex Due to Changes in the Body

After seeing some of the common changes to the body during pregnancy, you can probably already guess how and why sex is impacted. Below you will find suggestions for navigating these challenges as a couple; however, communicating your needs and limitations directly is critical during this season. In my third pregnancy, I had the benefit of experience to know that I would likely have severe and unceasing nausea. I told my husband, “When I’m pregnant, I cannot tolerate a toothbrush in my mouth let alone anything else.” He inferred accurately what this meant and knew that oral sex was off the menu for the foreseeable future.

1. Baby neosporin. Tell your partner about Leukhorrea when you notice it’s presence. Your partner may enjoy the sensations from increased lubrication. If you are concerned with the smell, you can and should talk to your physician, but know that this, too, is likely normal. Have a towel nearby to aid in clean-up afterward, if needed.

2. Morning sickness. You may have to postpone sex until your second trimester. Morning sickness is notoriously worse in the first trimester and then fades to nothing for some and/or becomes manageable for others during the second trimester. Make sure you have had a small meal or snack before attempting sex and avoid any position or act that triggers nausea. You may find that missionary position works for a time with the mommy-to-be on the bottom. Decreased movement can aid in the reduction of nausea. Your partner can also manually or orally stimulate the mommy-to-be with hands or toys. Be aware that smell is no longer your friend. If your partner’s breath or body odor offend you, request that he or she shower before becoming intimate.

3. Constipation. Prepare for gas to become a part of your sexual experience. Allow for it’s addition to be humorous and a funny story to share with your partner or close friend later. I had one girlfriend in particular encourage me to write a book about my sexual antics. It likely goes without saying that you will want to avoid anal sex or anal play when constipated.

4. Hemorrhoids. You will definitely want to avoid anal sex or anal play when hemorrhoids are present. While they may be embarrassing for the mommy-to-be, it’s unlikely that they will be embarrassing for your partner. If anything, they will illicit feelings of empathy and concern. Since sex from behind or “doggy style” will remain a viable position throughout pregnancy, talk to your partner about your feelings of insecurity. Ask for reassurance and what you need to feel comfortable while in the sex from behind position.

5. Lightening crotch. Talk to your physician about these symptoms to ensure that he or she does not have concerns for sex. Assuming that your doctor does not, you may want to try a relaxing bath prior to sex to allow for reduction in muscle tension. Like with everything else on this list, listening to your body is key. If you notice pain during sex, stop. Dr. Butler recommends partners performing gentle perineal massage as a form of intimacy, especially in those last few weeks when belly is at its biggest, and comfort is at its lowest, plus it can help decrease risk of tearing! Couples can also purchase a therapeutic Pelvic Wand (Intimate Rose is her recommendation) for this, or use a toy they already have, with or without vibration, to perform it with a little more control (and fun!).

6. Everything hurts. Similar to lightening crotch, consider a warm relaxing bath prior to sex to allow for relaxation of the mind and body. Your partner can also massage the parts of your body that are sore, which can provide a nice warm-up to sex. Avoid positions that increase pain and let your partner know if he or she does something that increases pain. My husband had expressed directives to not touch my low back when in the sex from behind position. I could not tolerate any additional pressure.

7. Contents under pressure. This is a tricky one. After 20 weeks gestation, pregnant women are supposed to refrain from lying flat on their back for proper blood and oxygen flow to the fetus. Moreover, lying on your back can also increase heartburn symptoms. Thrusting can increase feelings of queasy, acid tummy. For this, you can avoid sex after meals. You can also use gentle thrusting or manual stimulation.

8. Leaky, achy boobs. You will likely need to avoid nipple play. Show your partner where he or she can and cannot touch your breasts. If they are very tender and require support, a bra can be worn during sex to reduce movement.

Recap of Topic: Impacts Due to Changes in the Body

Your sexual relationship with your partner will likely change during pregnancy. For most couples, these changes are temporary and will rectify themselves following delivery, save the leaky nipples. I do encourage and recommend sex during pregnancy as a way to connect and bond. Your lives are about to change drastically and you will have markedly less time for yourselves let alone one another. Take advantage of your newborn free months and enjoy one another as much as the situation will allow.

Sexual Positions to Consider When Pregnant

While there are several sexual positions you can try while pregnant, the position(s) that work best for you and your partner will be unique to you. The mommy-to-be may also notice increased sensation and pleasure associated with increased blood flow to the pelvic region. Despite the many ailments pregnant women encounter, it is common for pregnant women to experience an increase in libido. Toward the end of pregnancy, Dr. Butler recommends
orgasms to stimulate and progress labor. If partnered penetration is not an option or no longer comfortable, oral stimulation or toys/fingers with or without a partner are all viable options. Pack that vibrator in the hospital bag and use it in the bathroom if you need to!

1. Sex from behind. This will be a great position throughout pregnancy. This can be done in a standing position or on all fours. As the woman’s belly grows, pillows can be used to help support her body from below. Communication is still crucial to ensure that the angle and depth of penetration is not uncomfortable.

2. Mommy-to-be on top. Another great position which allows for the mommy-to-be to control the depth of penetration and rate of thrusting.

3. Spooning sexual position. Not just for cuddling, the spooning position allows for the mommy-to-be to lie comfortably on her side while her partner is able to penetrate from behind. As long as she does not roll completely to her back, the mommy-to-be can lift her leg to allow for manual stimulation as well.

4. Elevated missionary. This position requires some maneuvering and stamina as the partner will have to support their body weight to avoid putting pressure on the bump. To get into this position, you must first place a ramp under the mommy-to-be’s back. You can achieve this by stacking pillows. Once comfortably supported and not flat on her back, the partner can use his upper body strength to perform missionary sex. If maneuvering the belly is too much of a challenge, you can also achieve a variation of this position by having momma come to the edge of the bed with adequate support for her back. In this position, her partner can enter her while standing.

Recap of Topic: Sexual Positions When Pregnant

It’s very likely that preferred sexual positions will change throughout pregnancy as the belly continues to grow. As long as approved by the OBGYN, sex is perfectly healthy and safe during pregnancy. As the belly grows, sex from behind, spooning, mommy-to-be on top and elevated missionary are recommended positions that are safe for everyone involved.

^{Recommended Product of the Week}

This week’s recommended product(s) is Belly Laughs by Jenny McCarthy. I read Jenny’s book during my first pregnancy and loved the humor and humility she showed. I remember feeling relief that I wasn’t the only one who struggled through pregnancy, which helped me to feel less ashamed and alone.