Understanding the different changes and possible ailments that may happen to your “bits” during your pregnancy, your birth and your recovery will help you feel informed and able to distinguish what is ‘normal’ and when you may need to seek advice from a health professional.
By “bits” we refer to your vulva, vagina, anus and pelvic organs.
Changes and ailments in pregnancy
Discharge - is mostly a healthy symptom and helps ‘wash’ harmful bacteria out of the vagina. It is increased during pregnancy as your body is even more keen to protect itself from infection.
Normal discharge is clear or milky coloured with a distinct but not unpleasant smell and you will often simply find it in your knickers or on a pad, as a whitish stain. It should not be accompanied by any other concerning symptoms.
- Top tip: to prevent irritation, avoid underwear made of synthetic materials and, if you need/choose to use panty liners, opt for cloth ones.
- When to contact your midwife/doctor: if your discharge changes colour (to brown, green, bloody or grey), becomes offensive or changes smell, changes in consistency (becomes thick or lumpy), is suddenly very watery, or is accompanied by pain to your lower abdomen, pelvis or vulva/vagina
UTIs – are infections of the urinary system, most commonly affecting the bladder (cystitis). They are more common in pregnancy and, if left untreated, could rapidly travel to your kidneys and cause complications to your pregnancy, including preterm labour.
- Top tip: to avoid transfer of bacteria, always wipe front to back and ensure you empty your bladder fully when you go to the toilet and after having sex.
- When to contact your midwife/doctor: Never hesitate to seek medical advice if you are concerned or think you may have a urine infection. Symptoms can include: frequency, urgency, pain/stinging/burning when passing urine, blood in the urine, discomfort or pain in lower tummy, urine that is cloudy, dark and/or has a strong or foul smell, discharge from the urethra, high fever, pain in lower/upper back, tightenings, chills and, possibly, nausea and vomiting.
Thrush – occurs when there is an overgrowth of Candida Albicans, a yeast-like fungus that naturally lives within our ‘gut’. This can be caused by the intake of antibiotics, diet, lifestyle choices and/or when there is a pH imbalance within the vagina due to other causes.
- Top tip: Go pant-free as much as possible and keep the area well ‘ventilated’ by choosing loose-fitting clothing. Wash with plain water and use Spritz For Bits to relieve the irritation.
- When to contact your midwife/doctor: It is important to exclude other infections/conditions, so seek advice if: your vulva/vagina feels irritated, itchy and/or swollen, you have mild pelvic pain, a white lumpy discharge or an unusual white-ish watery discharge. You may be prescribed a cream and a pessary. However, bear in mind that thrush needs to be treated systemically (by changes to diet, lifestyle, etc) rather than topically (by applying treatment only to the affected area), or it is likely to keep recurring.
Piles – are swollen blood vessels in or around your anus (bum hole). Constipation plays a starring role in the appearance (and exacerbation) of piles so, if you want to avoid/ease them, it is essential to prevent/manage constipation.
- Top tip: Soak the area by sitting in a bowl/bath with Soak for Bits or place a warm/cold compress previously sprayed with Spritz for Bits.
- When to contact your midwife/doctor: If you experience bleeding, itching or pain around your anus and are unsure if you have piles; the bleeding is heavier than just a little blood when you wipe; your stools appear black/tarry (and you’re not on iron tablets), your symptoms are severe or haven’t eased despite treatment/management.
Vulval varicosities – these are swollen blood vessels that occur around your vulva. To help alleviate the pressure and discomfort, avoid tight clothing and standing/sitting for prolonged periods.
- Top tip: Promote circulation by raising your feet above the level of your heart - you can rest them on the wall. Place a pillow under your right hip to tilt you slightly left (prevents you from feeling dizzy and ensures good circulation to the placenta is maintained). After about 5 minutes, lower your legs onto the bed/couch and turn on your left side for a few minutes before sitting up. Also, follow the top tip for piles.
- When to contact your midwife/doctor: Although there is little they can do, do mention your symptoms during your routine visit, and call them if the swelling/pain worsens or you are concerned.
Bleeding – can have a variety of causes and may be nothing to worry about. ‘Spotting’ during the first trimester can be quite common and some bleeding can still happen after 12 weeks of pregnancy. Sometimes there is no obvious reason for this, but causes could include: ectropion, infection, having the ‘show’, placenta praevia, early labour or placental abruption.
- Top tip: Monitor your blood loss by using light-coloured pads/panty-liners and keeping note of when you bleed and how much.
- When to contact your midwife/doctor: Discuss any type of bleeding with your midwife/maternity assessment centre to determine if you need further assessment. Spotting during the first trimester or after intercourse can be common but seek advice if the bleeding becomes more than spotting or is accompanied by pain. Any heavier loss of fresh/watery blood, with or without pain, should be investigated as soon as possible. If your loss is very heavy or you feel very unwell, call an ambulance.
Perineal massage – when done regularly, from 34 weeks of pregnancy, perineal massage has been clinically proven to help make the perineum (the muscle between your vagina and anus, which stretches to allow your baby to be born) more elastic and stretch better during childbirth, reducing your risk of tearing and the need for an episiotomy.
- Top tip: use our My Expert Midwife’s perineal massage oil which has been specially blended and designed for perineal massage or an oil such as almond oil.
Warm compress - Applying this to the perineum, when it is stretching during the birth, helps the tissues warm up and improves their flexibility and stretch during the birth, reducing the incidence of tearing.
Tender, bruised, swollen bits and recovering from tears and episiotomy – your vulva and perineum are likely to feel sore and uncomfortable after the birth of your baby, more so if you’ve sustained a tear or a cut (episiotomy).
- Top tip: You can use Spritz for Bits for instant relief from day one. Investing time in helping your bits to recover will be time well spent, so ensure you get plenty of rest and self-care.
- When to contact your midwife/doctor: If the pain and/or swelling worsens or does not improve with pain-relief and management, you notice an offensive smell, bleeding or abnormal discharge from the wound, or you feel unwell.
Bleeding - Blood loss after childbirth can vary enormously and can be very different from any period you have experienced.
- Top tip: Have plenty of thick, absorbent maternity pads for the first few days after the birth and don’t be alarmed if your blood loss increases when you breastfeed or are more active than usual.
- When to contact your midwife/doctor: If you soak through your pad in less than 2 hours, pass multiple clots or single clots larger than a golf ball, you have worsening or persistent pain despite taking pain-relief, your blood loss smells foul/offensive, or you feel ill, faint, hot or sick.
Piles – may worsen after the birth of your baby, adding a whole new level to your endurance of discomfort.
- Top tip: keep well topped-up with regular pain-relief and take bulk-forming laxatives if you’re struggling with your bowels. A steroid-based pile-cream may be just what you need for the first couple of days.
- When to contact your midwife/doctor: If the pain/swelling does not improve with topical treatment and pain-relief, there’s more than just a little blood on wiping your bottom, or you cannot manage your constipation.
Incontinence – is relatively common following birth and may last a few weeks.
- Top tip: Go to the toilet as soon as you get the urge and empty your bladder fully. If you don’t get the urge until it’s almost too late, put an alarm on your phone and sit on the toilet every 1-2 hours to ‘retrain’ your bladder.
- When to contact your midwife/doctor: If you see no improvement, despite management and regular pelvic floor exercises. Your midwife/GP may need to refer you to a physiotherapist.