If you're not comfortable talking to your gyno about every detail of your sex life and lady parts, you're not alone. There are some things even your best girlfriends don't know. But while you should be open and honest with all your doctors, there's no better time than pregnancy to come totally clean. "There's no such thing as a stupid question or confession when it comes to a pregnant patient, or any patient for that matter," says Sherry Ross, M.D., OB/GYN and women's health expert at Providence Saint John's Health Center in Santa Monica, California. "But in pregnancy, there's another person involved and certain behaviors could have a significant damaging effect on you or your child."
To ensure that your pregnancy goes smoothly and you give your child the best start at a healthy, happy life, don't keep these 10 secrets from your OB/GYN.
These emotions are completely normal and expected—and it's important to discuss them with your OB/GYN. "As if the slew of new hormones introduced to your body during pregnancy weren't enough to throw you off kilter, your body's also changing physically and you're mentally preparing for the biggest change of your life," says Leah S. Millheiser, M.D., OB/GYN, director of the female sexual medicine program at Stanford University. "If you have a history of depression, either currently or in the past, and have gone off depression meds in order to conceive, you could be having serious difficulties grappling with the reality of your situation." Remember that worries are not a sign of weakness and that your doctor is ready to help. Talk with her about your feelings so she can suggest a mental health counselor or a pregnancy group you can join.
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While the verdict isn't totally clear when it comes to how much alcohol is dangerous during pregnancy, the American College of Gynecology's stance still remains that all pregnant women should abstain from all alcohol during pregnancy. However, if you haven't completely complied with this rule—either unintentionally or intentionally—it's vital that you tell your OB/GYN. "Many women don't know they're pregnant until about 4 to 6 weeks in, after they've gone out on a Saturday night and had a few drinks and they feel too guilty or ashamed to tell their gynecologist," says Shawn Tassone, Ph.D., a board-certified OB/GYN and integrative medicine doctor. "But fetal alcohol syndrome is caused by consistent exposure to alcohol throughout the pregnancy, not a few beers one time."
Smoking, even in small amounts, is a serious issue during pregnancy, especially when the patient isn't being up front with their OB/GYN about how much and how often. "Smoking can affect the blood vessels in the placenta, resulting in delayed fetal growth, poor lung and brain development and an increased risk of Sudden Infant Death Syndrome after birth," says Yana Markidan, a New Jersey-based OB/GYN. "Likewise, it significantly increases the risk of placental separation, known as abruption, which can be catastrophic in pregnancy." Knowing you're a smoker, your gyno will request additional growth screenings for your baby to ensure he or she is growing properly and discuss suitable coping strategies to help you quit smoking.
Stress not only affects our body physically, but also our emotions and behaviors. And if you're carrying a passenger in the womb, stress's negative consequences can affect you both. "When a newly pregnant mom is stressed, chemicals are released that can affect her growing baby, putting the child at greater risk for depression, irritability, and a more sensitive temperament," says Sherry Ross, M.D., OB/GYN in Santa Monica, California. Whether it's your first term or third term, speak with your doctor about the levels of stress in your life so he or she can suggest activities that help lower stress, like taking warm baths, practicing breathing exercises or attending yoga classes.
Your OB/GYN knows not all pregnant women are in monogomous relationships and is prepared to help you navigate any situation you find yourself in, but it's on you to be open and honest. "Most STI testing is done on the initial visit, so additional testing is necessary if a woman has sexual intercourse with another partner afterwards, especially because a lot of STIs have no physical symptoms but can still be quite harmful to your baby," says Dr. Markidan. You should discuss the timing of these sexual interactions with your OB/GYN to ensure appropriate testing for STIs. Not sure who the father is? Don't be ashamed. Your OB/GYN won't judge and will instead talk with you about what's needed to conduct DNA testing.
Yes, this is your OB/GYN's business—especially when it happens to 1 in 6 pregnant women, according to the March of Dimes organization. Physical or emotional abuse from a significant other or loved one is never okay, but when it's during pregnancy it's more vital than ever that you talk about it with your gyno. "Abuse, which includes physical, emotional, and sexual violence and threats, can get worse due to the new stresses and anxieties that come along with the parenting package," says Dr. Millheiser. Your doctor can ensure that you get the right medical attention—physically and mentally—and help you find a safe place to stay.
Especially with the influx of the Zika virus, which has become a major concern during prenatal care for many patients, your doc needs to know if you plan on leaving the country or state. "Although rare, we're still learning about Zika's devastating effects on the developing fetus, so recognizing exposure is essential," says Dr. Markidan. You should run all travel plans by your gyno, especially during your third trimester, when you could end up having complications when you're far away from your doctor. "Most OB/GYNs will tell you to go during your second trimester if you have a choice, as you tend to have the most energy at this stage and your risk for complications are relatively low," Dr. Millheiser says.
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There's a common misconception that all women's sex drives increase during pregnancy—when women's sex drives can also decrease or remain the same. "It's important to remember that sex drive and desire are unique to every woman, pregnant or not," says Dr. Millheiser. "It's really important for women to know it's okay to speak with their healthcare providers about any sexual concerns they may have because, as providers, it's our responsibility to listen, assess, and propose potential solutions." Sexual troubles wax and wane over time as a result of a variety of things, such as stress, relationship issues, or pregnancy.
When sexual troubles are chronic—lasting over six months and causing a woman personal distress—a woman may be experiencing female sexual dysfunction (FSD). "If you're worried you may have FSD, share your concerns with your healthcare provider who can provide solutions like therapy and potentially treatment, once you're no longer pregnant or breastfeeding," Dr. Millheiser says. "Recognizing that many women feel uncomfortable talking about their sexual concerns, I try to begin a dialogue by asking them about the quality of their sex life, encourage them to share how they're feeling with their partners and then providing them with easy interventions they can incorporate into their lives."
It might seem silly to bring this up when you're at an appointment with your OB/GYN, but good dental hygiene can play a key role in keeping your baby safe during pregnancy. "Hormonal changes during pregnancy can lead to several changes in the mouth—the gums in particular," says Dr. Markidan. "Gum disease can lead to preterm labor if left untreated, so it's important to let your OB/GYN know if, for any reason, you're unable to receive dental treatment or have not in a long time."
"Eating poorly and being overweight is no joke, especially in pregnancy, as it increases your risk of gestational diabetes, birth defects, high blood pressure, infection, having a larger baby or C-section and even miscarriage," says Dr. Ross. Plus, exercise not only helps you maintain a proper weight, but it also gives you the energy and stamina you'll need to get through the next nine months of body changes. Most common exercises are safe in pregnancy and, as long as you're not losing weight and your baby's growing appropriately there are really no issues.