Anxiety during pregnancy

By Dr. Amanda Selk on December 16, 2013

Pregnant women are plagued by worry. Here, we address some of those common concerns.

Q: I have a thing about belly buttons. Do all “innies” become “outies”?

As the uterus grows in the second and third trimester, there is an increase in the amount of pressure in the abdominal cavity and innies will often become outies. It can happen anywhere from the second trimester onward but there are a few women where it doesn’t happen at all. Don’t stress too much though because, for the vast majority of women, your belly button will go back to being an innie after your baby is born.

Q: OK, I am worried about pooping during delivery. Does this always happen?

In order for a baby to come out vaginally, it has to put pressure on your rectum (where your poop is stored before it comes out). Unless you have a Cesarean section there is no way around this. It’s totally normal. So although not everyone poops, the vast majority of women do because when you push the baby out, you will push anything in your rectum out of the way. It’s normal and all the professionals in your labour room are so used to it that they really don’t notice it. So try your best to forget about it and instead concentrate on the wonderful little person you will be holding in your arms soon.

Q: I am worried my epidural won’t work. Does this happen a lot?

Epidurals usually work and they work really well. There are rare situations where they work more on one side than the other and the even rarer situation where a women just doesn’t get good pain relief. Luckily, if the epidural is not working well, the anesthetist (the doctor who does epidurals) can often redo it. Epidurals take away contraction pain but they do not generally take away pressure so many women can still feel pressure and sometimes some stretching/burning during the last stages of pushing.

Q: I fell the other day—should I be worried about hurting the baby?

It depends how you fell and how hard you fell. If you just slipped a short distance and landed on a knee but didn’t bump your belly you are probably fine. Any bump to the belly or a hard fall on your bottom should be checked out. Don’t wait until your next medical appointment. The placenta can be damaged in a fall and can separate from the wall of the uterus which can be dangerous for both mom and baby. It is also important to seek medical attention if you develop pain, bleeding, cramping, your baby isn’t moving as well or if you have an Rh negative blood type.

Q: I am worried my swollen feet won’t go back to their old size. Does that happen?

The vast majority of women with swollen feet will go back to normal two to three weeks post delivery. Most swollen feet actually get worse the first week after delivery and then slowly shrink back to normal. There is a rare person who swears their feet stay bigger postpartum, but this is a rare group.

Q: My friend told me she was told to get a vaccine for whooping cough while she was pregnant. Is that a new thing and is it safe?

In 2012, the Centre for Disease Control (CDC) in the U.S., recommended that all pregnant women receive a dose of Tdap, which covers tetanus and pertussis (whooping cough) regardless of whether the woman has been immunized before. The rationale for the new recommendation is that there has been a large number of cases of pertussis in North America in the past few years, especially in babies under six months of age. Most babies get pertussis infections from their moms or other close family members. More than half of babies under a year who get pertussis end up hospitalized, 20 percent get pneumonia (a lung infection) and one percent will die. It’s ideal if women are vaccinated after 20 weeks gestation as this protects the baby better than getting it earlier. The vaccines are safe both in pregnancy and for breastfeeding and if you missed it in pregnancy, there is still benefit that can be gained if you get it postpartum.

By Dr. Amanda Selk| December 16, 2013

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