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Sciatic pain—or sciatica, as it is sometimes called—is probably one of the most painful conditions associated with pregnancy. Your sciatic nerve is the largest nerve in your body. It passes from your pelvis on either side and down the back of your thigh, where it divides into smaller nerves. You can pinch and injure the nerve in many ways; during pregnancy, however, compression of the nerve from the baby’s position is the most likely cause of sciatic pain. You are probably feeling the pain on the side where the compression is.
Although you can’t prevent sciatic pain, you may notice that certain positions and activities will either aggravate it or make it better. Sciatica can be completely debilitating when it flares up. Warm or cold packs, physical therapy exercises, pillows under your hip, and lying with your hips elevated may all help to relieve the discomfort, though none of these is a sure bet. Sciatica usually does not last throughout the entire pregnancy; it often disappears completely when the baby changes position. If this doesn’t happen, your sciatic pain should resolve completely when the baby is born.
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I am 30 weeks pregnant, and I’ve noticed little pimples that erupted just outside my vagina and that are starting to itch. I have had genital herpes before (although I haven’t had an outbreak for a couple of years), and I believe it may be back. Should I be concerned, should I take anything, or should I just wait for the eruption to go away? I know this could be a problem if I were about to go into labor, but that isn’t the case. What are the concerns at this point in my pregnancy?
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Any time you experience some new or unusual physical condition, whether you are pregnant or not, it is important to have a doctor or another medical practitioner check it out. Your symptoms may indicate genital herpes or another condition that should be treated. Let your practitioner know that you have had genital herpes outbreaks before. Genital herpes is a sexually transmitted infection caused by the herpes simplex virus. Between 20 and 25 percent of pregnant women have genital herpes. Women who have outbreaks in the third trimester or at birth risk transmitting the virus to their babies, for whom the infection could be life threatening. A cesarean is the only way these women can safely deliver their babies. If you have a genital herpes lesion, it will not cause any problem as long as it heals within the next couple of weeks. Your doctor or midwife should discuss treatment options with you. Some antiviral drugs are considered safe to use in pregnancy, and new information about such drugs is becoming available all the time.
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Pets pose few dangers during pregnancy or childhood. Of course, they must be kept healthy and clean. Dogs and cats should be appropriately vaccinated. All the animals must be friendly and safe for children to be around, and even a friendly dog shouldn’t be left alone with a baby or toddler. Animals that do not tolerate children well should not be part of a human family. Most cats pay little attention to a baby. Your cats need to know, though, that the baby’s bed is not a place for them to be. Once your baby is crawling and walking, make sure that the litter box is tucked away somewhere where he can’t get to it. As your child grows, teach him to wash his hands thoroughly after handling any pet.
Lastly, enjoy your animals. They are a part of your family, and by growing up with them, your child will learn to love all of nature’s creatures.
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I am 35 weeks pregnant, and I have been said to be at high risk of complications because I have gestational diabetes and take insulin.
My doctor now wants me to have a “biophysical profile.”
What is this, and why is it done? Is it routinely done, or is this unusual? What other types of testing are done at this stage of pregnancy?-
Fetal testing such as a biophysical profile at this stage is not routine. It is done for a specific reason, such as to check the well-being of an overdue baby (at 41 weeks or beyond) or to assess the functionality of the placenta. Because you have gestational diabetes, your doctor wants to watch the baby extra closely during these last weeks of your pregnancy.
A biophysical profile uses ultrasound and takes from 20 to 60 minutes to complete. The baby is scored between zero and two points for each part. A total score below eight indicates a need for further testing. The least common of the three tests, a Doppler flow study, uses ultrasound to assess the rate of blood flow in the umbilical blood vein and in the baby’s arteries, brain, and heart. The procedure is much like a regular ultrasound exam, except that the test uses color to differentiate the blood vessels. Waveforms on an ultrasound screen show variations in the rate of the blood flow. Decreased flow may indicate that the baby is not receiving enough blood, nutrients, and oxygen from the placenta.
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The common term for this event, lightening, doesn’t quite convey what actually happens: The baby’s head descends into the pelvis. Because of decreased pressure on the diaphragm and stomach, you will indeed feel “lightened” when your baby drops, and your breathing and digestion will become easier. You’ll probably also feel the need to urinate more often, however, and you may feel pressure or aches and pains in your pelvic joints and perineum. You’ll notice a change in the shape of your abdomen; the bulge will have shifted down and forward. If this is your first baby, lightening may occur about two weeks before labor starts. In women who have given birth before, the baby often doesn’t drop until labor begins.
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I had twin girls four years ago. When I was pregnant, I was told they were in separate sacs and therefore not identical. Once they were born, the doctor said they might be identical, because they had the same blood type. They look very much alike, and I am asked all the time if they are identical. Is there any way to know for sure whether they are identical or fraternal?
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Identical twins occur when one egg divides into two, so that the babies have the same genetic makeup. Fraternal twins occur when two separate eggs are fertilized. Like fraternal twins, identical twins normally have two separate amniotic sacs. It is extremely rare for these twins to share one sac, and dangerous, too, since the babies’ umbilical cords could get entangled during the pregnancy. Your girls could indeed be identical, especially if they look a great deal alike. The fact that they have the same blood type isn’t a clear indication, as it is quite common for siblings within any family to have the same blood type. The only way to know for certain is to have the girls genetically tested. Their doctor should be able to help you find out how to do this and the costs involved.
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I’ve been receiving conflicting opinions concerning childbirth classes, specifically Lamaze. I am 61/2 months pregnant with my 170 first baby and would like to know your views on the subject. Is a program like Lamaze helpful if I’m planning to use an epidural? I am from Sweden, and in my country, this doesn’t seem to be such a big issue. I don’t want to take the classes just because it’s expected.
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All labor involves some pain. Even though you wish to have an epidural, it is very important to learn about alternative ways of dealing with labor pain, and books simply cannot teach you the coping skills the way a class can. Whether your childbirth class involves Lamaze breathing and relaxation techniques or other approaches to childbirth, the class should incorporate discussions of natural methods of coping with pain as well as medication options.
As with all types of education, childbirth classes are taught by some great teachers and some not-so-great teachers, but in general these classes are extremely helpful as preparation for labor and birth. Your course should help you understand what will happen with your body in labor and how to work with this natural process. Your teacher should tell you what you need to know so that you won’t be afraid of what your body is going through and so that you can make informed choices in labor. The classes provide this information in an open, accepting atmosphere in which you feel your questions are welcome. A good instructor will teach you to be flexible, because labor is always somewhat unpredictable, and will help you to feel supported, confident, and capable. By taking the classes, you will be better prepared to have a positive birth experience, whether you end up giving birth vaginally with an epidural, having a non-medicated birth at home, or having a planned or unplanned cesarean. Finally, by emphasizing that there is no right or better way to give birth, your instructor will dispel any anxiety or guilt you may feel about your choices.
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As your baby and your uterus grow, the pressure upward on your stomach increases. This causes stomach acids to back up into your esophagus. The condition may also cause Breech Position Transverse Position sudden vomiting, without the lingering nausea that is usual with morning sickness.
Be sure you let your practitioner know about this problem. He or she may recommend an antacid and offer some additional suggestions for relief.
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Midwives care for healthy women who have low-risk pregnancies and uncomplicated deliveries. The philosophy of midwifery is to encourage as natural a labor as possible and to provide continuous support for the laboring woman. Besides typically being present for a longer period during labor than a physician would be, midwives favor low medical intervention. In the hospital, however, they support a women’s choice to have epidural anesthesia, and they use other interventions or bring in an obstetrician when necessary.
Certified nurse-midwives (CNMs) frequently share a practice with one or more physicians and consult with them as needed. Having your care provided by a CNM may be more affordable than using a physician. Whether a midwife would be better for you, though, may depend on the level of care you need. In many countries, midwives manage most normal births and leave cesarean or complicated births to their physician colleagues.
Whether to use a physician or midwife is a personal decision. I encourage you to make the choice that feels right for you.
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I am pregnant with my second child. My first child was born by cesarean section under general anesthesia because of fetal distress. For this second baby, I will be having another cesarean, but my doctor told me that he would rather I have a spinal anesthetic than go to sleep. My question is this: Are there any side effects from a spinal? The thought of a needle going near my spine is quite scary!
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Except in emergencies, spinal anesthesia is usually preferred over general anesthesia for cesarean births. General anesthesia has no long-term effects on babies, but if they are exposed to it in the uterus for more than a few minutes, they can be quite sleepy at birth. Spinal anesthesia works quickly and lasts for only a couple of hours. It is very safe for the baby.
The thought of a needle in the back can be frightening. I hope that by explaining the process of spinal anesthesia, I can ease your fears about it. An anesthesiologist administers a spinal anesthetic by placing a specially designed needle through the membrane outside your spinal fluid in the lumbar region of your back (well below the end of your spinal cord.) The doctor injects a numbing medication directly into the spinal fluid. A spinal differs from an epidural in that, with a spinal, the needle passes through the membrane where the spinal fluid is; with an epidural, it does not. Also, with an epidural a tiny catheter is inserted. This allows more doses to be given for longer pain relief. Both procedures produce numbing from the breasts or belly button down to your toes.
Fewer than 4 percent of women who have spinal anesthesia get a “spinal headache,” which occurs after a small amount of spinal fluid leaks out. This problem is corrected with a “blood patch,” in which a small amount of the woman’s own blood is injected into the area.
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About Tori Kropp
Known as "the Dear Abby of pregnancy," Tori has been interviewed on national television and radio and in national print publications, including CNN, The Wall Street Journal, New York Post, Washington Times, Atlanta Journal Constitution and Chicago Sun-Times.
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Ask Your Question
Could you tell me a little about sciatica in pregnancy? What causes it? What makes it worse? What helps eliminate it? What can you do to keep it from flaring up? Once you get it, does it last the entire pregnancy? And why do you only get it on one side or the other? Mine began at 22 weeks. At first, it felt like just a burning sensation in the buttocks, but if I do much walking, I also get shooting pains down my leg.