Pregnancy Q&A with Alta View Nurse Midwives

By Intermountain Healthcare

Hi Moms! The experts at Intermountain Alta View Nurse Midwives spent an afternoon recently answering your OB/GYN questions. We appreciate your thoughtful questions and truly enjoyed providing you feedback. We wanted to post a recap for those who may have missed the chat. If you have more questions, feel free to reach out to us at any time 801-501-3300. 

Pregnancy questions answered by nurse midwives

Q. How long does it take for stitches to dissolve after having a baby?  

A. Stitches can take anywhere from one week to a few weeks to dissolve.

Q. When does the stinging/burning feeling go away after going to the bathroom?

A. The stinging/burning feeling usually lasts only a few days; however, if it’s been a week or so, you may have something else going on, such as an infection. If it’s been over a week and you are having unbearable discomfort/pain, then you need to see your provider. 

Remember, just because we say "nothing in the vagina for six weeks" following delivery does not always mean you'll be healed by then. It can take time. If intercourse hurts, you can always use plenty of lubrication to help. Coconut oil is a great natural lubricant that also can help with healing.

Q. Which birth control pills are most popular?

A. We suggest pills with low estrogen to minimize as many side effects as possible; however, with birth control pills, it’s really based on a trial basis and what you feel works best for you.

Q. I'm nursing, and my periods have different lengths apart and are sometimes extremely heavy or really light. Is that normal?

A. Depending on how long you have been breastfeeding, this can be normal. Your periods should regulate on their own. You may always call or see your provider if you are truly concerned.

Q. I had my IUD removed about 4 months ago and ever since I have had REALLY painful ovulations and periods. Is that normal?

A. It can depend upon the IUD you had. Sometimes your periods can change over time and become more painful or heavier, or they can become lighter, less painful over time. There things your provider can do to help you with your symptoms. Sorry, painful periods are not fun!

Q. My insurance will pay for one of two pumps. One is a closed-pump system but doesn't have super great reviews. The other is an open-pump system, which can cause mold, but otherwise has really good reviews. How common is mold in your pump? The brands offered are Ameda and Medela. (Medela is the one that has an open pump.)

A. We have found that the Medela brand is a great pump, although it really depends on personal preference. We often don’t hear about mold in pumps, but to prevent this, I would suggest keeping your pump as clean as possible. Clean each pump after each feeding. Vinegar is a great natural cleaner. You can start by cleaning it with 100% strength vinegar, then adding water, diluting it until it’s completely water.

Q. How long after delivery am I expecting to bleed? If I stop bleeding before my 6 week appointment, can I return to "normal" activity before being checked? (Swimming, sex, etc.)

A. Usually most women will bleed anywhere from 4-8 weeks, depending on if you have stitches or had a tear. We still recommend waiting six weeks to get back to “normal” activities; however, your body may take longer to heal. Always watch for signs of infection: foul odor, increased pain, and change in discharge.

Q. The birth control (depo shot) I am on makes me really grumpy, and it expires on August 1st, so I need to figure out something new. I don't really want to use hormones, and I hate condoms. What would you recommend?

A. It’s true that hormones can affect our moods. There are other forms of methods that do not have hormones. The Paragard (copper) IUD does not have any hormones and you can have it in place for 10 years, with 99% effectiveness. There are diaphragms, spermicide foams, female condoms, etc. However these methods are less effective. You are more than welcome to come and see us. We could discuss options that would benefit you

Q. How early into a pregnancy can you see twins?

A. Usually, you can see a twin on ultrasound as early has 6-8 weeks, as long as one is not hiding.

Q. I have Nexplanon. I have been bleeding for several days, every other week. Is this normal? Tempted to get it removed, but would hate to because of the cost.

A. Unfortunately, one side effect of the Nexplanon is irregular bleeding. Each bleeding cycle can be different every month, from light too heavy to light, etc. If you feel this is too bothersome for you, there are many other options out there. You are more than welcome to come visit with us and we discuss other options for you that you may benefit greatly from 801-501-3300

Q. I had preeclampsia with my first pregnancy. When I get pregnant again, will anything be different as far as frequency of doctor visits or how my pregnancy is treated?

A. Considering that you have had preeclampsia in a prior pregnancy, it shouldn't change your visits while you are being monitored throughout your pregnancy while your provider will be looking for all the signs and symptoms. Without knowing your full history or recurrence of preeclampsia, it could be anywhere from 1 in 3 women to 1 in 5 women. If you have certain health criteria, present.

Q.  I got the copper IUD about a year ago and just started my period about 4 months ago. I've noticed that my periods are extremely heavy for 2 days, which is not normal for me. And my cramps are terrible now, too. Is there anything I can do to help?

A. Two major side effects of the copper IUD are painful periods and heavier bleeding. Not fun!  You can try pain meds such as NSAIDS (ie. ibuprofen, naproxen, etc).

Q. Regarding the noninvasive cell free blood test, do you need to do genetic counseling beforehand? I'm confused as to why I'd need to schedule an appointment with a GC before having the blood test done.

A. There are usually certain criteria a pregnant woman will meet to qualify for genetic counseling prior to a blood test. As I don't know your history, you may have one of those criteria. Your current provider may have evaluated your history and pregnancy and recommended genetic counseling. It is helpful for women to see a genetic counselor prior to the blood work so they understand what they are being tested for. With that being said, not all women need genetic counseling prior to blood work. It just depends on your particular situation and history.

Q. Is a pelvic support belt at all helpful in dealing with the pain of symphisis pubis dysfunction/pelvic girdle pain during pregnancy? What I've read has given the belts mixed reviews, but I'm looking for ways to manage my pain.

A. Overall yes, they are helpful. They are good to use during your most active times of the day, however you don't want to wear them all day long as they can make the pain worsen. So, a general recommendation is to wear them no more than 4 hours per day, and to try a couple on to find the one that is most comfortable and fits you best. Some women love them, while some hate them. You may also want a referral to a physical therapist, since that can help with the pubic pain and you will need to be evaluated by your provider for that. If you have any other questions, feel free to call our office or come in for an evaluation.

Q. My baby is now a year old, and we are thinking about having another. But for the last three months, I have not gotten pregnant. I am still nursing. Could this be affect getting pregnant?

A. Nursing can affect fertility, but it’s not unheard of for you to get pregnant during nursing.

Q. Which IUD would you recommend? I am leaning towards the copper because it doesn't have hormones in it, but what are the pros and cons of each type of IUD?

A. Great question. There are now three types of IUD's, the Mirena, Skyla, and Paragard. They all have pros and cons. The Paragard is a hormone free copper covered IUD that is good for 10 years. They are generally easy to place, especially if you have any children vaginally. The downside to the copper IUD is that you do continue to have your periods, and sometimes they are heavier then they were prior to having the IUD. The pro side is that you never have to think about them, they are good for 10 years, and they are hormone free. The Mirena and Skyla are both hormonal type of IUD's. Both release a daily amount of progesterone into your uterus that ultimately thins the lining of your uterus. Originally you will have some spotting which will reside in 3-6 months, and then you will have either very light or no periods. They are also less cyclic. These are good for 5 years and 3 years respectively. Again, this is a great option because it is one you don't have to think about and are very popular. IUD's are 99.97% effective in preventing pregnancy, fairly easy to place, although sometimes painful to place, and don't require any maintenance. It really just comes down to preference. If you have a history of heavy periods I don't recommend the Paragard, but if you like having your period every month it is a great option.

Q. I was considering an IUD, but after some problems my friend had and reading here, is it common to have painful periods with them? And what kind would you recommend?

A. Not all IUD's are painful and problematic. While there is always a love/hate relationship with any birth control, most people really like certain types of IUDs. If you'd like to come in for a visit, we could evaluate your specific history and see what type of IUD would be best suited for you and may even give you other methods that you may like better. Our office phone number is 801-501-3300. We would be happy to help.

Q. How long does it take for the stitches to dissolve? I'm 2 1/2 weeks postpartum, and I can still feel my stitch. It is rather annoying!

A. Stitches usually take a few weeks to dissolve. However, you can always go in and be evaluated. Your provider can remove the stitch your repair has fully healed. Just know even if the stitches have dissolved or have been removed, the healing process may take a lot longer, so give your body plenty of time. Use lubrication with intercourse if you are having discomfort. See your provider for any signs of infection: foul odor or increased pain

Q. I want to have my baby that's due in November naturally. Do you have any suggestions on labor without an epidural?

A. There are many great methods to help you labor unmedicated. Hypnobirthing, hypnobabies, Lamaze, Bradley methods are a few courses that can help you mentally cope through labor. We also provide a variety of comfort measures, laboring in the tub, counterpressure, massage therapy, aromatherapy, music, position changes, squat bar, walking, birthing stool, exercise ball, to name a few at Alta View hospital we provide all of these options.

Q. I had a depo shot and a miscarriage three months ago, and I've been spotting for the past two months. Can I get pregnant? Or do I need to prevent it in case of another miscarriage?

A. I'm so sorry about your miscarriage. That is a difficult thing. Depo shots are good for 12 weeks, so if you are anywhere past 11 weeks from having had that shot you will need to use another form of birth control to prevent pregnancy. The biggest problem post miscarriage is that you may ovulate before your first period, and you won't know when that is. You can get another Depo shot, use birth control pills, get an IUD, get a Nexplanon, or use condoms to prevent another pregnancy until you are ready to try again. In the meantime, be sure to be taking prenatal vitamins everyday. The best thing you can do for you and your baby prior to getting pregnant is taking prenatal vitamins for 3 months before you get pregnant. Good luck!

Q. Does the IUD cause you to gain weight or to not lose weight easily?

A. Typically the IUD does not send hormone throughout your body, and only sends the hormone to your uterus. It's hormones that are sent through your body that cause you to have the most common side effects of a birth control method, which are food cravings, water weight gain, nausea, headaches, and mood swings. From my experience, the IUD can cause some of these symptoms about 15% of the time. Though the weight gain can be from water weight or increased food cravings, which is what you have to watch out for, though it is not common.

Q. I'm 5 weeks postpartum and having cramps in my back and abdomen again. Should I be concerned? I did get some medicine for a UTI about 2 weeks ago.

A. Generally, cramping in the first 6 weeks post partum is normal; it is your uterus shrinking/cramping back to its pre-pregnancy size. It is more common during breastfeeding and worse with each pregnancy. The back pain isn't so normal. If you are having no other problems, no pain with urination, no excessive bleeding and no fever, you probably just need to stretch it out. It is also okay at this point to start light exercises again. If stretching and heat doesn't help relieve the pain you may want to check with your health care provider to make sure nothing else is wrong. Sometimes, if you had an epidural, the site where you got the epidural may be slightly sore or bruised for a few months post partum. Good luck!!!

Q. Can I get pregnant or start trying even if I'm still nursing my first child ?

A.  Way to go on breastfeeding!  You can get pregnant if you are still nursing; however it depends on how long you've been nursing. Once your feedings become further apart, you are more likely to ovulate versus feedings every 2-3 hours. Just know that pregnancy is more likely if you are not breastfeeding.

Q. I am 32 weeks pregnant with my first child. What are the most common concerns I should watch for?

A. I would recommend getting on the Baby Center website or downloading a pregnancy app that can give you appropriate common concerns per trimester. Hopefully that helps you - there are a lot of good pregnancy apps out there, so just peruse them and see which one you like.

Q. How can I tell if it is the heat or my birth control (mini pill) that is making my hands and feet swell?

A. Most likely, the swelling you're experiencing is most likely not related to your birth control options. It is really hot outside right now, so you definitely need to stay well hydrated. Also long periods of time standing, can cause swollen feet/hands. At the end of the day, put your feet up and relax!