Confessions of a Pregnant Doctor: Sex, Stretch Marks & the 3rd Trimester

Bodily changes, preventing stretch marks and perineal injury, sex life, fitness and other mishaps…all part of the job for a pregnant doctor

Frequent Sassy Mama contributor Dr Cheryl Kam is now in the third trimester of her first pregnancy, and after years of doling out expert medical advice, we were curious how she felt about it all now that she’s experiencing it from the other side. Check out part 1 of her series, which covers her choice of OBGYN to her decision to keep medical visits to a minimum, and part 2 where she discusses how to avoid nausea, her recommendations for the best prenatal vitamins, and essential pregnancy nutrition. Here in part 3, she comes to terms with her ever-changing size, the ups and downs of pregnancy sex, the benefits of perineal massage, and much more…

In the first trimester I didn’t have much to show for my internal suffering and whirlwind of changes.

Then once I hit the fifth month my body changed so quickly, it took a fair bit of mental robustness to rationalise and bat off the knee jerk comments on how I was comparatively pudgier. I felt rotund, yet I knew it was for a good cause.

Everyone was beginning to take an interest in how much weight I had put on (9kg and gaining, thank you very much, and this is NORMAL), and I could see them giving me virtual makeovers in their heads not realising I AM GROWING A HUMAN FROM SCRATCH.

I do feel like a sack of potatoes some days. Those sultry mothers on Instagram with their bump hugging dresses and contoured faces really need to come back down to planet Earth where gravity is 9.8 m/s2, please.

No selfie angle would work, and my husband could never take an Instagram-worthy photo of me. I was irate at him, and at myself. I was snappy and dragon-like in temperament too, apparently.

PMS vs Pregnancy hormones…. choose wisely, husbands!

Also, where was this blasted pregnancy glow everyone spoke about? Well, people tell me I have it but I can’t tell if they’re imagining things. I still apply blush and found myself a spectacular coral lip colour so people don’t think I’ve lost the will to live.

I also dramatically exploded out of a much loved pre-pregnancy dress while at work. A patient pointed out the gaping hole near my enlarging bottom as I got up to examine her. It was the defining moment to pack up all my usual clothes (and buy new ones, hurray!).

I have used that experience to steel myself for future embarrassing moments. Like forgetting to Kegel before a sneeze and having a conspicuous pee trickle.

One bonus:  My boobs have finally had the growth spurt I have been waiting all my life for, but… my sex drive has flatlined. This is ironic and bad!

Breathe…embrace…and accept…that one may need lube.

Some of you lucky ladies may have an increased sex drive and that is wonderful! Do not be afraid to enjoy a healthy intimate relationship with your partner. As long as baby is all cozy and wrapped up in a tonne of amniotic fluid, layers of womb tissue and an intact amniotic sac, they couldn’t possibly comprehend the difference between you having a bonk and simply watching your favourite comedy.

Preventing perineum injury

On that note, studies have shown priming your perineum is effective in preventing tears during labor, especially after 36 weeks, so apart from aubergines, questionable props or the famous Epi-no (which has been shown to work by the way!), it could be a favourable option for dear husband to step in for some “Episiotomy prevention”.

When did “fun sex” turn into “functional sex”?  Talk to any TTC couple and you will know it is a constant mind bend. And when you’re feeling really unsexy, have a read about perineal massage.

How do I prevent Stretch Marks?

They used to say it was genetics and left it at that, but with the latest nutritional studies we are beginning to uncover the effects of nutrients on our genes.

Top tip:  Having enough zinc (red meat, wheatgerm), Vitamin A (sweet potatoes, carrots, dark greens) and Vitamin E (sunflower seeds, avocados) can do wonders for improving skin elasticity and therefore preventing tiger stripes. If you suspect a deficiency, please get checked out.

This beats any amount of duck feather oil or virgin peacock essence which are molecularly too huge to be absorbed through the skin and are probably made mostly out of mineral oils anyway. Sorry!  Moisturise yes, with a cream-based emulsion.

To exercise or to lay absolute still?

My mother wouldn’t let me carry anything, climb any stairs, and I swear she holds her breath for me when I sneeze. Is she afraid her daughter’s cervix would open up like clouds on a rainy day and drop her grandson onto the pavement?

Don’t get me wrong, those with threatened miscarriages and structural problems need to heed prevailing medical advice, but how about the rest of us? I enjoy my weekly workouts with functional trainer Karen Lee, do my own yoga daily, and attend a prenatal yoga class once a week.

Keeping active really helps in keeping my lower back pains and pelvic aches at bay, and I really love getting the circulation going.

You’ll also find me leaning over and doing pelvic rocks at every opportunity. I couldn’t care less what anyone thinks anymore. I am the Queen bee.

If you did Yoga before, do Yoga.  (Just not cobra, wheel, bridge, inversions or any vigorous pranayama breathing). If you used to run, run.

Active and keen bean mums do need to consciously put a cap on exercise and not push with new mileages or weight increments to prevent injury due to increased Relaxin hormone, making you over-stretchy and unable to protect your bones and joints at extreme ranges of movement.

Read more: Pregnancy Fitness and Third Trimester Workout Tips

Super human mums doing head stands, back bends, too much core work (and bragging about it on social media) are simply promoting injury, sprains and the dreaded Diastasis Recti (separated abs) for the normal human preggo.

The goal here is merely to maintain pre-pregnancy fitness and to trust that your body is doing a lot of prep already, even while you are laying down doing bugger all. Again, another of those humbling things about being preggo. Go with the flow.

Simple things like kegels, pelvic rocks, cat and cow pose should be your go-to moves, best done throughout the day and throughout the pregnancy.

Relaxation is as important as exertion!

Every night I like to lay on my yoga mat and rock lightly side to side on my back, do some light stretching, and use a tennis ball against the wall or the floor to release tension points such as the piriformis muscle, the main culprit behind sciatica.

These balls have been a life saver, as no masseuse would touch me once I declared my pregnancy.

Meditation, hypnosis and body relaxation scripts all help prepare you in managing the anxiety and mind over matter issues when it comes to the birth (and beyond!).

My pelvic dysfunction story…

So during pregnancy flexibility increases due to pregnancy hormones ,which can trick you (and me!) into thinking we are overnight gymnasts and cause strain and injury.

I got overzealous with fitness, pushed hard at interval training one week, didn’t account for the good old Relaxin hormone, and ended up overdoing those deep lunges and squats which were supposed to be so good for pregnancy.

I am way more bendy than the average pregger, and subsequently developed a touch of Symphysis Pubis pain, resulting in persistent inner thigh, and lower back pain.  Couldn’t open my legs (great, not only am I pregnant, I seem to have a chastity belt built right in!), and turning in bed woke me up.

It took a week for the penny to drop that I had SPD (symphysis pubis dysfunction), and I quickly connected with Monica Donaldson at Body With Soul, who is the guru for any pelvic floor issues. Give her a call if you’re having similar issues, mamas.

One session with one amazing Physiotherapist, a 10-day break from working out, and I was brand new and feeling positive about the whole giving birth idea again.

Is that a sea monster in my belly or is that…

Baby moving!

Wait — that’s a lot of moving… is it something I ate that’s not right for you? Is it too cramped in my uterus? Are you okay with me doing a downward dog?

I hope you like my dodgy singing.  And uh, yes that’s the beautiful sound of mummy farting.  Best get used to it!

Why aren’t you moving today?  Are you still there? Are you upset because I shouted at Daddy today?

What normal baby movement and what’s not?   

The sensation starts around 17-24 weeks for most mamas. Who really knows what’s the norm? This is where I learnt to exercise faith, hope and trust. And I’ll spy on your beating heart again at the next scan, little one!

The birth plan.  Do I need one? When do I make one?

It is a good idea to gather ideas, but only really solidify a birth plan with your OBGYN after week 32, when they will be able to ultrasound placenta position and ascertain the lie of the baby.

Read More: How to write a birth plan (with downloadable templates)

I started off being dead against home births and thinking of water births as unnecessarily exotic, then moved to being totally sold on the idea.

I’ve therefore lined up my team consisting of a supportive and attentive OBGYN, Angelyn my wonderful doula, and my brave husband who attends the 6 week intensive Bradley Method class with me to prep as my birth companion and baby catcher!

See you all real soon!