Category: Motherhood

These days, women have more information than ever when it comes to their reproductive health.
Women’s health is (finally!) being taken seriously by the medical community and thanks to technological advancements that allow us to better understand our bodies, modern women have more understanding about their reproductive health systems than women of any other generation. All that knowledge is empowering, but it also means that more women are finding out that they have anatomical differences, like a tilted or reverted uterus.
When it comes to reproductive health, emotions run high, so hearing that you have a tilted uterus can be scary. Is something wrong with you? Could this affect your chances of getting pregnant and delivering a healthy baby? Although most of us probably don’t give too much thought to our uteruses in day-to-day life, it’s still important to know that your reproductive system is healthy, and that it will be ready if you decide you want to have children.
Luckily, having a tilted uterus is usually just another variable when it comes to the ways our bodies are all made a little differently. Usually it’s nothing to be alarmed about.
However, there are some instances in which having a tilted uterus can indicate an underlying health concern, or can lead to trouble getting pregnant.
HealthyWay talked to women’s health and fertility specialists to answer all of the most common questions about having a tilted uterus. Here’s what you should know about having a tilted uterus, and how this condition affects conception, pregnancy, and delivery.

What is a tilted uterus?

Most people, including medical professionals, use the term “tilted uterus” to mean a uterus that points toward a woman’s back. This is also known as a retroverted uterus.
Many women are born with a uterus that is straight up and down within the abdomen, which is considered standard positioning. However, many woman have a uterus that tilts after the cervix, the opening to the uterus. The most common type of tilt is a uterus that leans slightly to the front, known as an anteverted uterus. A retroverted uterus—usually referred to simply as a tilted uterus—is the opposite of that.
Bat-Sheva L. Maslow, MD, a reproductive endocrinologist at Extend Fertility in New York City, says that having a tilted uterus is just another variation of normal, similar to being left-handed.
“While less common, having a retroverted uterus is not abnormal,” she says. In fact, about one in five women around the world have a tilted uterus.

Why do I have a tilted uterus?

If you’ve been told that you have a tilted uterus, you’re probably wondering how a tilted uterus develops. In most cases, this is just the way you were born.
“This condition can be the way some women are built; it is perfectly natural,” says Joshua M. Hurwitz, an OB-GYN and board-certified reproductive endocrinologist and infertility specialist at Reproductive Medicine Associates of Connecticut.
However, in some cases there are physical changes within the body that cause a tilted uterus. The most common is from scar tissue caused by endometriosis or fibroids. This scar tissue can weigh the uterus down, or pull in toward the back, resulting in a retroverted uterus. These conditions can also create scar tissue in the abdomen, which can then push the uterus backward. Women who have a tilted uterus accompanied by pain should talk to their doctors about whether they have any other signs of endometriosis, a condition in which the lining of the uterus grows outside the womb.
Other women might develop a tilted uterus after pregnancy. That’s because the ligaments that hold the uterus in place stretch and loosen during pregnancy, so after delivery the uterus can settle in a new position, resulting in a retroverted uterus. Menopause can cause this as well since the ligaments holding the uterus relax as estrogen drops, allowing the uterus to slip into a tilted position.
Because these conditions are all beyond your control, there is no way for a woman to prevent developing a tilted uterus.

What are the signs I might have a tilted uterus?

A woman with a tilted uterus will most often not have any signs or symptoms according to Phil Chenette, MD, a board-certified specialist in reproductive endocrinology and infertility with Pacific Fertility Center in San Francisco.
“Most women with a tilted uterus never know until it is found on pelvic exam or a pelvic ultrasound exam,” he says. Although it’s easy for a doctor to diagnose the condition during a routine exam or ultrasound, the women who have the condition usually have no signs, so a retroverted uterus usually goes unnoticed.
However, some women who have a tilted uterus will experience symptoms. A woman with a tilted uterus might experience menstrual cramps as pain that is located more toward her back than her abdomen, Maslow says. Additionally, some women who have a tilted uterus will experience more severe pain with menstruation—although that’s usually because of another underlying health issue like endometriosis (more on that in a moment).
A woman who has a tilted uterus might also experience pain during intercourse or while using tampons if her tilt is severe, Maslow explains. That’s because in some cases the uterus can tilt so severely that it puts pressure on the vagina. However, Maslow underscores that these symptoms are rare.
“The vast majority of women with retroverted uteri will experience no symptoms and not know they even have one unless a doctor has told them,” she says.

Is is harder to get pregnant with a tilted uterus?

Many women who hear that they have a retroverted uterus worry that having a tilted uterus will affect conception. The good news is that most of the time a woman with a tilted uterus will not have have a more difficult time getting pregnant that anyone else.
“As a fertility specialist, I do not believe there is any connection at all between a tilted uterus and infertility,” says Hurwitz. “Only in those exceptional cases where scar tissue from endometriosis or surgeries has caused this uterus to be mechanically displaced is there a tie-in to fertility problems.”
Chenette says that when a uterus is severely tilted it can lead to trouble conceiving. Some women have an acute retroversion, where the cervix has a tilt that is between 90 and 180 degrees, he says. Women with a more severe tilt and a sharper curve in their uterus are more likely to have trouble conceiving.
“Some women have a sharp hockey stick kind of curve and some have a slow gradual rounded curve,” Chenette says.
Having a significant tilt can prevent sperm from reaching the egg in women with a tilted uterus, thus making it more difficult to get pregnant.
“Since traversing those angles as a sperm cell can be challenging, women with a significant tilt can experience longer times to conception,” Chenette says.
If a woman with a tilted uterus is having trouble getting pregnant and all other infertility causes have been ruled out, a doctor might recommend intrauterine insemination or in vitro fertilization. During intrauterine insemination, a doctor places sperm in the main body of the uterus using a catheter. This way, sperm do not need to navigate the bend of a tilted uterus, and more of them are likely to reach the egg, increasing the chances of conception. During in vitro fertilization, an embryo (a fertilized egg) is placed in the uterus above the tilted portion. If this embryo successfully implants, the patient will become pregnant.
Although both procedures are highly effective even when a patient has a tilted uterus, Chenette says that assisted reproduction is a bit more complicated for a woman who has a tilted uterus.
“It takes an experienced doctor to perform insemination or embryo transfer in these patients,” he says. “The same cervical curve that produces the original problem can make insemination or embryo transfer challenging.”
However, usually a woman with a tilted uterus can become pregnant, even if she requires assistance.
“Careful ultrasound guidance and an experienced hand almost always solves this problem,” Chenette says.

How does a tilted uterus affect pregnancy and birth?

Although a tilted uterus can make conception tricky in some cases, it should not affect pregnancy at all.
“Once a woman conceives, which most do, the pregnancy proceeds normally,” Chenette says.
During pregnancy, the uterus expands rapidly. It starts off at about the size of an orange, and grows to the size of a grapefruit by the 12th week according to the American Pregnancy Association. By week 20 (halfway through pregnancy) the uterus usually reaches a woman’s belly button, and by full term the uterus is the size of a watermelon, stretching to the bottom of a woman’s rib cage. All of that growth works to correct the position of a tilted uterus.
“As the uterus grows with a pregnancy, it comes out of the pelvis and ‘unfolds,’” Maslow says. “By the time the baby is large enough for the mom to feel its movements, the uterus is typically out of the pelvis and you really no longer see much of a difference between those that are folded forwards or backwards.”
Whether or not the mother-to-be had a tilted uterus before pregnancy will not affect her during delivery, Maslow says.
“By the time the baby is term, there is no distinction between the way the uterus had been folded and as far as I know there isn’t any data to support that having a retroverted uterus has any impact on delivery outcomes,” she says.

How can a tilted uterus affect your sex life?

Sometimes a woman with a tilted uterus will experience pain during penetrative sex, if her tilt is severe enough that it is putting pressure on her vagina. Pain during sex is most commonly experienced by women who have endometriosis in addition to tilted uteri, so if you experience this, be sure to mention it to your doctor so you can discuss any other signs of symptoms you have that might be associated with endometriosis, Chenette says.
Most often there is a simple solution to pain experienced during intercourse, he adds.
“Sometimes a change in position is enough to relieve the discomfort,” he says.

What are the treatments for a tilted uterus?

Because a woman with a tilted uterus usually has no symptoms, there is often no need to correct the condition.
“The condition is not worrisome or dangerous at all and there is nothing to do about it or treat,” Hurwitz says.
However, if your tilted uterus is causing you pain either during sexual activity or during your period, your doctor will likely be able to recommend some treatments. One correction that you can try at home is doing a knee-to-chest exercise, according to Hurwitz. To try to reposition your tilted uterus using this exercise, lie on your back on the floor. Raise your right knee to your chest, holding for 15 to 30 seconds. Then, return that foot to the foot and draw your left knee up toward your chest. Do ten repetitions per side, three times each day. Even when knee-to-chest exercises aren’t enough to correct a tilted uterus, they can help with back pain that women with a severely tilted uterus can experience, Hurwitz says.
For women who have lots of pain that is caused by or made worse by a tilted uterus, doctors may recommend surgery to reposition the uterus. This is very rare, and usually only done when a woman has a tilted uterus that is associated with endometriosis, Hurwitz says.
Living a healthy lifestyle can help reduce pelvic pain, including the pain associated with a tilted uterus, Chenette says.
“Stress reduction and mindfulness techniques, as well as reducing alcohol and [improving] nutrition, can reduce some of the symptoms of pelvic pain,” he says.

So should you be worried about having a tilted uterus?

Unless you are having severe associated symptoms, having a tilted uterus isn’t anything to stress over.
“It is important to remember that a uterus can point in any direction: up, down, to either side, and even be rotated,” Hurwitz says. “This does not mean there is a medical, fertility, or pregnancy problem at all.”
In fact, the toughest part about having a tilted uterus is often finding out that you have the condition.
“I think the worst part for a woman hearing that she has a ‘tilted uterus’ is the anxiety and worry that the label places on her anatomy, which really does not have any negative effect anyway,” Hurwitz says.
Today it’s totally normal to hop online and research any new medical condition, but going down that rabbit hole can be scary. The experts who spoke with HealthyWay all emphasized that for most women having a tilted uterus is nothing to worry about.

When I was nearing the end of my pregnancy, I obsessed over every twinge of pain, trying to determine if I’d had my first contraction. I wondered constantly: What do contractions feel like? What will labor be like?
I also experienced what I can only describe as pregnancy-induced rage when women would say with a knowing smile, “Oh, you’ll just know,” when I asked what real contractions feel like.
Instead, I was left to anxiously pore over pregnancy message boards reading other women’s experiences of going into labor.
The night before I had my first contraction, we’d headed to the hospital because I thought I was leaking amniotic fluid. I wasn’t, but the triage nurse told me I was probably in the initial stages of labor.
So, when I felt that first contraction, I suspected my labor had started, although I wasn’t sure, because I didn’t know exactly what to expect. And I was scared out of my maternity panties.

All that stuff they teach you in childbirth class? Right out the window.
Until I realized, Hey, my body was made to do this. And in that moment, as my husband frantically ran around our house throwing stuff in a bag like a first-time dad on TV, I remained pretty calm. Because here’s the deal: A baby is going to come out of you one way or another.
But giving birth isn’t and shouldn’t be a scary experience! There’s no need to be nervous about giving birth. We’re going to tell you exactly what contractions feel like, how to manage your contractions through labor, and answer all your contraction questions.
Here’s everything you never knew you needed to know about what contractions feel like.

So what are contractions, anyway?

Short answer: Contractions are your body’s way of gearing up for labor.
But what if I told you there are actually two types of contractions? In addition to those contractions—the ones that kickstart your labor—there are Braxton Hicks contractions, also known as false labor contractions.
And what do Braxton Hicks contractions feel like? Those are more of a tightening in your abdomen, but you’ll know they’re not real, we’re-about-to-have-a-baby contractions because they’re sporadic, painless, and will usually stop if you rest or drink a glass of water.

So how the heck are you supposed to know the difference?
“Braxton Hicks are contractions as well, just not powerful enough to cause cervical change,” says Heather Bartos, an OB-GYN at Be. Women’s Health and Wellness Center near Denton, Texas. “Labor starts when there are persistent contractions and cervical change.”

What do contractions feel like?

You asked, and oh, baby, did we answer.
While contractions do usually signal the beginning of labor, how they feel can vary wildly from woman to woman.
“Imagine the worst menstrual cramp you’ve ever had,” says Bartos. ”Now imagine that all of the sudden you want to punch your partner in the face because it hurts so bad, like you’re trying to pass a huge bowel movement.  But you physically can’t get to them to punch them because it hurts too bad every three minutes or so. It almost brings you to your knees and takes your breath away.”
And that, ladies, is what contractions feel like.
Sounds great, right?

We also spoke to real moms and asked the question What do contractions feel like?
Ali Garrett, a veteran mom who’s given birth twice, says, “With my second baby, I had textbook contractions. When my contractions began, it felt like my belly was shrinking; a tightening if you will. It didn’t hurt, but it got my attention.”
Garrett had experienced Braxton Hicks throughout her pregnancy, but these contractions were the real deal.
“These contractions would last about 30 seconds, as opposed to Braxton Hicks, which would last about 10 seconds, but didn’t increase in pain or pressure.”
New mom Dora Smith-Cook says, “For me, contractions came on suddenly. They felt like a very intense version of menstrual cramps. Lots of pressure and tightening in my lower abdomen. It was a dull but powerful pain, almost like a vibration that shook my whole lower body.”
I gave birth six months ago, and my early contractions also felt like intense period cramping. Early on, I definitely felt the ebb and flow of a contraction like doctors describe. But closer to delivery, contractions came so fast I didn’t even have time to breathe through them.

Great, now I know what contractions feel like, but when will they start?

Now, I’m not saying your friend’s sister’s niece who had zero contractions during her labor is telling a fib, but…she’s probably not telling the truth either.
“99.9 percent of women will feel contractions,” says Bartos. “And they are painful.  I don’t know who that 0.01 percent woman is but I’d like to meet her!”

While Bartos says that most women will begin having intermittent labor contractions as early as 37 weeks, sometimes contractions aren’t felt until well into active labor.
Amanda Johnson, who gave birth to her son about four weeks before her due date, says, “My water broke first, and I didn’t even realize that I was having contractions until the nurses hooked me up to the monitor. For me, strong contractions didn’t begin until I was almost ready to push.”
When your water breaks, sometimes it will sort of feel like a hot water balloon has burst…inside you. But your bag of waters doesn’t always come out in a gush. Sometimes it’s like a trickle and can feel exactly like you’re peeing yourself (a sensation most pregnant women are already very familiar with).
Whether it comes out in a trickle or a gush, you can expect labor to begin within 12 to 24 hours if your water breaks, so get thee to the hospital pronto.

Contractions are happening! When should I head to the hospital?

Most doctors recommend following the 4-1-1 rule, which does not mean dialing information for the name of the pizza place down the street.
If your contractions are consistently four minutes apart, lasting about one minute each time, for about an hour, you should probably give your doctor a call and let them know you’re heading to the hospital.
If you want to labor at home longer, your doctor may okay it, but Bartos says it’s time to head to the hospital when the contractions feel like they are too much to bear, or if you start shivering or shaking a lot. These could be signs that you’re in transition, which means you’re dilated to around 7 centimeters.

Of course, it would be too easy if everyone had a textbook labor and delivery.
“With my first baby, I had no warning signs I was in labor until my water broke,” says Garrett. “Then contractions came quickly and painfully, without any warning.”
For most first time moms, it can be hours before your contractions reach the 4-1-1 mark consistently, and sometimes labor can stall altogether if contractions don’t continue to build.
“[My contractions] got closer together after a few hours, and occasionally I would have two back to back,” says Smith-Cook. “The level of intensity never really increased, which may have something to do with why I ended up with a c-section. I think if I had been able to deliver vaginally, they would have progressed to a stronger level.”

I heard sometimes you’re given medication to start contractions. Why is that?

Sometimes a doctor decides to administer Pitocin, a common medication given to jumpstart labor, especially if your water has broken but contractions haven’t started yet.
Pitocin is actually a big dose of oxytocin, the same hormone your body produces naturally to stimulate contractions.

Because it’s a much larger amount of oxytocin designed to stimulate labor, Pitocin contractions can be incredibly intense, and it may be difficult to labor through them without an epidural.
“I was given Pitocin after 24 hours with my first delivery,” says Garrett. “It was like getting struck by lightning; no peak or trough like they teach you in childbirth class, just blinding pain.”

What do contractions feel like during labor?

During labor, your contractions will get progressively more intense, until it’s hard to breathe through them.
It’s at that point that you may decide to get an epidural. “An epidural doesn’t take away the sensation of pressure,” says Bartos. “But the physical pain of contractions are significantly reduced.”
Epidurals can be especially helpful if you’re experiencing back labor, which is often felt when the baby’s head is pressing against your tailbone due to its position in the womb. Epidurals sound kind of scary, but the relief they provide can help you catch a break during labor and replenish your energy for pushing.

Aubree Dickerson, a first-time mom who gave birth in January, says, “My contractions felt like intense period cramps. It was hard to take a deep breath through them, so I could only take short small breaths. Then I got an epidural and felt nothing. Praise God for that!”
If you want to try to manage the pain of contractions naturally, you can try a ton of different pain management techniques, like good old-fashioned breathing exercises or even hypnotism.
For natural relief of back labor pain, you can try having your partner press firmly against the small of your back each time your experience a contraction. The pressure of their hand counters the weight of the baby’s head, relieving some of the pressure and pain.
So is one pain management technique better than another?
“It depends on the woman,” says Bartos. “Some women really prepare (hypnotherapy, classwork prepping) and do well with more natural techniques, but some women fear those modalities and request anesthesia. Either is a fine choice!”

My doctor says I have plenty of time after contractions start before delivery, but I’m worried about giving birth in the car!

“Once my contractions with my [linkbuilder id=”6718″ text=”second child”] were 10 minutes apart, we went ahead to the hospital, where my water broke five hours later and active labor began,” says Garrett. “Twelve hours later, we had a baby.”
Generally, first-time moms do tend to have a longer labor. Most of the time, active labor for first-time moms lasts between eight and 12 hours.
But sometimes labor can progress quickly, even for first-time moms.

Take my son’s birth, for example. I had intermittent contractions the night before I gave birth, and the next morning, I sent my husband off to work with the promise that I’d call if I felt anything. An hour later, I was trying to tell him to get home between contractions. About four hours later, our son was born. My contractions came hard and fast, and I felt the need to push within just a few minutes of arriving at the hospital. The nurses had to scramble to set up our room for delivery because they assumed I’d be in labor for hours!
The best thing to do? Head to the hospital whenever you feel like you need to. You’ll get checked out and sent back home if your doctor decides you’re not in active labor.
A few false alarms are totally worth avoiding an impromptu home birth.

Is it true I’ll have contractions after delivery too?

Ah, you sweet little starfish. No one told you that contractions don’t end immediately upon giving birth?
It’s true. They don’t. But, there’s a silver lining! Actually, there are two silver linings.
The first? You have your baby!

The second? After-labor contractions are nowhere near as painful as the ones felt during labor.
Generally, you’ll feel contractions as you deliver the placenta.
“Your uterus was up by your rib cage and it rapidly shrinks down to your belly button—that requires muscle contraction … These are essential for your uterus to return to normal—if this doesn’t happen, a woman can experience significant postpartum bleeding and hemorrhage,” says Bartos.
You may also continue to feel mild contractions for several weeks, particularly when you breastfeed, as your uterus continues to shrink back to its normal size. These contractions feel like manageable period cramps.

Now that I know what contractions feel like, I don’t exactly feel better about giving birth.

So here’s the deal: Giving birth hurts like a mother.
But it really is manageable. I promise.
Now that you know what contractions feel like, you can use this information to reframe your mindset about labor pain.
“Embracing the idea that childbirth is painful (for a short period of time only, thank goodness!) can actually help your brain prepare for such an event,” says Bartos.
And you know what, mama? You’re gonna do great.

Exhaustion. Tender breasts. Morning sickness. They’re all signs of pregnancy. But almost as important: They’re all signs that pregnancy hormones have kicked into high gear and they’re doing exactly what they need to do to keep you and your baby healthy.
Okay, okay. When you’re running to the bathroom for the third time in an hour, it may not feel like such a great thing. And the ebbs and flows of pregnancy hormones can have you tearing your hair out one minute and then marveling at how thick and lush it is the next. But hormones play a crucial role in helping the body get pregnant, stay pregnant, and prepare for the arrival of a baby.
Unlike your skin, hair, and belly, however, hormonal changes occur without us ever seeing them, making for one of the great mysteries of pregnancy.
What’s really going on at the hormonal level? When can you expect your pregnancy hormones to spike, and how do they change throughout the course of the nine months (give or take) of making a baby?
Let’s dive in!

What’s a hormone anyway?

We might not spend much time thinking about them, but hormones rule our lives. Produced by a number of glands throughout the body—from the pituitary to the thyroid—hormones are essentially chemicals that travel throughout the body, coordinating the functions of our organs and tissues.
“Hormones are for essential for life,” says nurse practitioner and certified nurse midwife Patricia A. Evans of MemorialCare Medical Group in Fountain Valley, California. “[They] contribute [to] and influence immune system functionality and can even affect behavior.”
Hormones also play a major role in puberty, dictating body changes and—in cisgender females—spurring the beginning of the body’s menstrual cycle.
Not having a period? Having periods that are too long or too frequent? All those issues come down to hormones, says Sherry Ross, MD, OB-GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California. And because fertility is directly tied to the body’s menstrual cycles, doctors will typically test a woman for a hormonal imbalance if she walks in the office citing infertility concerns. Correcting that imbalance can be the key to helping solve infertility woes.
On the other hand, when all of the hormones are right in line, it’s these chemicals floating around the body, keeping everything in check, that help make conception happen.
Not making the connection? That’s okay; you’re not the only one who hasn’t been back to science class in a while.
Diana Bitner, MD, an OB-GYN at Spectrum Health in Grand Rapids, Michigan, broke it down for us. “A correct hormone balance is crucial to getting pregnant, and hormones are in good balance when the ovary is functioning well and the brain and the ovary are communicating well,” she explains. “If the ovary is able to make a good quality egg, then the hormones are right.”
So how does it work?
When a woman is healthy and in the reproductive phase of her life, she’s typically ovulating every 28 to 30 days (depending on a woman’s “normal” cycle). When her period is starting, a new follicle in the ovary is being stimulated by a follicle-stimulating hormone (FSH).
“The cells around the immature egg make estrogen in the first half of the cycle,” Bitner explains.
Ovulation, which typically occurs smack dab in the middle of your menstrual cycle, is triggered by yet another hormone: luteinizing hormone (LH for short).
When the follicle stimulated by FSH syncs up with the LH-stimulated ovulation, the follicle releases an egg, Bitner says, and the body’s cells make yet another hormone called progesterone.
“The lining of the uterus is analogous to the ‘lawn,’ and [the hormone] estrogen acts as fertilizer and the progesterone as almost weed-killer to keep it from growing out of control,” Bitner says. Together the hormones help the lining of the uterus mature and get ready for a fertilized egg to plant. If that happens, the fertilized egg will then have a home on the “lawn” to develop into a fetus, the way a seed develops into a flower in your yard.

Pregnancy Hormones: The Big 3

So hormones help you turn all that bedroom fun into an actual pregnancy. Then what? More hormones get in on the action.
After an egg is fertilized by the sperm, it heads to the uterus to implant, and hormones kick in to help the body sustain a pregnancy and help the embryo grow into a fetus. The three main pregnancy hormones are human chorionic gonadotropin (hCG), progesterone, and estrogen.

Human Chorionic Gonadotropin (hCG)

A popular fad diet featuring human chorionic gonadotropin (hCG) has gotten the stink-eye from the U.S. Food and Drug Administration (FDA), making the term sound a little scary for a pregnant woman. Fortunately, the hCG produced by the body during pregnancy isn’t just healthy…it’s absolutely vital.
While all three major pregnancy hormones will increase in the weeks after conception, hCG is the first, Evans says, and it’s responsible for keeping the other two at appropriate levels while the placenta grows. Once the placenta is developed enough to sustain the growing embryo—at around 10 to 12 weeks, basically the tail end of the first trimester—hCG production slows down as the placenta steps up to the plate.

Progesterone

Initially produced by the ovaries, progesterone kicks in early in the pregnancy, and you’ll start seeing physical changes because of it. A rise in progesterone levels will increase a pregnant woman’s heart rate—and her appetite. It can also lead to some of the more uncomfortable side effects of pregnancy, such as fatigue.  
Because progesterone has an impact on the smooth muscles of the body, it affects the lower esophageal sphincter, Evans says, which can cause heartburn and acid reflux, mostly later in pregnancy. Progesterone also softens the cartilage, which contributes to pelvic pain. On the other hand, it’s that softening that helps the hips to expand during childbirth!
Low progesterone levels can lead to miscarriage, warns Anita Somani, MD, an OB-GYN with OhioHealth in Columbus, Ohio, so your OB-GYN or midwife may be doing blood tests to keep track of your progesterone levels, especially if you’ve had issues in the past.
If you’re looking at the blood tests for answers, here’s a basic guideline. Progesterone levels can range from 9 to 47 ng/mL in the first trimester, with an average of 12 to 20 ng/mL in the first 5 to 6 weeks of pregnancy. But Evans is quick to say that these numbers are not to be taken alone, as each woman’s body is different. “It is not the single value that can predict a healthy pregnancy outcome,” she warns. When in doubt, ask your doctor or midwife.
Some OB-GYNs do suggest women who have had a previous miscarriage or have experienced a pre-term delivery take progesterone during their pregnancy in addition to the amount the body produces.
Studies on the efficacy of added progesterone are mixed. One 2015 study published in the New England Journal of Medicine concluded that progesterone therapy in the first trimester of pregnancy “did not result in a significantly higher rate of live births among women with a history of unexplained recurrent miscarriages.” Because of studies like these, it’s not recommended that women take progesterone on their own without a doctor signing off.
The body’s progesterone production will slow down in the end of the first trimester as the placenta takes center stage.

Estrogen

Along with progesterone, estrogen is produced in the ovaries, and it helps sustain the lining of the uterus in the first trimester, supporting the developing embryo. It’s also one of the two hormones (again, along with progesterone) most responsible for the physical changes we have come to associate with pregnancy.
The most pronounced? Those achy, throbbing breasts can be blamed on increased estrogen production in your body. If you’ve got a stuffy nose, you can blame that on estrogen too. The hormone helps increase blood flow through the body. This is good news for your growing fetus, which will depend on that increased blood, but it can result in swelling in your nostrils. (Then again, it’s all that extra blood flow that contributes to a pregnant woman’s “glow.”)
The ovaries’ estrogen production will begin to wane near the end of the first trimester.

What about the baby?

While the big three hormones begin to taper off by the time you hit your second trimester, that doesn’t mean hormones aren’t still working on your body.
As the embryo grows, so does the placenta. By about week nine of your pregnancy, the placenta takes over pumping out estrogen and progesterone and adds yet another pregnancy hormone, human placental lactogen (hPL), to the mix. One of hPL’s main jobs is to inhibit insulin, preventing glucose from absorbing into a mother’s cells. In turn, that makes your bloodstream glucose levels increase, providing more sugar to the baby so he or she can grow.
Overall, hormones produced in the placenta will work together to promote fetal growth while also helping a mother’s body become an even better place for a baby to develop. That means some will spike, decrease, then spike again, and you’re just along for the ride.

Up and Down and Back Again

All that ebbing and flowing of hormone levels may be natural, but let’s face it, it’s not easy having your hormones fluctuate. From exhaustion to wild emotions, hormones can make you feel like you’re on a roller coaster.
“Mood swings, fatigue, nausea and vomiting, breast tenderness, sensitivity to smells and odors can be overwhelming at times,” Evans admits. “The good news is that these are temporary and most decrease with time.”
In truth, there’s nothing you can do about hormone fluctuations. They’re part of pregnancy. But they also don’t have to plague you the whole nine months.
“Change is normal and moods can be affected,” Bitner explains. “The best is self-care and awareness. If a women has underlying mood issues, such as anxiety or depression, the worries of pregnancy, body changes, and relationship changes can add stress and expose coping difficulties.
“The best way to cope is to have good self-care in place with a healthy diet, adequate sleep, a support network of family and friends, and (if necessary) counseling to deal with more difficult situations,” she adds. “Women who cope are able to ask for help when needed, believe they deserve to be happy and do well, and keep a network in place. Some women do need medication for mood during pregnancy and there are safe options.”
Evans recommends her patients break down the nine months into chunks to get through.
“I like to describe the first 20 weeks of pregnancy as [wedding] planning,” she says. “[You’re] busy with anticipation, worries, excitement for the future, and ups and downs of event planning. When the wedding day arrives at around 20 weeks, you find you have more energy and sense of euphoria as the honeymoon begins and you start buying baby clothes and life is grand as the hormones settle in and calm down.”
By the last month, however, the honeymoon is over and you’re facing yet another hormone change.
“As your body prepares to give up this growing life inside, you can’t breathe, sleep, eat, find clothes that fit and your feet have outgrown every pair of shoes in your closet, and all you want is to meet your new baby, and for the pregnancy to be done so you have more energy and a sense of euphoria never before experienced—the birth of your baby,” Evans says.

After Baby Comes

Once the baby arrives, your hormones will change once again. The placenta leaving the body means it’s no longer producing hormones, and estrogen and progesterone levels fall to low levels rapidly after birth.
If you decide to breastfeed, estrogen and progesterone will help support milk production and suppress ovulation (which is why many breastfeeding moms don’t get a period for months or even years after giving birth).
These hormonal changes can be dicey for moms who are risk of anxiety or depression, Bitner warns, as the loss of estrogen is associated with less serotonin activity.
“Serotonin is the brain chemical which impacts many women in how they cope and how they feel,” she explains. “Lower effective serotonin levels can lead to marked depression and/or anxiety, especially if other risk factors exist, such as sleep deprivation and life stressors.”
Depression treatment can start during pregnancy, or you may need to be watched for postpartum depression symptoms. So if you’re worried about the way hormonal fluctuations can affect your mood during and after pregnancy, it’s important to talk to your healthcare provider. There is help available.
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When those two pink lines appeared on your pregnancy test you were absolutely thrilled. You imagined cuddling with your baby and even got excited about the big, round belly that was coming your way. You started shopping and dreaming up the perfect name.
Then you started throwing up. And thus the quest to find nausea remedies became an essential part of your day.
Pregnancy is a beautiful time, but there is nothing that can put a damper on the excitement of the impending new arrival as much as morning sickness. (For starters, it must have been a man who coined that term, because any woman who has been pregnant knows that pregnancy nausea can last all day or creep up suddenly when you least expect it.)
To make matters worse, nausea usually peaks in the first trimester, when you might be opting to keep your news private. Trying to work or even just function while constantly feeling sick adds another level of emotional depletion to pregnancy when emotions are already running high, so finding nausea remedies that work for you is critical to feeling better.
While morning sickness is often short lived compared to the 40 weeks of pregnancy, that still means dealing with unending nausea for weeks. Who, besides moms-to-be, would be able to endure that?
Fortunately, if you’re spending your days puking in flower pots, running to the bathroom at work, or just feeling constantly queasy, there are some nausea remedies that can alleviate and prevent morning sickness. You can take advantage of these nausea remedies until the second trimester rolls around and brings sweet relief.
Here’s everything you should know about morning sickness—and the nausea remedies that can keep it at bay.

What causes morning sickness, anyway?

If you’re like most pregnant women, you’ve probably wondered why you’re feeling your worst when your body needs to be healthier than ever to support a pregnancy.
The answer is those pesky hormones. In particularly you can blame human chorionic gonadotropin (hCG), a hormone that is produced in the placenta and helps your fetus develop. This hormone first becomes detectable in your system about 11 days after you ovulate, and some women might need nausea remedies beginning right then. The hormone peaks around weeks 8 to 11 of pregnancy, according to the American Pregnancy Association. Not coincidentally, this is also when pregnancy nausea is at its worst and women are most in need of nausea remedies.
“We think there may be a relationship between high pregnancy hormone levels like human chorionic gonadotropin, estrogen, and morning sickness,” says Patricia Lo, an OB-GYN at MemorialCare Saddleback Medical Center in Laguna Hills, California. “Women with twins or triplets have higher levels of hCG and generally have worse symptoms.”
The small silver lining to feeling sick is that it is likely a sign of a healthy pregnancy. Low hCG levels can indicate an impending miscarriage, so higher hormone levels—and the nausea that accompanies them—are generally a good sign that your body is doing what it needs to to help your baby grow.
“Women with mild nausea and vomiting during pregnancy experience fewer miscarriages and stillbirths than women without these symptoms,” says Sherry Ross, an OB-GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California. “So, for me, when a woman is really nauseous and has occasional vomiting, I know she is probably carrying a healthy pregnancy!”
Of course the peace of mind is great, but it does little to alleviate the physical symptoms you’re experiencing, so experimenting with different nausea remedies that work for you is still important.
If you’re prone to nausea in general or have had morning sickness with a previous pregnancy, you’re more likely to experience it again, Lo says. Some people say that women who are carrying female fetuses are more likely to experience nausea, but experts disagree about whether this is true or merely an old wives’ tale.
And if you’re feeling frustrated that your sickness lasts all day, you’re not alone.
“Unfortunately, for most women, nausea and vomiting can persist throughout the day. For these women, the term pregnancy-related nausea and vomiting may be a better term” than morning sickness, Lo says.
Lo points out that nausea isn’t the only symptom of morning sickness—some women will experience dizziness or lightheadedness or have increased saliva. Although all of that is entirely normal, it certainly isn’t pleasant! Hang in there.

Study your triggers and you might not need nausea remedies.

Since pregnancy nausea differs from woman to woman, the most effective thing you can do to keep nausea at bay is to study your own symptoms and figure out what nausea remedies work best for them. Learn what triggers your morning sickness, and stay away from those things.
“Avoid anything that makes you nauseous,” says Lo. “This can include foods with strong odors, stuffy rooms, hot places, and loud noises.”
This step requires some patience, but it is ultimately very effective.
“It may take some trial and error before you find out what your triggers are,” Lo explains.

Figuring Out Which Nausea Remedies Work

The American Pregnancy Association says that half of pregnant women experience morning sickness, and the experts we spoke to put the number closer to 80 percent. That leaves a lot of women looking for nausea remedies just so they can go on completing their everyday tasks.
Fortunately, there are lots of available nausea remedies for morning sickness, ranging from lifestyle adjustments to dietary changes. Medically, there are over-the-counter and prescription medications that are available if you need them.
“Treatment for morning sickness is often necessary and is usually in the form of dietary adjustments and medications available over the counter,” says Michael Nageotte, MD, a perinatologist and associate chief medical officer at Miller Children’s & Women’s Hospital in Long Beach, California.
Treating and preventing morning sickness can be a matter of trial and error, so the nausea remedies here are arranged from the least invasive treatments to the most medical. However, all of these nausea remedies are safe and available if you need them.

Nausea Remedies That Can Help You Get Through the Day

1. 1. Take your vitamins.

   Preventing morning sickness can start before you need any nausea remedies. In fact, it can start before you’re even pregnant.
   “Women who take multivitamins when they are first trying to get pregnant generally have less morning sickness,” Lo says.
   Of course, that info might be useful for the future, but it’s no help if you’re already pregnant and trying to find nausea remedies that will give you a bit of relief. Taking your prenatals is still important even if you’re feeling sick, though, yet many women feel that the vitamins make them more likely to feel nauseated. If you find that to be the case for yourself, try taking them at a different time of day, like before bed, or with a meal.
   When I was expecting, even that didn’t work, so my midwife suggested taking two Flintstones chewable vitamins until I could get back to my prenatals without feeling sick. It worked well and was much more fun!

2. 2. Eat more often.

   If you’re feeling sick, snacking is the last thing you want to do, but eating is one of the most important nausea remedies during pregnancy. Having smaller, more frequent meals is one of the best ways to keep pregnancy nausea at bay, according to Lo.
   “Often, women avoid eating when they start having symptoms and an empty stomach can actually make their symptoms worse,” she says. Instead of avoiding meals, Lo recommends eating small meals every hour or two to keep your stomach settled. Sipping a drink can also help quell nausea.

3. 3. Become a picky eater.

   In addition to eating more often, it’s time to seriously consider what you’re eating if you’re trying to discover nausea remedies that work. Many women love simple carbs for keeping nausea at bay, and reaching for protein is another great option. Try to take note about which foods help settle your morning sickness and which do you more harm than good.
   “Ideally, eat foods high in carbohydrates and low in fat,” says Ross. “Avoid foods that are spicy, salty, or high in protein.”
   The BRAT diet (bananas, rice, applesauce, and toast) is a great remedy for nausea, she says.

4. 4. Go for ginger, one of the oldest nausea remedies in the book.

   Many women turn to traditional natural nausea remedies for relief from pregnancy nausea.
   “Natural remedies are often of value and it is unclear as to why they work,” says Nageotte.
   Fortunately, most moms-to-be are more interested in whether nausea remedies work than they are in discovering how those remedies work. Ginger is one of the most commonly recommended natural nausea remedies. You can sip ginger tea, suck lozenges, or eat fresh ginger.
   “It’s thought that ginger helps relax gastrointestinal muscles, relieving symptoms associated with morning sickness,” Ross says.
   Treats like ginger ale and ginger snap cookies are less effective because they don’t contain a large amount of ginger, but if they make you feel better, incorporate those into your diet every once in a while—surely the baby will appreciate the occasional cookie!

5. 5. Give acupuncture a try.

   Many women find that acupuncture and acupressure (pressing on certain points) are effective nausea remedies.
   “Acupuncture and acupressure are easy and safe alternatives to help the woes of morning sickness,” Ross says.
   The P-6 pressure point has been shown to help relieve mild nausea and vomiting. To activate this point, press into the middle of your forearm three fingers lengths down from where your wrist meets your hand. Certain nausea-relief bands also activate this point.

6. 6. Take vitamin B6.

   You’re already taking prenatals (right?), but many healthcare providers tell women experiencing pregnancy nausea to take vitamin B6. Taking 25 milligrams three times a day can keep you from feeling ill.
   “It’s not clear how it works, but has a great track record,” Ross says.
   If that doesn’t do the trick, you might want to talk to your doctor about Diclegis, a prescription drug that combines vitamin B6 and an antihistamine to treat morning sickness.

7. 7. Try prescription nausea remedies.

   If you’ve tried everything else and are still having severe morning sickness, your doctor may recommend more serious prescription nausea remedies, such as promethazine (brand name: Phenergan) and metoclopramide (brand name: Reglan).
   Women with severe pregnancy nausea may have to take ondansetron, more commonly known by the brand name Zofran. It’s important to be aware that there is a small increased risk of heart defect in the babies of mothers who take this medicine during the first trimester, Lo cautions. Because of this, it’s important to discuss the side effects of all nausea remedies—particularly prescription medications—with your doctor to weigh the risks and benefits.

8. 8. A change in mindset can be a powerful nausea remedy. Really.

   Morning sickness is absolutely miserable. There’s no denying that. But when you’re feeling overwhelmed and no nausea remedies are providing relief, try to remember that it will all be worth it in the end.
   “Feeling miserable the first 12 weeks can be a soft sign to your health care provider that all systems are working normally,” Ross said. “Reassuring women who don’t see a light at the end of the tunnel is important so they understand morning sickness is common, it’s short lasting, and it suggests your pregnancy is off to a healthy start.”

Understanding more about morning sickness might also help you get through those long weeks of feeling ill.

When should I get concerned if nausea remedies aren’t working?

In most cases, pregnancy-related nausea is a normal pregnancy symptom that will peak around the ninth week of pregnancy, Lo says. Although you should certainly speak to your doctor if you are concerned, most women can keep themselves and their baby healthy by using the nausea remedies listed above.
However, for some people, morning sickness becomes much more serious. The Duchess of Cambridge (aka Kate Middleton) brought the condition hyperemesis gravidarum (HG) into the public eye when she was pregnant with her first child, Prince George, in 2012. The duchess was so ill during the beginning of her pregnancy that she had to be hospitalized and receive intravenous fluids, which isn’t an uncommon nausea remedy for women with this rare and serious form of prenatal nausea.
“Hyperemesis gravidarum is severe nausea and vomiting associated with weight loss, dehydration, and often electrolyte abnormalities,” says Nageotte. “Patients are usually unable to tolerate anything orally for several days to weeks.”
Women who have HG vomit nearly constantly and will have other signs of dehydration, including dark urine. Unfortunately, normal nausea remedies aren’t very effective at treating HG. This condition is diagnosed based on symptoms, Lo says, and doctors may run additional tests to make sure that there isn’t another cause for your illness, such as a virus.
Because dehydration can be dangerous for both mother and baby, it’s important to talk to your doctor if you are at all concerned about the extent of your pregnancy nausea or if the nausea remedies listed above aren’t giving you relief.  
Although morning sickness is common in pregnancy, you don’t have to just suffer through it. Experiment with different nausea remedies to find the one that works for you, and keep in mind that it won’t last forever. You’ve got this, mama!