Preggie Pals
Body Changes During Pregnancy: The Cervix

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Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]

KAREN RUBY BROWN: With pregnancy come many physical changes. Many are obvious to the naked eyes such as you’re growing belly or skin changes. But, what about internal changes in pregnancy, I’m Karen Ruby Brown, a certified nurse midwife, and today we’re discussing cervical changes during pregnancy. This is Preggie Pals.

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STEPHANIE GLOVER: Welcome to Preggie Pals, broadcasting from the birth education centre of San Diego. Preggie Pals is your online on-the-go support group for expecting parents, and those hoping to become pregnant. I’m your host, Stephanie Glover. Thanks to all of our loyal listeners who have joined the Preggie Pals club. Our members get special episodes, bonus content after each new show plus special give aways and discounts. See our website for more information. Another way you to stay connected is by downloading our free Preggie Pals app available in the Android, iTunes and Windows market place. Sunny our producer is now going to give us some information about our virtual panelist program.

SUNNY GAULT: Hello everyone, so if you’re listening to today’s show and you’re not joining us here in the studio, you can still participate. We would love to hear your questions for our expert. We would love for you to just to kind of join the conversation and share your personal experience. So there’s a couple of different ways you can do that, you can like our Facebook page at Preggie Pals.

You can also follow us on Twitter which is Preggie then underscore Pals. And we’re going to be kind of twitting out some information and posting some stuff. Some photos to Facebook as we go along through today’s conversation. And feel free to write us back. To comment on some of the things that where’ll be discussing. You can even make it in to the show, we can read some of your comments in the show. If you are using Twitter use #preggiepalsvp. That VP stands for virtual panellist. And if you want some more information about our virtual panellist program, you can visit our website at www.newmommymedia.com

STEPHANIE GLOVER: Thank you Sunny

SUNNY GAULT: Yes

STEPHANIE GLOVER: So let’s go around the table here and I’m going to have the panellist introduce themselves. We have two Kristens in the room today. So I want to start with Kristen one

KRISTEN PAYVON: Alright, thank you. My name is Kristen Payvon. I am thirty three years old. My current job title is full time stay at home mom. Definitely, the hardest job I’ve ever had. And I am not currently pregnant. I have two children. My daughter Zoe just turned three last week. And my son Brady is ten and a half months old. And I have two vaginal births with both children. Two inductions and two vaginal births

MICHELLE ASHLEY: Alright, my name is Michelle Ashley. I am thirty four. I am in the insurance industry. I am due on December thirty first with my second son. They will be twenty months apart, so I have a toddler at home and delivered in a hospital, vaginal birth

KRISTEN STRATON: Hello, my name is Kristen Straton. I am a birth and postpartum doula. And I’m also in the marketing industry. I’m the mother of three really super adorable children. I have a four year old daughter and a two and a half year old son and a fifteenth month year old son. And I had caesarean births but I also went for a VBAC after two caesareans, so

STEPHANIE GLOVER: Great. Thank you so much for joining us

KRISTEN STRATON: Thanks you

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STEPHANIE GLOVER: Okay so before we get started today we’re just going to be discussing an article that was just, we just found online and it discusses the American College of Obstetrics and Gynecology which are referred to as ACOG, coming out regarding ultrasounds as means of dating the gestational age of the fetus. And essentially the article is saying that if a pregnant woman has received an early term or like an early pregnancy ultrasound for dating purposes.

If she receives an ultrasound later in pregnancy, it really shouldn’t be used to change her due date. So they’re saying that if you perceived an early one, ultrasound is going to be on fourteen weeks aren’t necessarily accurate or appropriate for changing the due date. And I know that Karen, being the midwife can maybe speak to this a little bit

KAREN RUBY BROWN: Sure, the earlier the ultrasound, the more accurate in terms of dating. So a first trimester ultrasound is always going to be more accurate than a second or third trimester ultrasound. In fact in the third trimester can be offed by a couple of weeks. And in the first trimester, you’re within a few days

STEPHANIE GLOVER: Okay

KAREN RUBY BROWN: So it’s just better practice and common [inaudible 00:04:54] to use those early ultrasounds

STEPHANIE GLOVER: Okay. And did any of the panellists experienced a later pregnancy ultrasound and maybe your care provider suggesting a different due date for you by chance or do anyone

MICHELLE ASHLEY: We just with number two, we went in a little bit later than normal. So, I thought I was ten weeks and ended up being past the eleven-week mark. So, I was talking to Karen earlier because you know having a December baby right on the, the cost of the new year, still a little anxious about it if he’s going to be a 2014 or 2015. It may, actually I felt a little bit more confident than definitely, we’re looking more of a December baby here. Hopefully

KRISTEN STRATON: I hear about this a lot especially in the online community where anxious moms were always about their doctor’s doing their late trimester ultrasound and the concern being that baby is too big now and therefore are going to either schedule an induction or recommended cesarean. So I really think that this is a really good thing that ACOG has come out with and also it’s kind of on the heels of their prevention of the primary cesarean section paper. So, I think hand in hand with that, it’s not only going to be good advice for moms to have accurate dating and more accurate expectations of when baby is going to arrive. But it’s also going to give moms more time to have pregnancy and have and gestate their baby without the pressures of either having unnecessary C section or unnecessary inductions so,

STEPHANIE GLOVER: And we know too that those sizing sonograms at the end have such a, you know, scale in terms of accuracy to begin with. They can be several pounds off. So, okay great. Well, thank you for your input

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STEPHANIE GLOVER: Today we are learning all about cervical changes in pregnancy. Joining us is our expert panelist is Karen Ruby Brown, a certified nurse-midwife with extensive experience in a variety of birth settings including hospital, birth centres and homes. She received her midwifery training and Masters of Science in Nursing at Yale University in 2002, has been with UCST midwifery service since 2003 and most recently opened a solo practice called Erin Midwifery, offering home and birth center deliveries. Welcome to the show Karen, thanks for joining us

KAREN RUBY BROWN: Thanks so much. Good to be here

STEPHANIE GLOVER: Great. So, let’s start by quickly explaining what the cervix is?

KAREN RUBY BROWN: The cervix is actually part of the uterus. It’s the part that we can feel with fingers and see with eyes. It’s the lower part that opens up and allows the baby to come out. It also allows menstrual blood to come out. It allows sperm and semen and other things to go in and so

STEPHANIE GLOVER: Great. And can you describe a pre-pregnancy cervix?

KAREN RUBY BROWN: Pre-pregnancy, the cervix is pretty firm. It’s pretty firm tissue and it’s generally closed. It can be a little bit open depending on when, what time of your menstrual cycle. It is so it can be softer it can be a little open, it can be firm. But generally speaking, it’s essentially closed and it’s essentially pretty firm. It also can be in different places in the vaginal vault. So sometimes you have to go looking for it

STEPHANIE GLOVER: And in the beginning of pregnancy, what changes occurred to the cervix?

KAREN RUBY BROWN: In the beginning of pregnancy, it gets full of blood so the vascularity increases by just, I don’t know the number. But it [inaudible 00:08:21] so it gets blue and swollen and softer

STEPHANIE GLOVER: And what causes that?

KAREN RUBY BROWN: The increase of vascularity. So the uterus as an organ is saying “okay, we’re about to grow a person here, let’s get some blood going”

STEPHANIE GLOVER: And so the increased vascularity is caused by hormones, like the hormonal shift?

KAREN RUBY BROWN: It’s caused by mechanical and hormonal shifts

STEPHANIE GLOVER: Okay. Great. And then what is the mucus plug and when does it form?

KAREN RUBY BROWN: The vagina is a mucous membrane

STEPHANIE GLOVER: Okay

KAREN RUBY BROWN: Right. Just like your mouth and your nose. And so mucous is always being produced by the cervix. And sometimes its noticeable and sometimes it’s not. During ovulation, you’ll see mucous called spinnbarkeit. And that is, it’s kind of a, kind of paving the way for the sperm to be able to travel easily up that passageway. And then in pregnancy, the mucous plug, the mucous that’s formed by the cervix gets kind of hard and forms like a cork right? And so it’s kind of ceiling off the entry and exit way because you want what’s in there to stay in and you want what’s out to stay out

STEPHANIE GLOVER: Gotcha. Do women lose the mucous plug throughout pregnancy or is that generally during labour or can it depend?

KAREN RUBY BROWN: Women can have increased mucous during pregnancy especially towards the end of pregnancy. There can be a lot of excess mucous. And it can be coming from, there can be discharge, extra discharge coming from the vagina, it can be mucous coming from the cervix. But as you get closer to term and closer to birthing your baby, the cervix which has had the job description of keeping what’s in, in and what’s out, out, now kind of has the change in emo and so part of the process of preparing for that change in job description is to let that mucous cork go. So, it releases it, and it can release it in one big handful. Or can release it in dribs and drabs. So, some women don’t even notice their mucous plug coming out, and some women are just astounded at what is in their hand when they just simply go and pee. So it can really run the [inaudible] and then through labour and birth, there’s more mucous. So the mucous keeps getting produced. It’s not like a, all or nothing thing, it’s not like the mucous plug is gone now so there’s no more mucous plug

STEPHANIE GLOVER: Okay, it keeps regenerating

KAREN RUBY BROWN: It’s producing, it regenerates, yep

STEPHANIE GLOVER: Now, for the panellists, did you guys experience losing your mucous plug or what are that kind of mean for you?

KRISTEN STRATON: In my, this is Kirsten Straton. In my first pregnancy, I had my membrane sweep which is a whole different subject, so we won’t even go there. But I did notice the loss of my mucous plug shortly thereafter. And it was kind of like an egg yolk consistency. And it happened over the course of about twenty-four hours. So, I was noticing a significant difference and it was, it definitely caught my attention but unfortunately, labor did not begin for another six days so. . .

STEPHANIE GLOVER: That was going to be my next question

KRISTEN STRATON: That does not mean that labour is imminent

STEPHANIE GLOVER: Gotcha

KAREN RUBY BROWN: It means you’re headed in the right direction. But it doesn’t mean that you should put your suitcases in your car

STEPHANIE GLOVER: Absolutely

KRISTEN PAYVON: This is Kristen Payvon. You know with each pregnancy, I didn’t actually. You know there was nothing noticeable, no event, you know, I went in for my induction and then at the end I had the baby. There’s no mucous event that I was aware of

STEPHANIE GLOVER: How about you Michelle?

MICHELLE ASHLEY: Yeah that’s probably more of my experience is maybe a little bit more discharged but nothing that I would’ve definitively said, yep that’s what that is so,

STEPHANIE GLOVER: Yeah I think I loss some of mine with my first around thirty five or thirty six weeks. And then with my second I think it was even a week before I deliver but it was just different it wasn’t as, you know like gelatine as, it was just kind of in passing and didn’t think too much of it. So, it’s really interesting to see the broad range and how different

KAREN RUBY BROWN: I like the term the mucous event, can I borrow it

STEPHANIE GLOVER: So what does it mean when the cervix is dilated?

KAREN RUBY BROWN: The cervix dilates to let the baby out. And it just means that the bottom of the uterus, the exit door is opening and essentially becoming a single passage with the vagina. So becomes one large room

STEPHANIE GLOVER: Okay. So, for baby to fit

KAREN RUBY BROWN: For baby to fit and you know the cervix can start softening and dilating well before labor starts especially with second or third or ten-time moms right? When your body has done it before the cervix can be a little bit softer and can be open even as early as thirty-five, thirty-six weeks and it doesn’t mean you’re going to labor it just means that you’re a little bit open. So there are women, multi-press women who can be three, four centimeters for weeks on end

STEPHANIE GLOVER: And it doesn’t even necessarily mean that all labors happening within

KAREN RUBY BROWN: No, it can be quite frustrating for these moms right? Because, we think of dilation as the indication of where our body is in labor. But if you’re not in labor and you’re four centimeters it can be frustrating at that point there won’t be a mucous plug because the cervix is just too soft and open. So, those moms might not notice the mucous plug at all

STEPHANIE GLOVER: So then when we’re speaking about labor progress, and we hear so much about dilation. I almost feel like that’s the most prevalent in terms of gaging what’s going on with the cervix. But there are also a lot of other changes that are prepping your cervix for labour. So, one of the terms is ripening. So what is cervical ripening? What does that mean?

KAREN RUBY BROWN: I love all the fruit metaphors. The fruit, are they metaphors or analogies? You know, the size of the uterus is a lemon, and then orange and then a

STEPHANIE GLOVER: Right

KAREN RUBY BROWN: Ripening just means it’s getting soft. So it is like fruit when you have a hard nectarine, it’s hard to eat right? It’s firm, it’s hard, it’s not indent able. When you have a ripe nectarine it’s indented able and you know it’s ready to eat. And same with the cervix, it’s just it, when it’s hard it’s not ready to open and when it’s soft that’s an indication that body is moving towards having the baby. It has to soften which is ripening it has to efface which is shortening. And it has to dilate which is opening. And all of those things need to happen. First-time moms, it happens usually sequentially right it’ll get softer and then it’ll get shorter and then it’ll get more open. And with second, third tenth time moms, it’s kind of a big free for all it just all happens at once

STEPHANIE GLOVER: Surprise

KAREN RUBY BROWN: A lot of the time yep

STEPHANIE GLOVER: And I’ve heard something about, is it like feeling the tip of your nose versus your lip? Or is it something like that?

KAREN RUBY BROWN: Yeah

STEPHANIE GLOVER: And just about the cervix feels like

KAREN RUBY BROWN: Yeah, do you guys know that? So, an unripe cervix is like your nose. A ripe cervix is like your lips. And a really ripe cervix is like the inside of your mouth. And when I was learning to do cervical exams, I was told to feel for the shaving cream in the whipped cream. Like that’s the kind of textural difference you’re looking for. That’s how soft the cervix can be. It can be really hard too when you’re first learning to identify a ripe ready to go cervix. Very subtle, texture changes

STEPHANIE GLOVER: Great. Well when we come back, we’ll discuss cervical changes in relation to labor. We’ll be right back

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STEPHANIE GLOVER: Welcome back. Today we’re discussing cervical changes in pregnancy and labor. Karen Ruby Brown, a certified nurse-midwife is our expert. What is a posterior cervix versus an anterior cervix?

KAREN RUBY BROWN: If you imagine the uteruses just kind of hanging out in, okay let’s try this, imagine a balloon in a paper bag right? And the paper bag has some air in it so it’s rectangle, it’s not a squish paper bag and then the balloon is kind of hanging out in there. The balloon can kind of flop towards the back or flop towards the front or goes straight up and down depending on kind of how big it is, how much air is in it. And, if you imagine the little air hole of the balloon depending on how that balloon is facing in the paper bag, imagine that little, the where you blow the air into it is the cervix. That can be towards the front of the paper bag or towards the back of the paper bag or towards one of the sides

STEPHANIE GLOVER: Okay

KAREN RUBY BROWN: Does that work for people? I just completely made that up. So what that means is that so keeping that image in mind when a clinician goes in to do a cervical check, they might have to reach really far back to feel the cervix, or the cervix might be under the pubic bone so really far in front. It can be off to one of the sides or it can be right in the middle. And what happens in labour is that as the cervix is dilating as the muscles of the uterus are pulling up on the lower uterine segment pulling that cervix open. And as the head is pressing against the cervix, it’s all going to kind of line up. So, it’s in line with the vagina.

So we talk about posterior cervixes as not quite in labour cervixes. And we talk about anterior cervixes as, I should say cervixes is probably the more correct term as kind of ready to let the baby come out because it’s forming one big room right? The vagina and the uterus it’s all that sliding door right? If you think of the cervix as the sliding door, it’s gone.

STEPHANIE GLOVER: Okay and are there ways other than you mentioned the internal exam using your hands or your fingers to determine the cervix, are there other ways to be able to, I guess notice the cervical changes. Can you tell them in ultrasound or are there other physical symptoms that will lead you to believe that the cervix is changing

KAREN RUBY BROWN: Yeah, ultrasound is used for pre-term labour check. So if someone is having some signs of pre-term labour an ultrasound might be done to look at the length of the cervix. Because it can, it’s nice and long earlier in the pregnancy it can be up to five or even more centimetres long. And then as you’re getting closer to labour it gets to about two and a half centimetres long and then shorter, shorter and shorter until it’s not long at all. So, there are ways to tell what the cervix is doing. So, talking specifically about labour progress, behavioural cues can help to identify what part of labour someone is in

STEPHANIE GLOVER: And I’ve also heard in as a doula, I’m sure you can speak to this about the purple line

KAREN RUBY BROWN: Yes

STEPHANIE GLOVER: Can you explain that to us?

KAREN RUBY BROWN: The purple line of dilation

STEPHANIE GLOVER: Yes

KAREN RUBY BROWN: When women are labouring they’re generally unclothed right? Women don’t like clothes on during labour. And so we have great opportunity to observe the area of the tailbone and the rectum and the perineum. And what happens, and you can notice it more in fairer skinned women, there is a line that you can see extending from the rectum up around the tailbone and the coccyx and the longer that line is, the greater the dilation

STEPHANIE GLOVER: And how does that line formed? Is it from pressure of the baby or

KAREN RUBY BROWN: I mean, my guess is that it’s simple as the baby’s head is so low that it’s pushing on that curve of the tailbone, the sacrum and the coccyx. And that’s putting pressure on that skin because we basically have a seam that runs through the center of our bodies all the way around. Right? The [inaudible] negara that forms along that seam. And some people you can really see that seam, you can see it on the perineum. So I think it’s that tissue just getting stretched. And the lower the baby and the fewer layers of tissue in between the baby’s head and the outside skin, the more you’re going to just see outside visual changes

STEPHANIE GLOVER: That’s so interesting

KAREN RUBY BROWN: I’ve never used it to actually “diagnosed dilation” right or stage of labour but it is a really interesting thing. And there’s this very interesting thing that I have tried in labour where there’s a textures change in the lower abdomen that you can actually feel the juncture of the lower uterine segment and the fundus, the body of the uterus. And if you’re, if you can kind of get into with your fingers, the number of centimetres up from the pubic bone supposedly correlates with dilation. But I haven’t done a scientific experiment it’s just one of those cool little things that we can play within labour

STEPHANIE GLOVER: Well it’s so common, I mean I know that there’s a bit of controversy even with a lot of cervical checks during labour. So what are the reasons that you might want to have fewer cervical checks

KAREN RUBY BROWN: Risk of infection. So, risk of infection especially if the water bag is broken, you don’t have that protective layer surrounding the baby and protecting the babies. So, the more checks you do, the more bacteria even with sterile gloves you’re dragging bacteria in, the more bacteria you’re dragging in and you can increase that risk. The other thing is, who likes cervical checks? They’re not something that, you know there, women do ask for them because they want to know where they are, they need to wrap their mind around where they are, but they’re not generally very enjoyable for women in labour, they’re uncomfortable

STEPHANIE GLOVER: They’re so sensitive to and you feel everything

KAREN RUBY BROWN: Yep. And even just having to lie still, having to lie in your back. So, those are just basic reasons

STEPHANIE GLOVER: And I would say too, even like you said I think sometimes women, if you want to control a situation and so we want to kind of know what are those markers where am I in this process? But then if you’ve heard where you’re still at a certain dilation that can be really disheartening. And so did anyone here have experienced with feeling like they were maybe stalled, you know if you’ve heard that term before

KRISTEN PAYVON: I definitely was, I mean, with both inductions when I went in I was about three centimetres dilated. And did an entire round of Pitocin, it was on the max dose and hadn’t changed at all, and wasn’t feeling any pain. My water had not broken yet at that point. So, it was frustrating because they did check me periodically. It was about over the course of about twelve hours. And you know, you’re in a bed hooked up everything and you know, they kept saying nothing’s changing. And then my doctor came in and broke my water and then at that point things progress pretty quickly. But yeah I was about twelve hours with each child actually.

STEPHANIE GLOVER: Yeah and that’s you know

KRISTEN PAYVON: Just twelve hours of

STEPHANIE GLOVER: What’s next or you know why isn’t this working or how about either of you ladies.

KRISTEN STRATON: Well my own experience is a laboring mom having been at one centimeter for twenty one hours. I definitely know that frustration. As a doula, I, my clients choose to have a vaginal exam. It can sometimes seems very reassuring and joyful to know that progress is being made but it can also be too full. They can be disheartening, it can be frustrating. But sometimes it does give us good information.

Sometimes it gives us information that maybe baby’s not engaged in cervix or maybe moms having some fear or some sort of emotional response that it’s not allowing her to relax and just let her body do what it needs to do. So, it’s also very important thing for us to realize that there is a mind-body connection to the cervix. And I’m sure Karen can speak to that as a midwife as well.

So that’s something to consider as well because when we go in for exams during prenatal appointments and we consent to vaginal exams, sometimes we get, set ourselves at for failure because our body’s not working cause we’re not dilated. We’re not doing that. And so I’m still as dilated at thirty-seven weeks at three centimeters and I’m still high and tight. And, you know, it doesn’t mean that your body’s not doing what it’s meant to do. It’s just, it’s different. So I think women should be really kind to themselves when it comes to dilation because their bodies were made to have babies and

STEPHANIE GLOVER: I think it’s the greatest exercise in patience

KRISTEN STRATON: It is

KAREN RUBY BROWN: It is

STEPHANIE GLOVER: And faith

KRISTEN STRATON: And so is parenting for that matter

STEPHANIE GLOVER: Just setting you up for the next

KRISTEN STRATON: Eighteen, thirty years

STEPHANIE GLOVER: And then I know we had a separate episode on cervical scar tissue. And I know that, that can actually prevent some dilation at certain points in pregnancy Karen can you speak to that at all. What are some ways to work around cervical scar tissue? Briefly

KAREN RUBY BROWN: Yeah. So if someone’s had a leep procedure which is surgical removal of part of the cervix for abnormal cells. There can be some, some scar tissue forming, it’s like, imagine a perl string with a fishing line through it. It can just be really, really hard fibrous stuff and it just won’t open no matter how much you’re dilate, you’re contracting rather and so sometimes you just need a clinician to go in there and just massage it out. Just get rid of it. And so that’s, sometimes it’s discovered in labour. “Oh, there’s scar tissue. Have you had a procedure? Yes. I mean, ideally we deal this beforehand but sometimes we don’t. . .

STEPHANIE GLOVER: Right

KAREN RUBY BROWN: Just massage it out

STEPHANIE GLOVER: Okay

KAREN RUBY BROWN: It’s not comfortable but it can lead to labour which is what we want right?

STEPHANIE GLOVER: It’s what probably there for.

KAREN RUBY BROWN: That’s right

STEPHANIE GLOVER: Well thank you Karen for joining us today. For more information about Karen Ruby Brown as well as information on any of our panellist, visit the episode page on our website. This conversation continues for members of the Preggie Pals club. After the show, Karen’s going to be discussing what an incompetent cervix is. To join our club, visit our website www.newmommymedia.com

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SUNNY GAULT: Hey Preggie Pals, before we wrap up today’s show, we have an important message to pass along. And it’s a message about giving. Here in the US most of us are blessed to have many amenities at our disposal including basics such as water and sanitation services. But there are countries around the world who are misfortunate. Joining us today on the phone is Sarina Prabasi. She’s the CEO of Water Aide America. Thanks so much for being with us today

SARINA PRABASI: Thank you for having me

SUNNY GAULT: So not having safe water is a crisis situation in many countries. And we have heard this before. We do hear about our countries where they don’t have enough water or various resources. But what I really like about your organization is it seems to focus more on mothers and their children and families in general. So can you tell us a little bit more about that problem and how it impacts families on other countries

SARINA PRABASI: Sure. Lack of water sanitation affects everybody. But women and children really pay a much higher price for the carry the burden of not having this. Women are responsible in most countries for collecting water often in very dangerous conditions. Walking long distances, miles upon miles on a daily basis just to collect enough water that their families use in a day.

So it’s a daily struggle and drudgery and takes a lot of time. Kids as well, kids suffer disproportionately from water-related diseases and the numbers are really horrifying. Five hundred thousand children die every year from diarrhea that is completely preventable and is caused by unsafe water and poor sanitation. Particularly also for girls, school children, as well as girls just like women, are responsible for collecting water in many countries often that start quite young when they’re girls. And in schools as well. Schools that don’t have water and safe toilets, and the basics.
You know, you can’t expect children to stay in school and really be learning when they’re sick from the unsafe water or when they are in school and they’re thirsty they don’t have water to drink. So it really, it touches upon the lives of infants, children and women, mothers particularly

SUNNY GAULT: Tell us a little bit more about water in America and what you guys are doing to help with the situation

SARINA PRABASI: Sure. Water Aid focuses on providing safe water. Sanitation includes safe toilets, which is something that a lot of people don’t think about but it’s a very basic human need. And hygiene practices, something as basic as handwashing with soap can really save lives. And Water Aid does this in an integrated way combining water sanitation and hygiene for the best impact on people’s lives and the best outcomes so girls can stay in school that women can free up hours of time that they could start a business such as farming or do something else rather than spending hours and hours collecting water.

So we work with local governments. We work with communities, we work with private sectors and businesses. To make a change that is much bigger than our organization. At the same time our direct work has reached millions of people. And water sanitation investing in water and sanitation is one of the best investments people can make because it’s a, you get a huge return. So for investing in something as basic as water and sanitation you get a return on in the benefits of education, the benefits of health, the benefits of economic, benefits of people starting small businesses.

So, yeah the benefits are really multiple. There are studies and there’s evidence that shows that every dollar you invest in water and sanitation has returns. Economic returns many times. So sanitation is something like seven dollars for return, for every dollar you invest. So, these are very good investments to make

SUNNY GAULT: Absolutely

SARINA PRABASI: If you think about giving, that’s an investment

SUNNY GAULT: Yeah. Absolutely! Well and you mentioned giving, so today id giving Tuesday and for those of you who don’t know what giving Tuesday is, it’s a time during holiday season that’s dedicated to giving back. And today, you guys are actually matching donations today?

SARINA PRABASI: We’re very lucky we have some special bonus who is matching up to a hundred and fifty thousand dollars. So every dollar that we receive today on giving Tuesday, it doubles

SUNNY GAULT: That is awesome. So how can we help about the other three hundred sixty-four days of the year? People listening to this and it are not giving Tuesday and they still want to help, how can they do that?

SARINA PRABASI: Well the first thing to do is to visit our website www.wateraid.org. there are a lot of resources and information. There’s a very easy donate link, we always like that. We, you know it’s the donations that really keep us going but allow us to support communities all over the world. But there are also other ways to get involved, there’s, you can volunteer, you can spread, help us spread the message about water and sanitation and really the website is the first place to start www.wateraid.org

SUNNY GAULT: Alright. Well, Sarina thanks so much for being with us today and for helping to make our world a better place. We appreciate it

SARINA PRABASI: Thank you very much. Thank you for having me

[Theme Music]

STEPHANIE GLOVER: That wraps up our show for today. We appreciate you listening to Preggie Pals.
Don’t forget to check out our sister shows
• Parent Savers for parents with newborn, infants and toddlers
• Twin Talks for parents of multiples
• Our show The Boob Group for moms who breastfeed their babies

This Preggie Pals; “Your Pregnancy Your Way”

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This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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