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You’ll know your female ball python is gravid by watching for several key signs.
Check for a swollen, sometimes lumpy abdomen that appears about 84 days after breeding. Your snake will likely become more restless and seek cooler areas of the enclosure.
Many gravid pythons refuse food and display a distinctive "pregnancy glow" with more vibrant skin. You might notice her coiling more tightly and basking more frequently.
Proper identification matters – it prevents unnecessary stress and guarantees you’ll provide the right care during this critical time. The secret to successful breeding lies in understanding these subtle body changes and behaviors.
Table Of Contents
- Key Takeaways
- Identifying Gravid Ball Pythons
- Signs of a Gravid Ball Python
- Ball Python Breeding Requirements
- What is Ovulation in Ball Pythons?
- Caring for a Gravid Ball Python
- Gravidity Vs Pregnancy in Ball Pythons
- Preparing for Ball Python Egg Laying
- Ball Python Gestation Period and Egg Incubation
- Post-Laying Care for Ball Pythons
- Confirming Gravidity and Avoiding False Identification
- Frequently Asked Questions (FAQs)
- How long is a ball python gravid for?
- How to tell if your ball python is going to lay eggs?
- What is a gravid female snake?
- Can I let my ball python incubate her own eggs?
- Is my female ball python gravid?
- How can you tell if a ball python is pregnant?
- How do you know if a ball python is gravid?
- Do gravid ball pythons lay eggs?
- How do ball pythons get pregnant?
- What color does a gravid ball python change to?
- Conclusion
Key Takeaways
- You’ll notice physical changes in your gravid ball python, including a swollen and lumpy abdomen that appears around 84 days after breeding, along with more vibrant skin coloration.
- Your snake’s behavior will shift significantly – she’ll become more restless, seek cooler areas, refuse food, and spend more time basking or soaking.
- You’ll want to maintain specific environmental conditions: 88-92°F on the warm side, 60-70% humidity, and provide a secure nesting box with soft substrate about two weeks after the pre-lay shed.
- You can confirm true gravidity through professional methods like ultrasound or gentle palpation by a vet, as other conditions like impaction or obesity can mimic pregnancy signs.
Identifying Gravid Ball Pythons
You’ll learn to identify a gravid ball python by recognizing physical signs, such as a swollen abdomen, and behavioral changes, like increased restlessness.
By understanding these physical signs and behavioral changes, you can determine if your female ball python is gravid.
This understanding is important for providing proper care and ensuring a successful breeding process.
Physical Signs and Changes
You’ll notice a gravid ball python by its physical changes.
Look for:
- Lumpy abdomen
- Scale changes
- Swollen belly
- Skin texture changes
- Posture shifts.
A lumpy appearance, swollen abdomen, and weight gain indicate follicle growth.
Your ball python may also exhibit cool seeking behavior, and a prelay shed.
Behavioral Patterns and Changes
As you observe your ball python, you’ll notice changes in her behavior.
She may exhibit restlessness, hiding behavior, and aggression changes. Soaking frequency increases, and basking changes occur.
A gravid ball python’s behavior is distinct, with cool seeking and appetite changes. You might see nesting behavior, where she prepares a safe spot.
Behavioral changes are key indicators of gravidity. Watch for decreased appetite, increased hiding, and restlessness.
These signs, combined with physical changes, help you identify a gravid ball python. Understanding these behavioral patterns helps you provide the right care.
Behavior Normal State Gravid State
Importance of Accurate Identification
You must identify gravidity signs in your ball python accurately.
Misidentification risks improper care. Track changes, and consult experts to reduce stress and maintain health monitoring, key to breeding success and proper care.
Recognize gravid ball python behavior, like a lumpy appearance, to provide the best support.
Signs of a Gravid Ball Python
You’ll notice several signs that indicate your female ball python is gravid, including a swollen abdomen, lumpy appearance, and changes in appetite.
As you observe your python’s behavior and physical condition, you’ll be able to identify these signs, such as food refusal, weight gain, and aggressive behavior, which can confirm gravidity.
Sudden Swelling of The Abdomen
You’ll see your female ball python’s belly swell, like she’s eaten a big meal.
This abdominal distension is a clear sign of gravidity.
Here are key points to note:
- Swelling causes abdominal expansion
- Egg development leads to visible ridges
- Reproductive changes peak during ovulation
- Decreased appetite is common
- Weight gain occurs due to follicle development, causing a swollen abdomen.
Lumpy Appearance and Weight Gain
One of the clearest signs your ball python is expectant is a lumpy appearance, caused by follicle development.
You’ll notice a distinct shape as follicles grow, giving her belly a marble-like look and feel.
This pairs with weight gain and a swollen abdomen, making her body feel heavier and firmer to the touch.
Keep an eye out for these changes, as they indicate healthy progress in your snake’s gestation period.
Understanding ball python breeding cycles is crucial for identifying these physical changes and providing proper care.
Keyword | Description |
---|---|
Follicle Development | Follicles are egg-containing sacs that develop along the python’s midbody region, causing a lumpy appearance. |
Weight Changes | The python experiences weight gain and a noticeable size increase due to the developing eggs and associated fluids. |
Lump Appearance | The belly takes on a lumpy shape with visible bumps, indicating the presence of developing follicles and eggs. |
This section aims to inform readers about the physical changes their ball python will undergo during its **
Food Refusal and Decreased Appetite
You’ll notice your gravid ball python’s appetite changes, with meal skipping or food refusal.
Decreased appetite is common due to hormonal shifts.
Monitor her feeding habits, especially pre-ovulation.
Offer small, infrequent meals to keep stress low.
Appetite changes, including reduced intake and fasting periods, are normal.
Gravid ball python behavior includes appetite changes, so watch for decreased appetite and adjust feeding habits accordingly.
Ensuring your python’s overall health and well-being during this period, as part of gravid python symptoms, is crucial.
Aggressive Behavior During Ovulation
You’ll observe irritability increase in your female ball python during ovulation, with signs including:
- Striking/biting
- Musk release
- Defensive posturing
- Handling reduction
- Female aggression.
This ovulation stress is normal, so minimize handling to avoid triggering further aggression, ensuring safe gravid ball python behavior management.
Ball Python Breeding Requirements
You’ll need to evaluate several factors when breeding ball pythons, including age and weight requirements.
Your female ball python should be at least two years old and weigh over 1,500g to be considered ready for breeding.
You’ll also need to understand the mating and fertilization process.
Age and Weight Requirements for Gravidity
To breed a female ball python, consider these requirements:
- Age Limits: at least two years old
- Weight Thresholds: 1,500 grams
- Maturity Signs: strong weight, condition
- Growth Rates: guarantee healthy development, avoiding egg-binding, for a successful gravid ball python pregnancy.
Proper breeding season adjustments are paramount for a successful breeding process, ensuring healthy development.
Mating and Fertilization Process
You’re now familiar with age and weight requirements.
Next, let’s explore the mating and fertilization process. Mating involves tail intertwining, lasting up to 24 hours, allowing for sperm transfer and storage.
This leads to fertilization, where sperm meets eggs, starting gravidity. Sperm retention enables fertilization to occur days or weeks after mating, making mating a necessity.
Understanding fertilization timing and mating behaviors is key to successful breeding, avoiding infertile eggs.
Environmental Triggers for Mating Behavior
Getting your ball python ready for mating means understanding nature’s timing. Subtle temperature fluctuations and lighting cycles that mirror seasonal changes trigger their breeding behavior.
Healthy, mature ball pythons are essential for successful breeding programs. Gradual shifts in humidity and cozy nesting spots encourage natural instincts.
To heighten their interest:
- Mimic shorter autumn days, a cue for the breeding season.
- Cool nights enhance pheromone production, a key to mating.
- Support reproductive health with spikes in humidity, aiding pheromone signals.
These adjustments set the stage for successful python partnerships, with cooling temperatures and shorter daylight hours sparking their natural mating rituals.
What is Ovulation in Ball Pythons?
You’re looking to understand ovulation in ball pythons, which is a pivotal step in determining if your female ball python is gravid.
Ovulation in ball pythons occurs when the abdomen swells noticeably, and eggs ripen, typically happening about 84 days after pairing with a male, which is a pivotal step and involves ovulation.
Identifying Ovulation Through Physical Signs
When your ball python ovulates, you’ll notice a swollen abdomen, lumpy appearance, and weight gain.
Her skin may look looser with scale changes, signaling ovulation has begun, a key python ovulation sign, including mid-body swelling and a lumpy abdomen.
Understanding ball python pregnancy is essential for identifying these physical signs and providing proper care, especially recognizing key python ovulation sign, and ensuring the best approach for ball python pregnancy.
Post-Ovulation Behavior and Changes
After ovulation, you’ll notice changes:
- Coiling behavior
- Appetite changes
- Resting habits
- Hiding preference
- Aggression levels.
Monitor these signs to maintain proper pregnant ball python care, recognizing ball python pregnancy signs for a healthy gravid female.
Importance of Ovulation in Gravidity
You’re now aware of post-ovulation behavior.
Ovulation sparks follicle development, leading to egg fertilization.
It’s key to grasp its importance:
- Tracks fertilization timing
- Promotes egg health
- Supports hormone influence
- Optimizes care adjustments
- Boosts confidence, helping you master each stage of your female ball python’s journey, ensuring successful gestation timing and pre-lay shed trigger, which is crucial for successful breeding.
Caring for a Gravid Ball Python
You’ll need to provide a suitable environment for your gravid ball python, including proper temperature and humidity control.
By adjusting feeding requirements and providing a safe, stress-free space, you can help promote a healthy pregnancy and successful egg laying.
Temperature and Humidity Control
How does your gravid ball python’s environment impact her success? Maintaining precise temperature and humidity control is essential during this delicate period.
Set your heat sources to create a temperature gradient: 88-92°F on the warm side and 80-84°F on the cool side, with ambient temperatures around 75-80°F. Install a reliable ball python thermostat to prevent temperature fluctuations.
- Your female ball python depends on you for consistent environmental monitoring – think of yourself as her personal climate controller!
Monitor humidity levels carefully with a hygrometer, keeping them between 60-70% during gravidity. As egg-laying approaches, gradually increase humidity to 80-90%. Provide proper ventilation to prevent mold growth while maintaining moisture.
Use multiple thermometers and hygrometers to track conditions across the enclosure. Position heat sources strategically to create appropriate temperature zones, and adjust thermostat settings as needed.
Feeding Requirements and Adjustments
While maintaining proper heat levels matters, your female ball python’s nutrition needs special attention during gravidity.
You’ll notice appetite changes – many females eat less or stop eating completely. This is normal.
Here’s how to handle feeding schedules during gravidity:
- Offer smaller prey items every 10-14 days
- Switch to pre-killed prey for easier digestion
- Supplement with calcium powder when she does eat
- Track weight changes weekly
- Keep fresh water available at all times
Let her guide the feeding pace – some gravid pythons may refuse food for weeks. If she shows interest in food, offer appropriately-sized meals. Monitor her weight and hydration levels to keep her healthy throughout the process and ensure proper hydration.
Providing a Safe and Stress-Free Environment
During your ball python’s gravid period, create a peaceful sanctuary that minimizes external stimuli.
Place multiple hide boxes throughout the enclosure, ensuring she can easily move between warm and cool spots.
Maintain stable temperatures between 88-92°F and humidity at 60-70%.
Reduce handling and keep the environment quiet, especially when she displays nesting behavior.
Monitor her closely but discreetly, ensuring her health while respecting her need for security and isolation.
A stress-free habitat supports successful egg development.
Gravidity Vs Pregnancy in Ball Pythons
You’ll notice that experts use the term "gravid" instead of "pregnant" when talking about ball pythons because these reptiles lay eggs rather than give birth to live young.
While both terms describe expecting mothers, gravidity specifically refers to egg-laying animals like snakes, which carry and develop their eggs internally before laying them, and this distinction is important for understanding the reproductive process of ball pythons.
Differences Between Gravidity and Pregnancy
Many reptile owners confuse gravidity with pregnancy. They’re fundamentally different reproductive processes.
The key differences are outlined in the table below, highlighting the distinct characteristics of each reproductive process.
Aspect | Gravidity (Ball Pythons) | Pregnancy (Mammals) |
---|---|---|
Definition | Carrying developing eggs | Carrying live embryos/fetuses |
Process | External egg development after laying | Internal fetal development |
Duration | ~44-50 days from ovulation to laying | Varies by species |
Signs | Lumpy abdomen, "pasta belly," scale changes | Progressive belly growth |
Terms | Female is "gravid" | Female is "pregnant" |
Understanding these differences helps you provide proper care during your female ball python’s reproductive cycle.
Common Misconceptions and Myths
Reptile enthusiasts often stumble into several myths about ball python gravidity. The "sperm retention myth" suggests females always produce fertile eggs after mating, when in reality, false gravidity occurs frequently.
The following table outlines common misconceptions about ball python pregnancy:
Misconception | Reality | Impact |
---|---|---|
Pre-lay shed confusion | Not all shedding indicates pregnancy | Leads to false expectations |
Glow misinterpretation | "Pregnancy glow" resembles normal shedding | Creates false positives |
Weight gain fallacy | Many factors cause weight changes | Results in misdiagnosis |
Palpation inaccuracy remains common among beginners who mistake digestive bulges for eggs. Remember: signs of pregnancy vary between individual female ball pythons, making accurate identification essential.
Importance of Accurate Understanding
Understanding the difference between gravidity and pregnancy protects your ball python’s health and breeding success.
Accurate diagnosis prevents dangerous misinterpretations that could harm your snake.
Observation | Gravid Sign | Common Misinterpretation |
---|---|---|
Swollen mid-body | Developing eggs | Obesity or impaction |
Food refusal | Normal during gravidity | Illness or stress |
Cool-seeking behavior | Temperature regulation for eggs | Environmental issues |
Pre-lay shed | Preparing for egg-laying | Regular shedding cycle |
When you recognize true gravidity signs, you can provide proper reproductive care.
Palpating python eggs should only be done by experienced keepers to avoid damaging developing eggs.
Preparing for Ball Python Egg Laying
You’ll need to prepare a warm, humid nesting box with soft substrate about two weeks after your ball python’s pre-lay shed.
Once your gravid python shows increased pacing and position changes, it’s time to set up a secure laying area with temperatures between 88-92°F and humidity levels of 60-70%, which requires a secure laying area.
Creating a Suitable Environment
While gravidity differs from mammalian pregnancy, preparing your python’s environment remains essential for egg development.
Create an ideal nesting site with these key elements:
- Maintain temperature gradients of 88-92°F on the warm side
- Keep humidity levels at 60-70% consistently
- Provide a spacious nesting box filled with damp sphagnum moss
- Select soft substrate like cypress mulch for comfort
- Make sure multiple secure hides are throughout the vivarium
Your gravid ball python needs this carefully controlled environment to successfully develop and lay her eggs. Understanding optimal incubation conditions is essential for a successful breeding process, ensuring the best possible outcome for your python.
Nesting Behaviors and Preferences
Once your environment is set up, watch for ball python nesting behaviors. After prelay shed, females actively reshape their space.
Provide a dark nesting box with damp substrate at 65-70% humidity. A proper ball python nest setup is essential for successful breeding.
- Females push bedding around to create nest depressions
- Black plastic tubs with shredded material work well for nest site selection
- Cool seeking behavior indicates approaching egg-laying time
- Maintain temperature gradients with warm side at 90°F
- Guarantee enclosure security to reduce stress during nesting
Adjusting Feeding and Watering Schedules
As a gravid female ball python approaches egg-laying, her feeding schedule requires careful adjustment.
During this period, your snake will likely show decreased appetite or refuse meals completely—this is normal reproductive behavior. Offer smaller prey items every 10-14 days, allowing her to accept or decline based on her comfort level.
Water intake becomes essential during gestation. Make sure her water bowl remains clean, full, and large enough for occasional soaking, as hydration management directly impacts egg development and her overall health.
Monitor her weight gain without overfeeding. A proper nutrition plan balances her needs while preparing for nesting behavior. Many breeders find that their gravid pythons naturally regulate their intake, so focus on maintaining consistent meal scheduling rather than forcing feeds.
Ball Python Gestation Period and Egg Incubation
Your female ball python will carry her eggs for about 44-50 days after ovulation before laying them in a secure location.
You’ll need to maintain proper incubation conditions with temperatures between 88-92°F and humidity levels of 60-70% for the eggs to develop properly over the next 50-60 days, which is crucial for successful egg development.
Average Gestation Period and Egg Laying
After you’ve prepared the nesting box, your ball python gestation timeline reaches its finale.
Females lay eggs 44-50 days after ovulation, with clutch size variations from 4-8 eggs typically, though some produce up to 13.
You’ll spot "slugs" (infertile eggs) by their yellowish color and tapered shape.
The egg laying process marks the end of gravidity and begins the exciting incubation phase of your python’s reproduction journey.
Incubation Process and Requirements
Successful egg incubation requires four essential elements:
- Temperature Control: Maintain a steady 88-92°F throughout the incubation period
- Humidity Management: Keep levels between 90-100% to prevent egg dehydration
- Proper Medium: Use a 2:1 vermiculite-perlite mix for ideal moisture retention
- Minimal Disturbance: Monitor development with an egg candler rather than handling eggs directly
You’ll need a reliable incubator with precise temperature controls for the 60-day incubation process.
To guarantee the best results, understanding egg incubator systems is important for maintaining ideal conditions.
Hatching and Post-Hatching Care
Once your ball python eggs begin hatching, you’ll want to monitor them closely in a well-maintained brooder setup.
Keep the temperature steady at 88-90°F and humidity between 70-80% for ideal hatchling care.
Your neonate feeding schedule should start about 5-7 days after their first shed.
The first shed is a critical milestone, marking the beginning of a new phase in their development.
Track each hatchling’s growth using this chart for post-hatch monitoring.
Remember, some babies might take longer to start feeding – that’s normal.
Focus on maintaining proper temperatures and keeping their enclosure
Post-Laying Care for Ball Pythons
You’ll need to provide proper care for your female ball python after she lays her eggs to guarantee her full recovery and health.
Your snake will require specific temperature settings, regular monitoring, and careful feeding schedules to regain her strength and return to her normal routines.
Maternal Recovery and Care
Your female ball python needs special attention when laying eggs.
Focus on maternal recovery with these key aspects:
- Provide fresh water daily and monitor her hydration needs closely
- Offer smaller, frequent meals to support post-lay nutrition without overwhelming her system
- Keep the environment calm and quiet to minimize stress during recovery time
- Check her weight weekly to track progress toward normal body weight
Maintain humidity between 60-70% and watch for a post-lay shed, which signals healthy recovery.
Remove nesting materials gently to help her return back to normal routines.
Egg Incubation and Hatching
Your python’s egg incubation journey marks a critical phase in breeding success. Start by setting up a specialized incubator that maintains consistent egg temperature at 88°F (31°C).
Proper humidity control around 90% prevents harmful dehydration and supports healthy egg development.
Step | Ideal Setting | Why It’s Important |
---|---|---|
Egg Temperature | 88°F | Guarantees even embryo development |
Humidity Control | 85-90% | Prevents dehydration |
Check Eggs Weekly | Check for dimpling | Monitors egg health |
Monitor the incubation process daily, watching for any changes in egg appearance. Adjust your incubation methods if you notice dimpling or discoloration.
Keep the environment stable, as fluctuations can harm developing embryos. Python egg incubation typically takes 55-60 days.
A reliable thermostat and hygrometer are essential tools for maintaining ideal conditions.
Post-Hatching Care and Monitoring
Once your eggs have hatched, proper neonate feeding becomes critical.
Here’s what to monitor:
- Hatchling Care: Offer pinky mice after their first shed, typically 7-10 days post-emergence.
- Environmental Monitoring: Maintain 88-90°F hot spots with 60% humidity in the brooder management setup.
- Scale Shedding: Track first sheds as indicators of health while the mother undergoes her own maternal recovery.
You’ll need separate enclosures for each baby during postlay care.
Confirming Gravidity and Avoiding False Identification
You’ll need to check your ball python carefully to confirm true gravidity, as lumpy bellies can sometimes result from other conditions like impaction or obesity.
An ultrasound performed by a reptile veterinarian provides the most accurate confirmation, though experienced breeders can also use gentle palpation techniques to feel for developing eggs, which helps in confirming true gravidity.
Palpation and Ultrasound Techniques
Through gentle palpation methods, you can feel for follicle identification along your female ball python’s abdomen.
When performed correctly, palpation helps detect egg development through the mid-section.
Ultrasound imaging provides clearer confirmation of gravidity with specialized equipment.
A linear transducer works best for abdominal scanning in reptiles.
Method Accuracy Risks
For most owners, a vet visit guarantees proper python ovulation signs are accurately identified.
Recognizing False Gravidity and Pseudopregnancy
While palpation reveals genuine egg development, some snakes experience pseudopregnancy that mimics true gravidity.
Hormonal imbalances can trigger false gravidity in your female ball python, making identification challenging.
Watch for these key differences:
- Weight fluctuations without consistent gain
- Temporary behavioral changes that quickly revert
- Absence of egg-laying preparation despite other signs
Don’t fall for reproductive myths—pseudopregnancy signs often lack the progressive development pattern of true gravidity. If pregnancy mimicry continues, consult your veterinarian for proper gravidity tests.
Importance of Accurate Confirmation
Certainty saves both heartache and hassle when confirming if your female ball python is truly gravid. Accurate diagnosis prevents wasted preparation time and potential health risks to your snake.
Medical verification through proper gravidity tests guarantees you’re ready for the egg development process ahead.
Confirmation methods include:
- Ultrasound imaging – shows actual eggs with 100% certainty
- Professional palpation – detects egg placement and development
- Pre-lay shed timing – occurs 2-3 weeks before egg laying
- Body weight tracking – monitors consistent weight gain
- Behavioral changes – validates other pregnancy signs
Avoiding false positives helps you provide the right care at the right time, confirming both mother and eggs stay healthy.
Frequently Asked Questions (FAQs)
How long is a ball python gravid for?
Your special bundle of joy will stay in development for approximately 44-50 days from ovulation until egg-laying.
You’ll notice physical changes and behavioral shifts throughout this period as she prepares for motherhood.
How to tell if your ball python is going to lay eggs?
Look for a pre-lay shed, increased reclusive behavior, and a swollen abdomen. Your python will seek cooler areas, refuse food, and create a nest 2-3 weeks before laying eggs.
What is a gravid female snake?
You’d think snakes just got fat, but a gravid female snake is carrying eggs.
She’s pregnant but with eggs rather than live young.
You’ll notice physical and behavioral changes during this time.
Can I let my ball python incubate her own eggs?
While ball pythons can protect eggs naturally, artificial incubation offers better control of temperature and humidity.
It’s not recommended to let her incubate eggs as survival rates are markedly lower in maternal incubation.
Artificial incubation is preferred for its ability to provide optimal conditions, thus it is the method that offers better control.
Is my female ball python gravid?
Without examining your snake, I can’t confirm. Check for these signs: cooler-seeking behavior, increased weight, swollen abdomen, lumpy appearance, lying on back, refusal to eat, and a "pre-lay shed.
How can you tell if a ball python is pregnant?
You’ll notice a million clues when your ball python is gravid.
Watch for a swollen abdomen, lumpy appearance, cool-seeking behavior, refusal to eat, increased soaking, and a pre-lay shed about 2-3 weeks before eggs arrive.
How do you know if a ball python is gravid?
You’ll observe a lumpy abdomen, water bowl coiling, cool-seeking behavior, decreased appetite, and restlessness. Your python may also show color changes and become more active before laying eggs.
Do gravid ball pythons lay eggs?
As sure as eggs in a basket, your gravid ball python will lay eggs.
After a 44-50 day gestation period following ovulation, she’ll produce a clutch of typically 4-8 white, oval eggs.
How do ball pythons get pregnant?
Ball pythons reproduce through mating. The male coils his tail around the female’s, connecting their cloacas for up to 24 hours. Females can store sperm for months before fertilizing their eggs.
What color does a gravid ball python change to?
Gravid ball pythons often develop lighter, more contrasting scales – sometimes called a "pregnancy glow." You’ll notice subtle color shifts, with scales appearing more vibrant against a slightly paler background.
Conclusion
Like Sherlock Holmes seeking clues, you’ll now recognize how to tell if your female ball python is gravid.
Watch for the swollen abdomen, decreased appetite, and restless behavior.
Remember, proper identification makes sure your snake gets the care she needs during this important time.
By monitoring these signs and providing the right environment, you’ll support your python through her pregnancy journey.
Trust your observations and consult a vet if you’re unsure – your snake’s health depends on it.
- https://pangovet.com/pet-health-wellness/snakes/how-to-tell-ball-python-pregnant/
- https://www.snakesforpets.com/how-to-tell-if-your-female-ball-python-is-gravid/
- https://snakesnuggles.com/how-to-tell-if-your-female-ball-python-is-gravid/
- https://onlinelibrary.wiley.com/doi/abs/10.1111/bij.12286
- https://www.jherpmedsurg.com/doi/abs/10.5818/1529-9651-26.3-4.108