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Managing Symptoms of Pregnancy


The journey to motherhood has begun. You feel a mixture of anticipation, joy, hope, excitement, and perhaps a little apprehension. Unfortunately, these euphoric moments may be punctuated with episodes of nausea, constipation , and back pain . How do you get through the rest of the pregnancy without these nagging discomforts?

During pregnancy a woman's body goes through some major changes to meet the demands of her growing baby. These changes are initiated by the sex hormones estrogen, progesterone, and the other hormones of pregnancy, and are often accompanied by numerous discomforts. These normal side effects, which vary among women and pregnancies, are not the same as complications. (Complications of pregnancy include hypertension , anemia , gestational diabetes , pre-eclampsia , and vaginal bleeding.) Here are some common pregnancy discomforts and tips on how to manage them.

Breast Changes

Breast changes include tenderness, heaviness, tingling, as well as an increase in size, darkening of the areolae (skin around the nipples), and more apparent bumps and blood vessels.

What may help : Wear a supportive bra. Try different styles and sizes. You may be more comfortable than bras you currently wear.

Food Cravings

Your taste may change and you may crave certain foods, especially sweets, while other food becomes distasteful.

What may help : Eat a balanced diet and eat as you desire, but avoid binging on high-calorie and high-fat food.

Fatigue

Fatigue is especially common during the first 8-10 weeks due to metabolic changes in your system. Fatigue may also be related to poor nutrition, being overweight, lack of regular exercise, and insomnia .

What may help : Take frequent naps and rest whenever you can. Cut back on your work or daily activities, but engage in regular moderate activity ( eg, walking). Eat small, frequent meals to keep energy levels even.

Emotional Turbulence

You may feel like you are on an emotional roller coaster—excited and euphoric, but also full of doubt and anxiety . You may cry easily and worry about any number of things, such as your pregnancy, the health of your baby, giving birth, your relationship with your partner, and your future.

What may help : Keep in mind that it is normal to have these feelings. Talk openly with your partner, family, friends, and supportive others. Join groups or classes for expectant mothers. You will find that sharing experiences is very helpful.

Constipation

Smooth muscles in the intestine may relax during pregnancy and lead to constipation.

What may help : Eat plenty of high fiber foods such as whole grains , fruits, and vegetables . Make sure you drink plenty of fluids and get regular exercise.

Frequent Urination

As the enlarging uterus puts pressure on your bladder, you may need to urinate more frequently.

What may help : Try to reduce your fluid intake before going to bed but only just before going to bed. Also, avoid drinks with caffeine.

Hemorrhoids

Varicose veins in the anus cause itchiness and pain, triggered by internal pressure from the baby and constipation.

What may help : Eat a high-fiber diet with whole grains, raw fruit, and vegetables; drink plenty of water; exercise regularly. Creams are available to soothe the burning and itching.

Hair Loss

Hormone changes can cause you to lose some hair in the weeks following delivery.

What may help : Remember that new hair will grow within a few months. Until then, you might try wearing a shorter, fluffier hairstyle. Avoid agents that damage the hair such as dyes, perms, and hot air from blow drying.

Nausea and Vomiting

Morning sickness can be experienced at any time of day and is usually caused by high pregnancy hormone levels. Every woman has a different experience—some do not have any nausea, while others are nauseated often. Rarely does sickness become so severe and prolonged that a woman cannot keep any food down and needs to be hospitalized. In most women, bouts of nausea subside by the fourth month. Contact your healthcare provider if you find you are unable to drink, retain fluids, or are losing weight.

What may help : Avoid foods that are high in fat, acidic, or very spicy. Have small frequent snacks of bland food to keep your stomach from being empty. If you are nauseous upon rising in the morning, keep some dry crackers or toast next to your bed. Avoid tobacco smoke and smells that make you nauseated.

Skin Changes

You may notice a darkening of moles and freckles and the areolae around the nipples. Some women develop a dark line from the navel down to their pubic area, or darkened blotches on the face.

What may help : These skin changes are caused by hormones and usually disappear after delivery.

Bleeding Gums

Inflammation and swelling of the gums is often caused by poor oral hygiene. During pregnancy, however, the gums may bleed easily as the result of increased progesterone and expanded blood supply which softens the gums. This situation increases the risk of food collecting at the base of the gums, which could lead to tooth decay and gum disease .

What may help : Practice good oral hygiene. Brush teeth several times per day, especially after eating, and use dental floss. Make sure you visit the dentist during your pregnancy.

Varicose Veins

Dark purplish, swollen veins may develop in the lower leg, causing aching and itching. These can be due to pregnancy hormones, the weight of the baby, increased blood volume, and heredity.

What may help : Do not stand for long periods of time or sit with your legs crossed. You can also try elevating your legs on a pillow when lying down. When sitting, keeping your legs raised. Try support stockings before getting out of bed.

Back Pain

Back aches are common during pregnancy and may result from increased weight in the abdominal region, postural changes, and stretching and softening of ligaments.

What may help : When bending, keep your back straight and bend your knees. Do not stay in the same position for too long—move around. Avoid heavy lifting. Try to develop good posture and do not wear heels. Try back exercises for pregnant women. Supportive garments like a BellyBra may also be helpful. These are special garments to support your back and abdomen.

Indigestion and Heartburn

Indigestion and heartburn are most common during the last trimester due to increased pressure on the stomach, which causes a reflux of gastric juices into the esophagus.

What may help : Avoid fried, spicy, or acidic foods and drinks. Eat small, frequent snacks rather than several large meals. Avoid lying down after eating. Elevate your head with propped up pillows when you go to bed. Talk to your healthcare provider about which medicines are safe for you to take.

Insomnia

You may have difficulty sleeping due to discomfort, sweating, leg cramps, the baby kicking, or the need to urinate.

What may help : Try to unwind before going to bed with a warm bath, relaxing music, stress-relieving exercises, and comfortable bed clothing.

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women's Health
http://www.womenshealth.gov

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

Women's Health Matters
http://www.womenshealthmatters.ca

References:

Back Pain. American Pregnancy Organization Website. Available at: http://www.americanpregnancy.org/pregnancyhealth/backpain.html. Updated March 2007. Accessed December 20, 2012.

Common Symptoms, Signs and Laboratory Changes in Pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.Updated November 29, 2012. Accessed December 20, 2012

Insomnia During Pregnancy. American Pregnancy Organization website. Available at: http://www.americanpregnancy.org/pregnancyhealth/insomnia.html. Updated March 2007. Accessed December 20, 2012.

Mood Swings During Pregnancy. American Pregnancy Organization website. Available at: http://www.americanpregnancy.org/pregnancyhealth/moodswings.html. Updated May 2011. Accessed December 20, 2012.

Morning Sickness. American Pregnancy Organization website: Available at: http://www.americanpregnancy.org/pregnancyhealth/morningsickness.html. Updated March 2007. Accessed December 20, 2012.

Pregnancy and Hair Loss. American Pregnancy Organization website. Available at: http://www.americanpregnancy.org/pregnancyhealth/hairloss.html. Updated March 2007. Accessed December 20, 2012.

Pregnancy and Swollen Gums. American Pregnancy Organization website. Available at: http://www.americanpregnancy.org/pregnancyhealth/swollengums.html. Updated March 2007. Accessed December 20, 2012.

Treatments of Discomforts During Pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.Updated November 2, 2012. Accessed December 20, 2012.

9/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kalus SM, Kornman LH, Quinlivan JA. Managing back pain in pregnancy using a support garment: a randomised trial. BJOG. 2008;115:68-75. Epub 2007 Nov 12.



Last reviewed December 2012 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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