Pregnancy is a time of both physical and emotional changes. Aside from the obvious changes in your body shape, the size of your uterus and shifts in your hormonal levels and metabolism can contribute to various physical and emotional discomforts. Common discomforts of pregnancy can cause some mothers to request early elective delivery. It is important to note that babies need at least 39 weeks to grow and develop before they are born. Research has shown that early elective deliveries, before 39 weeks gestation, without medical reason is linked to reduced quality of health in the infant with no benefit to the mother or infant. The pregnancy discomforts mentioned below are common; however they are not medical reasons for early delivery. The good news is, not all common discomforts of pregnancy are experienced by all women and may or may not be part of your pregnancy. It is important to remember that:
- You may need to try more than one remedy before you find one that works for you.
- Good nutrition is especially important for a comfortable and healthy pregnancy.
- Eating well can minimize discomforts and help your body cope with the stresses of daily life.
- If you have a physical discomfort that is severe or does not go away, contact your health care provider.
- If you have a chronic health condition, such as diabetes or asthma, it is very important to see your health care provider throughout your pregnancy.
Backaches often occur as your increasing weight pulls your spine forward and shifts your center of gravity.
- First, consider the possibility of backache as a symptom of pre-term labor.
- Practice good posture. Tuck your buttocks under and stand straight and tall.
- Always be careful when lifting objects. Bend your knees instead of bending over at the waist. Lift with your legs instead of your back.
- Wear supportive shoes with low heels.
- Avoid standing for long periods of time. Put one foot on a step stool to relieve back stress while standing.
- Exercise at least three times a week (e.g., swim, walk, stretch).
- Join a prenatal exercise or yoga class.
- The pelvic tilt exercise may help reduce discomfort.
- Consider wearing a maternity support belt to help relieve some of the pressure. Maternity pants with a low, supportive waistband may also be helpful.
- Apply heat using warm bath soaks, warm wet towels, a hot water bottle or heating pad.
- Get a back massage.
- If the pain continues, ask your health care provider for a referral to a physical therapist.
- Avoid medications. No medications are considered 100 percent safe for use during pregnancy. Aspirin and other painkillers, such as ibuprofen, may be harmful to your baby. Ask your health care provider about medication to treat backache.
In preparation for producing milk, your breasts will increase in size during pregnancy as your milk glands enlarge and fatty tissue increases. They may become tender and more sensitive and may tingle with temperature change or touch. As your blood supply increases, the blood vessels enlarge, and bluish veins may appear on your breasts. The areola and nipple also darken and the Montgomery glands, the small pores around the areola, enlarge. Some women will notice a substance leaking from the nipple in the last three months of pregnancy. This is colostrum, the substance produced before breast milk. If you do not leak colostrum in the last part of pregnancy, do not worry that you may not be able to produce breast milk.
- Wear a supportive bra to ease the strain on your breasts and back muscles as your breasts become heavy. You may be more comfortable sleeping in a bra.
- Wear disposable or washable breast pads if you are leaking colostrum.
- Avoid soap on your areola and nipple, as this tends to dry out the skin. Use warm water to keep the area clean.
- If you are leaking, allow your breasts to air dry a few times a day and after a shower.
- Cotton bras are preferable to those made of synthetic fabrics, because cotton allows the skin to breathe. If you plan to nurse your baby, your nursing bras will probably be about one cup size larger than those you need in late pregnancy so purchase your nursing bras in the ninth month.
During pregnancy, your digestive system slows down due to hormonal changes and your digestive organs are displaced due to the growing uterus. You may also become constipated from irregular eating habits, changes in environment, stress, and added calcium and iron in your diet. Some medications, too little exercise, and not enough fiber and liquids may also contribute to the problem. Constipation refers only to bowel movements that are hard in consistency or painful. Infrequent bowel movements are not unusual.
- Drink plenty of liquids, especially water (at least eight, 8-ounce glasses daily).
- Get more exercise, especially walking, for at least 30 minutes a day.
- Add high fiber foods to your diet. Eat raw or cooked fruits and vegetables, dried fruit (especially prunes), prune juice, bran (3 tablespoons daily), beans and whole grain products (such as whole wheat bread, brown rice and oatmeal).
- Eat small, frequent meals and thoroughly chew your food.
- Iron supplements can cause constipation. If you need to take iron supplements, take them with prune juice.
- Avoid using any type of laxative other than bulk producing ones, stool softeners or enemas, unless under the supervision of your health care provider.
- Drink a glass of water before going to bed to help relieve constipation.
Hemorrhoids are varicose veins in the rectal area caused by the increased blood volume and additional weight of pregnancy. They may itch or burn during bowel movements and sometimes bleed slightly.
- Since constipation can make hemorrhoids worse, try to avoid becoming constipated.
- Metamucil or a gentle stool softener may be needed, check with your health care provider before taking them.
- Avoid sitting on the toilet for long periods of time or straining while having bowel movements. Put your feet up on a stool to reduce straining.
- Pads of witch hazel may help relieve pain and itching. It can be very helpful to refrigerate the pads, as they may be more soothing when applied cold.
- An ice pack applied to hemorrhoids may bring some relief. Avoid hemorrhoid medicines that contain local anesthetics that may be harmful to your unborn baby.
- A 15 to 20 minute warm bath three or four times each day relieves hemorrhoid discomfort.
- Do Kegel exercises regularly.
- Avoid using a “doughnut” to sit on as this decreases blood circulation.
This is a problem in the first three and last three months of pregnancy. As the uterus grows it places pressure on the bladder, even more so when the baby drops. In the last part of pregnancy, it is very common to leak a small amount of urine anytime you cough, sneeze or laugh too hard. Frequent urination almost always goes away following delivery.
- Do the Kegel exercise. Squeeze the muscles around the vagina tightly (as though you were stopping the flow of urine midstream) for a few seconds, and then relax. Repeat this 10 times. Do a set of Kegels at least five times a day.
During pregnancy, some women have trouble falling or staying asleep. In the early months, trouble sleeping may be part of your body’s adjustment to pregnancy. During the last few months, your increased size may make your normal sleeping position difficult, and the baby’s kicking may wake you up during the night. Also, increased bladder pressure may cause you to wake up often during the night.
- Exercise daily.
- Take a warm, relaxing bath before bed.
- Reduce any noise or lighting which might keep you awake.
- Avoid eating a big meal within two hours of going to bed.
- Do childbirth preparation exercises such as deep breathing or other relaxation techniques.
- Experiment to find the most comfortable sleeping positions. Lie on your side and place several pillows between your knees.
- Avoid sleeping on your back starting the 20th week of pregnancy. The combined weight of your uterus and baby compress the major vessels which supply blood to the placenta and lower part of your body. This could cause decrease the oxygen supply to your baby.
- Read a novel or other book of interest.
- Get a massage.
- Avoid products that contain caffeine, as they may keep you awake.
- Try to develop a regular sleeping schedule and routine.
- Plan for naps or short rest periods during the day.
- If you are unable to sleep, relax and do not worry. Sleeping patterns change in late pregnancy due to hormones. This can cause you to sleep for only 2 to 3 hours at a time, which is normal. Your wakefulness may be your body’s way of preparing you for the upcoming changes in your life.
- Avoid all sleeping medications. There are no safe medications to relieve sleeping difficulties during pregnancy. Some sleeping aid products contain multiple ingredients, some of which harm your baby.
Women often feel more tired than usual and need extra sleep during pregnancy. During the early months, fatigue is caused by natural hormonal changes as your body adjusts to pregnancy. During the last month or two, carrying the extra weight of the baby will be tiring. Fatigue is an important sign from your body that you need extra rest. Listen to your body, and do not push yourself!
- Accept the fact that you need extra rest and pace your daily life accordingly.
- Take naps when you feel tired. Sit down and put your feet up.
- Try a rest break instead of a coffee break.
- Caffeine and other stimulants may increase fatigue and be harmful.
- Eat small, well-balanced meals several times a day.
- Exercise regularly. This will make you less, not more, tired.
- Avoid taking on extra responsibilities during this time in your life.
- Be sure to consume enough calories, iron, and folic acid.
- Avoid all medications for fatigue. There are no safe medicines you can take for fatigue during pregnancy.
Heartburn or intestinal gas
Pregnant women may get heartburn because the stomach muscles relax and food tends to back up. Sometimes the stomach makes more acid during pregnancy. The growing baby pressing against the stomach can force acid upward causing heartburn.
- Greasy, fried or highly seasoned foods may produce heartburn. Determine which foods give you heartburn and avoid them.
- Avoid both coffee and cigarettes, as they irritate the stomach making heartburn worse.
- Eat several small meals a day, rather than three large meals.
- To help coat your stomach and esophagus, try sipping water, milk, carbonated water or papaya juice. You can also try eating 1/2 tablespoon of yogurt, heavy cream, Half and Half, or a small dish of vanilla ice cream.
- Drink plenty of liquids, especially water (eight to ten, 8-ounce glasses daily).
- Wear clothing that is loose around your waist.
- Do not lie down right after eating. When you do lie down to sleep or rest, use pillows to slightly raise your head.
- Avoid acidic foods, such as citrus fruits, tomatoes, red peppers, and chocolate. They can cause heartburn.
- To reduce heartburn try the “flying exercise”. While standing, raise and lower your arms quickly, bringing the backs of your hands together over your head. Repeat several times.
- A leisurely walk reduces heartburn for some women; for others, sitting quietly and breathing deeply is helpful.
Light-headedness and/or dizziness are normal when you get up quickly. These symptoms may also result from lack of fluids, low blood sugar or anemia (a lower than normal number of red blood cells).
- Change positions slowly. Move from lying down to sitting, and then wait a minute before standing up.
- Avoid standing up for long periods of time.
- Take frequent rest periods.
- Eat healthy foods high in iron in frequent, small amounts throughout the day.
- Drink 8 to 10 glasses of water per day. If your health care provider determines that you are anemic, iron supplements or a change in diet may be recommended.
Being pregnant can lead to many conflicting emotions and mood changes. Many women are subject to sudden outbursts of emotion that can be caused by several factors, including fatigue, stress and hormonal changes.
- Talk over your feelings and concerns with your partner or another trusted person.
- Consider joining or starting a pregnancy support group.
- Continue with activities that you enjoy. This is a great time for you and your partner to spend time together before the baby arrives.
- Take time to pamper yourself. Hair and nails often grow quickly during pregnancy.
- Exercise on a regular basis. You may find prenatal exercise classes to be a valuable source of support from other pregnant mothers.
- Avoid becoming overly tired. Take naps on a regular basis whenever possible. Even a 15-minute rest break can help.
- Be sure your diet is healthy and that you have enough protein and iron every day.
- Attend classes, read books, and watch videos on various aspects of pregnancy, childbirth preparation and newborn care. Knowing what to expect will help ease tension.
Muscle Cramps are common during pregnancy, but the cause is difficult to determine. Possible causes include a calcium imbalance, pointing your toes when you stretch, and decreased circulation in your legs.
- Be sure to include enough calcium (1,000 mg/per day) in your diet. Dairy products are an excellent source of calcium. Non-dairy sources of calcium include tofu, molasses and dark-green, leafy vegetables, such as broccoli or bok choy and okra.
- Exercise to increase the circulation in your legs.
- Elevate your legs as often as possible.
- Keep your legs warm.
- Take a warm bath before you go to bed.
- Do not point your toes when you stretch. Instead flex your feet by pulling your toes toward your knees.
- Avoid lying on your back as this can decrease the circulation to your legs.
- Loosen the bedding at the foot of your bed.
- Before going to bed, stretch your calf muscles.
- Try leg lunges:
- Stand in a lunge position with one foot well in front of the other.
- Keep your back leg straight with your heel flat on the floor.
- Gradually bend your front leg at the knee and lean forward. You can use your arms for balance by placing your hands against a wall.
- Hold for a few seconds and repeat.
- Switch legs.
What to do when you have a leg cramp:
- Sit on the floor with your legs straight (do not lock your knees) and flex your toes towards your knees. You can accomplish the same thing by sitting on the floor and putting a long towel or scarf around the ball of your foot. Hold on to both ends of the towel or scarf and gently pull it towards your body. An elastic exercise band also works well for this.
- Massage the cramped muscles. Sometimes applying an ice pack is more effective.
- When you can, stand up and walk around.
- Soak your cramped muscles in warm water, or use a heating pad or hot water bottle.
- Avoid all medicines for leg cramps. There are no safe medications you can take for leg cramps during a pregnancy.
Nausea and vomiting
Nausea sometimes occurs early in pregnancy and usually goes away after the third month. Although it is called “morning sickness,” it can happen any time of the day or night, or you may never experience nausea. Different remedies help different women.
- Eat a piece of bread or a few crackers before you get out of bed in the morning or when you feel nauseous. Put them close to your bed the night before.
- Get out of bed slowly. Avoid sudden movements.
- Eat small meals several times during the day so your stomach does not remain empty for long periods of time (Six small meals instead of three larger ones).
- Eat high-protein meals (lean meats, vegetable proteins, beans, legumes), complex carbohydrate foods (crackers, breads, potatoes, rice) and fruit and fruit juices. Such foods help prevent low blood-sugar levels which can cause nausea.
- Drink soups and other liquids between meals, rather than with meals.
- Avoid greasy or fried foods. These foods are hard to digest and may cause nausea.
- Even cooking certain foods for others can cause nausea in some women. Open windows or use the exhaust fan to get rid of odors.
- Eat lightly seasoned foods and avoid spicy foods.
- Sip soda water (carbonated water or ginger ale) when you feel nauseated.
- Drink herbal teas such as ginger, spearmint, peppermint, or raspberry leaf. Some herbs are not suitable to use during pregnancy.
- Fresh air may help. Take a short walk or try sleeping with a window open.
- Try sucking on cold foods such as popsicle’s or ice.
- Try using motion bands on your wrists.
Nosebleeds and bleeding gums
Nasal membranes become swollen due to increased blood volume during pregnancy and may cause nosebleeds in some women. An increase in hormones during pregnancy, as well as the increase in blood volume, may cause tenderness, swelling and bleeding of your gums. A lack of Vitamin C in your diet may also contribute to this condition.
- During a nosebleed, lie down and apply pressure and cold compresses to your nose.
- Use a humidifier if the air in your home tends to be very dry. A higher level of humidity in your surroundings will help decrease the chance of nosebleeds.
- Try a thin coating of petroleum jelly in each nostril, especially at bedtime.
- Continue practicing good oral hygiene.
Lower abdominal and pelvic discomfort
During pregnancy, the pelvic joints relax in order to increase the size and flexibility of the pelvis in preparation for birth. This may cause pressure on the sciatic nerve and may lead to pain in the pelvic area, down the thigh and into the leg.
At times, a discomfort known as “Round Ligament Pain” can take your breath away. You may be walking and suddenly feel a “knife-stabbing” pain on one or both sides of your lower abdomen or groin. Or you may feel a spasm in your vagina or rectum. As quickly as it came on, it may go away. There are ligaments that hold the uterus in place, one on both sides of the uterus and a third going across the pelvic floor. As the uterus grows, these ligaments stretch like a rubber band. Any sudden movement or position change can cause them to spasm.
- A heating pad, hot water bottle or ice pack applied to the painful area may bring some relief.
- Massage may be helpful.
- Experiment with different sleeping positions to find the one that is most comfortable for you. Try sleeping on your side, with one leg forward supported on a pillow and the other back, as if you were running.
- Use proper body mechanics when lifting, bending and stretching during your pregnancy and after you deliver.
- The pelvic tilt may be helpful in reducing discomfort.
- Consider wearing a maternity support belt to help relieve some of the pressure.
Call your health care provider immediately if you have abdominal pain and it continues or becomes stronger as time goes on. If you cannot contact your health care provider, go to the hospital.
Shortness of breath
Your growing uterus puts pressure on your internal organs and diaphragm, which leaves less room for your lungs to expand and leads to shortness of breath. Going up a flight of stairs is tough towards the end of pregnancy, and you will find it harder to breathe. At night, it becomes harder to find a comfortable position where you can breathe easily.
- Hold your arms over your head. This raises your rib cage and temporarily gives you more breathing space.
- Try sleeping with your head elevated by pillows.
- Practice very slow deep breathing while relaxing. It will help you use your lung space to its greatest capacity.
- Slow down when climbing stairs.
In the last few weeks of pregnancy, “lightening” occurs, which is when the baby drops into the pelvis. Once this happens, the pressure is off the diaphragm, your lungs will have more room, and breathing becomes much easier.
Due to hormonal changes that occur during pregnancy, it is normal to have a brown coloring on your cheeks, nose and forehead. This is known as chloasma or “the mask of pregnancy.” It is also normal for your nipples to become darker and to have a dark line on your abdomen from your navel down to your pubic bone (the linea nigra). Be reassured that the hormone that causes this increase in pigmentation and discoloration will decrease after your baby is born. The discoloration will fade or disappear after delivery.
Some women will have a problem with acne or skin breakouts during pregnancy. Do not take any oral medications for this problem without your health care provider’s advice.
- Avoid sunburn, which may deepen skin coloring.
- For acne or breakouts, wash your face as you normally would.
About 90 percent of pregnant women experience stretch marks. There is nothing you can put on your skin to prevent stretch marks. Stretch marks are a type of scar tissue that forms when the skin’s normal elasticity is not sufficient to accommodate the stretching required during pregnancy. Excessive weight gain in pregnancy is the most common cause of stretch marks. Stretch marks occur most often on the abdomen, but some women also develop them on their thighs, upper arms and breasts. Fair-haired women, blondes and redheads tend to have very red looking stretch marks. Brunettes may get them as well. Although stretch marks may not disappear entirely after delivery, those that remain usually fade to a lighter, silvery color.
- Ensure that your diet contains enough foods high in protein. This will help your skin stay healthy.
- Keeping your skin soft and moisturized will not prevent stretch marks, but it may help minimize itching. Try a gentle massage with a moisturizing lotion.
Itching is a common discomfort of pregnancy that is usually caused by stretching of the growing abdomen and the hormones of pregnancy. Those who have dry skin or eczema may find these conditions worsen during pregnancy.
- Avoid hot showers (this may dry skin out).
- Use lots of lotion; unscented is better.
- Take an oatmeal bath once or twice a week.
- Wear loose clothing.
- Avoid going out in the heat of the day.
Some women may develop welts in the last month or two of pregnancy. They usually begin on the stomach by the stretch marks and later spread to the thighs and upper arms. This can be very itchy but won’t harm you or your baby. Topical ointments can be prescribed to relieve the itching.
Stuffy nose/food or chemical allergies
Sometimes a stuffy nose and allergies occur during pregnancy, even among women who have not experienced them before. Consult with your health care provider about the use of antihistamines.
- Try to determine what you are allergic to, and avoid it if possible.
- Smoking or being in a smoke-filled room can make your allergies worse.
- Breathing steam from a hot shower, a pot of boiling water (removed from the stove first) or a vaporizer may help clear a stuffy nose. If you use a vaporizer, be sure to keep it clean to prevent bacteria and mold from growing. A cool mist humidifier may also bring relief.
- Place warm, moist towels on your face to make it easier to cough and clear your chest. If you have a cold, try drinking hot soups.
- Salt-water nose drops (made from 1/4 teaspoon of salt dissolved in 1 cup of warm water) may be helpful. Make a fresh solution each time you need to use the drops.
- Use finger pressure on your sinuses or massage your sinuses. Rub on the bony ridge above and under your eyebrows, under your eyes and down the sides of your nose.
- Avoid using nasal sprays or drops (except salt-water drops). They work by shrinking blood vessels and may affect your whole body and your baby’s body.
- Do not take cold or allergy medicines without consulting your healthcare provider.
Swelling (feet, legs, face and hands)
During pregnancy, it is normal to experience swelling of the feet, legs and hands that makes your skin feel tight. The amount of blood in your body increases approximately 40 percent. In addition, your body naturally holds water. Your heart needs to work harder to circulate this extra fluid. For about one out of three women, swelling of the hands and feet occurs during the last three months of pregnancy and is often greater during hot weather. Some swelling or puffiness is not unusual or serious, but it can be uncomfortable.
- Eat foods high in protein, such as beans, cheese, fish, meat, poultry and tofu.
- Try to avoid standing for long periods of time.
- Drink the fresh juice of a lemon in a cup of warm water to help decrease fluid retention.
- Rest two or three times a day with your legs elevated higher than your heart. Lie down with pillows under your calves and feet. Lying down on your left side is better for circulation.
- Avoid wearing tight clothing, such as pants, leotards and knee-high stockings. Varicose veins may be associated with swelling.
- Exercise regularly by walking or swimming.
- Try submerging in water to your shoulders. The water should be no warmer than body temperature.
- Avoid sitting with your legs crossed. Use a footstool when sitting and perform ankle circles whenever possible.
- Check your fluid intake and drink when thirsty.
Puffiness of the eyelids, face and fingers when accompanied by high blood pressure, headaches, blurred vision, or spots in your vision may be a sign of a more serious condition called Preeclampsia also called Pregnancy Induced Hypertension (PIH). Be aware of the warning signs and contact your health care provider immediately if you have these symptoms or are concerned. PIH is a condition only related to pregnancy and requires medical attention.
Medications to avoid
- There are no safe medications to take for swelling during pregnancy.
- Diuretics or “water pills” can cause an imbalance in the salt and potassium levels in your body, and this can be dangerous for you and your baby.
Vaginal discharge/yeast infections
Increased blood supply and hormones during pregnancy cause the vagina to increase its normal secretions and alter its chemistry (pH). This can create an ideal condition for the common vaginal infection, monilia (yeast), to grow.
- Wear skirts rather than slacks.
- Wear 100% cotton underwear.
- Avoid douching during pregnancy unless advised by your healthcare provider.
- Call your health care provider if the discharge burns, itches, smells, or causes genital swelling.
- Consider eating yogurt on a daily basis to increase the amount of helpful bacteria in your system.
Medication to avoid
- Pregnancy limits the choice of medications that are safe to use to treat yeast infections. Be sure to check with your health care provider before using previously prescribed medication or over-the-counter remedies.
Varicose veins develop from weak areas in the walls of blood vessels and are due in part to heredity. The veins may swell in the leg and groin area. This is common during pregnancy and may be caused by the pressure and weight of the baby and uterus.
- Exercise regularly. Walking and swimming are ideal for improving circulation.
- Avoid clothing that binds or is tight, especially knee-high stockings. Tight clothing may decrease blood circulation in your legs.
- Wear support hose when you plan on standing or walking for a long time. Put them on before getting out of bed in the morning.
- Avoid standing or sitting in one place for long periods of time if possible. If you need to sit for a long time, get up occasionally and walk around. This is important during long automobile, airplane, train or bus trips.
- Avoid sitting with your legs crossed, as this decreases the circulation in your legs.
- Put your feet on a footstool when sitting.
- Lie down with your feet elevated above the level of your heart several times during the day.
- Wear shoes with well-padded soles and low heels to reduce stress on your legs from walking.
- If exercise or movement is restricted during your pregnancy, consider isometric exercises as they tone muscles and promote circulation.
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