Pregnancy is a time when the body changes enormously to adapt to the new life within you – your baby. Most women sail through pregnancy smoothly. But due to the changes your body undergoes, it is common to have minor problems. This chapter focuses on minor and more serious problems that may occur in pregnancy. This will help you understand when to seek help from your doctor.
This is the commonest complaint in pregnancy
During pregnancy, your ligaments become softer and stretch to prepare you for delivery.
This is brought about by a hormone called relaxing. Also, the growing baby makes you change your posture and this in turn can put a strain on the joints of your lower back and pelvis, which can cause backache.
How to avoid backache
• Avoid lifting heavy objects.
• Bend your knees and keep your back straight when lifting or picking something up from the floor.
• Move your feet when turning around to avoid twisting your spine.
• Wear flat shoes that allow your weight to be evenly distributed.
• Work at a surface that is high enough so that you don’t stoop.
• Try to balance the weight between two bags when carrying shopping.
• Sit with your back straight and well supported.
• Make sure you get enough rest – particularly later in pregnancy.
How to ease backache
• A firm mattress can help to prevent and relieve backache. If your mattress is too soft, put a piece of hardboard under it to make it firmer.
• Gentle massage can help.
When to get help
If your backache is very painful you can ask to see a physiotherapist. They will be able to give you some advice and may suggest some helpful exercises.
This is also a common complaint among pregnant women. You may become constipated very early in pregnancy because of the hormonal changes taking place in your body.
How to avoid constipation
• Eat foods that are high in fiber, like whole meal breads, wholegrain cereals, fruit and vegetables, and pulses such as beans and lentils.
Drinking fruit juice removes all the fiber. So, fruit are best eaten whole.
• Exercise regularly to keep your muscles toned.
• Drink plenty of water.
• Ask your doctor whether you can change the iron preparation.
Cramp is a sudden, sharp pain, usually in your calf muscles or feet. It is most common at night, but nobody really knows what causes it.
How to avoid cramp
Regular, gentle exercise in pregnancy, particularly ankle and leg movements, will improve your circulation and may help to prevent cramp occurring.
How to ease cramp
It usually helps if you pull your toes hard up towards your ankle or rub the muscle hard.
You may often feel faint when you are pregnant especially in early pregnancy. This is because of hormonal changes taking place in your body and happens if your brain is not getting enough blood and therefore enough oxygen. If your oxygen level gets too low, you may actually faint. You are most likely to feel faint if you stand still for too long or get up too quickly from a chair or out of a hot bath. It can also happen when you are lying on your back.
How to avoid feeling faint
• Try to get up slowly after sitting or lying down.
• If you feel faint when standing still, find a seat quickly and the feeling should pass. If it doesn’t, lie down on your side.
• If you feel faint while lying on your back, turn on your side. It is advisable not to lie flat on your back at any time in later pregnancy or during labor.
During pregnancy you are likely to feel warmer than normal. This is due to hormonal changes and to an increase in the blood supply to your skin. You are also likely to sweat more.
How to avoid feeling hot
• Wear loose clothing made of natural fibers, as these are more absorbent and ‘breathe’ more than synthetic fibers.
• Keep your room cool. You could use an electric fan to cool it down.
• Wash frequently to help you to feel fresh.
5 CONDITIONS AND PROBLEMS IN PREGNANCY
Some pregnant women find they get a lot of headaches.
How to ease headaches
• Try and get more regular rest and relaxation.
• Paracetamol in the recommended dose is generally considered safe for pregnant women but there are some painkillers that you should avoid. Speak to your pharmacist, nurse, midwife, health visitor or GP about how much paracetamol you can take and for how long.
When to get help
If you often have bad headaches, tell your midwife or doctor. Severe headaches can be a sign of high blood pressure
Incontinence is a common problem. It can affect you during and after pregnancy.
Sometimes pregnant women are unable to prevent a sudden spurt of urine or a small leak when they cough, sneeze or laugh, or when moving suddenly or just getting up from a sitting position. This may be temporary, because the pelvic floor muscles relax slightly to prepare for the baby’s delivery.
Some women have more severe incontinence and find that they cannot help wetting themselves.
When to get help
In many cases incontinence is curable, so if you have got a problem talk to your midwife, doctor or health visitor.
Indigestion and heartburn
Indigestion is partly caused by hormonal changes and in later pregnancy by your growing uterus pressing on your stomach. Heartburn is more than just indigestion. It is a strong, burning pain in the chest caused by stomach acid passing from your stomach into the tube leading to your stomach. This is because the valve between your stomach and this tube relaxes during pregnancy.
How to avoid indigestion
• Try eating smaller meals more often.
• Sit up straight when you are eating, as this takes the pressure off your stomach.
• Avoid the foods which affect you, e.g. fried or highly spiced food, but make sure you are still eating well.
How to avoid heartburn
• Heartburn is often brought on by lying flat. Sleep well propped up with plenty of pillows.
• Avoid eating and drinking for a few hours before you go to bed.
• Your midwife or GP may prescribe an antacid if the problem is persistent.
How to ease heartburn
• Drink a glass of milk. Have one by your bed in case you wake with heartburn in the night.
• Note that you should not take antacid tablets before checking with your midwife, doctor or pharmacist that they are safe for you to take.
Mild itching is common in pregnancy because of the increased blood supply to the skin. In late pregnancy the skin of the abdomen is stretched, and this may also cause itchiness.
How to avoid itching
• Wearing loose clothing may help.
• You may also want to avoid synthetic materials.
Leaking nipples are normal and usually nothing to worry about. The leaking milk is colostrum, which is the first milk your breasts make to feed your baby.
When to get help
See your midwife or doctor if the milk becomes bloodstained.
Nausea and morning sickness
Nausea is very common in the early weeks of pregnancy. Some women feel sick, and some are sick. It can happen at any time of day – or even all day long.
Hormonal changes in the first three months are probably one cause. Nausea usually disappears around the 12th to 14th weeks. It can be one of the most trying problems in early pregnancy. It comes at a time when you may be feeling tired and emotional, and when many people around you may not realise that you are pregnant.
How to avoid nausea and morning sickness
• If you feel sick first thing in the morning, give yourself time to get up slowly. If possible, eat something like dry toast or a plain biscuit before you get up.
• Get plenty of rest and sleep whenever you can. Feeling tired can make the sickness worse.
• Eat small amounts of food often rather than several large meals, but don’t stop eating.
• Drink plenty of fluids.
• Ask those close to you for extra help and support.
• Distract yourself as much as you can. Often the nausea gets worse the more you think about it.
• Avoid foods and smells that make you feel worse. It helps if someone else can cook. If not, go for bland, non-greasy foods, such as baked potatoes, pasta and milk puddings, which are simple to prepare.
• Wear comfortable clothes. Tight waistbands can make you feel worse.
When to get help
If you are being sick all the time and cannot keep anything down, tell your midwife or doctor. Some pregnant women experience severe nausea and vomiting. This condition is known as hyperemesis gravidarum and needs specialist treatment.
5 CONDITIONS AND PROBLEMS IN PREGNANCY 61
Nose bleeds are quite common in pregnancy because of hormonal changes. They don’t usually last long but can be quite heavy. As long as you don’t lose a lot of blood, there is nothing to worry about. You may also find that your nose gets more blocked up than usual.
How to stop nose bleeds
• Sit with your head forward.
• Press the sides of your nose together between your thumb and forefinger, just below the bony part, for 10 minutes and try not to swallow the blood.
• Repeat for a further 10 minutes if this is unsuccessful.
• If the bleeding continues, seek medical advice.
Passing urine often
Needing to pass urine often may start in early pregnancy. Sometimes it continues right through pregnancy. In later pregnancy it’s the result of the baby’s head pressing on the bladder.
How to reduce the need to pass urine
• If you find that you have to get up in the night try cutting out drinks in the late evening, but make sure you keep drinking plenty during the day.
• Later in pregnancy, some women find it helps to rock backwards and forwards while they are on the toilet. This lessens the pressure of the uterus on the bladder so that you can empty it properly. Then you may not need to pass water again quite so soon.
When to get help
If you have any pain while passing water or you pass any blood, you may have a urine infection, which will need treatment. Drink plenty of water to dilute your urine and reduce pain. You should contact your GP within 24 hours.
The growing baby will increase pressure on your bladder. If you find this a problem, you can improve the situation by doing exercises to tone up your pelvic floor muscles (see page 35).
Ask a midwife or obstetric physiotherapist (see pages 54 and 55) for advice.
Pelvic joint pain
If during or after your pregnancy you have pain in your pelvic joints when walking, climbing stairs or turning in bed, you could have pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD). This is a slight misalignment or stiffness of your pelvic joints, at either the back or front. It affects up to one in four pregnant women to a lesser or greater extent. Some women have minor discomfort, others may have much greater immobility.
When to get help
Getting diagnosed as early as possible can help to minimise the pain and avoid long-term discomfort. Treatment usually involves gently pressing on or moving the affected joint so that it works normally again.
Ask a member of your maternity team for a referral to a manual physiotherapist, osteopath or chiropractor who is experienced in treating pelvic joint problems. They tend not to get better completely without treatment from an experienced practitioner.
If you have any queries please do not hesitate to ask us – Jananam team