Pregnancy Discomforts

You could have a very healthy pregnancy and still experience any number of discomforts. These discomforts are caused by the changes that pregnancy brings about in your body. Most don't require treatment, but in many cases there are a few simple things you can do to help make matters better. You should, however, discuss any problem that bothers you with your doctor.

Backache

As your baby continues to grow, the additional weight in front causes you to lean back to compensate. This stresses the ligaments and muscles of your lower back, and often causes back pain. Abdominal muscles weakened by pregnancy also can cause back pain.

What to Do

Minimize your back pain by gaining only as much weight as your doctor recommends.

Self-care Steps for Backache

• Wear low-heeled, cushioned shoes.

• Apply ice packs.

• Sleep on a very firm mattress.

• Sleep on your side, with a pillow between your legs.

• Use a chair with good back support, or place a small pillow behind your lower back when you sit.

• Learn to lift properly

• Do low-impact exercises, such as walking and swimming.

• Do pelvic tilt exercises. Stand with your back against a wall and slowly press the small of your back against the wall. Release and repeat several times a day.

Bleeding Gums

Inflammation triggered by hormonal changes during pregnancy can cause bleeding gums, which are common. Sore and swollen gums are less common.

What to Do

See your dental provider if your gums are particularly painful or swollen or if they bleed easily.

Self-care Steps for Bleeding Gums

• Brush twice a day and floss daily.

• Continue your regular dental checkups and cleanings.

Breathlessness

Breathlessness is common both early in pregnancy and in the third trimester. Early on, the hormone progesterone affects the brain and causes you to breathe more deeply. During the third trimester, difficulty breathing can result from the uterus compressing the diaphragm, which presses on your lungs. During the final weeks, this problem can ease up as the fetus drops in the uterus.

What to Do

Call your doctor if your breathlessness is severe or is accompanied by rapid heartbeat, rapid breathing, shortness of breath, or chest pain.

Self-care Steps for Breathlessness

• Sleep and sit in comfortable positions. Sleeping propped up can help.

• Use good posture when sitting.

• Wear loose, comfortable clothing.

• Exercise regularly during pregnancy with your doctor's advice.

• Ask your health care provider about breathing exercises.

Constipation

More than half of all pregnant women suffer constipation. The hormone progesterone is one cause. It relaxes the muscles and slows down the wavelike contractions that move stool through your digestive tract. Iron in prenatal vitamins can also contribute to constipation.

What to Do

If the self-care steps listed below fail, talk to your doctor. He or she might recommend a stool softener that is safe during pregnancy.

Self-care Steps for Constipation

• Increase fiber in your diet with such foods as fruits, vegetables, beans and bran.

• Exercise regularly (consult your doctor).

Dizziness

It's not unusual to feel lightheaded or dizzy during pregnancy. Some reasons: Your overall blood pressure is lower, and the enlarged uterus can compress and block the large vein carrying blood to your heart. Either way, your brain's blood supply can be reduced. Low blood sugar can be another cause.

What to Do

Brief lightheadedness, especially when you stand up from a sitting position or lie on your back, is common. But call your doctor right away if you experience repeated dizziness or fainting.

Self-care Steps for Dizziness

• Rise up slowly from seated or lying positions.

• Avoid becoming overheated; don't take hot showers or baths.

• Avoid lying flat on your back during the third trimester.

• Eat at regular intervals.

• When dizzy, either sit down and bend over while breathing deeply or lie on your side. Both positions increase the flow of blood to your brain.

• Drink enough fluids.

• Exercise regularly. Walking is a good exercise during pregnancy.

• Ask your health care provider whether you could be anemic.

Fatigue

Practically every expectant mother deals with bouts of tiredness. It's understandable, since your body has to direct some of its energy toward supporting the growing fetus. During the first semester, your body is undergoing many changes, and by the third trimester you are carrying much more weight. Often, you are restless and suffer from interrupted sleep.

What to Do

If you experience severe, persistent fatigue even after trying the self-care steps below, call your doctor.

Self-care Steps for Fatigue

• Pace your activities.

• Sleep and nap as much as you can.

• Exercise regularly (talk with your doctor).

Frequent Urination

Especially at night, many pregnant women feel the urge to urinate more frequently during their first trimester. That's because of hormonal changes and the added pressure your growing uterus exerts on your bladder. The result: You feel a strong urge to urinate, but only pass a small amount of urine. During the third trimester, frequent urination may again occur as the fetus drops in preparation for delivery. Urinary tract infections can also trigger frequent urination.

What to Do

If you experience pain while urinating, contact your doctor.

Self-care Steps for Frequent Urination

• Avoid drinking excess fluids after dinner to reduce disturbed sleep.

Heartburn

Heartburn and indigestion plague almost every pregnant woman. Again, blame the hormone progesterone. It relaxes the ring-like sphincter at the base of your esophagus, which normally closes off entry to the stomach. When that doesn't occur, food mixed with digestive enzymes can back up into your esophagus. The result: irritation and a burning sensation in your chest. You can also feel full because of the pressure your growing uterus puts on your stomach.

What to Do

Call your doctor if your heartburn persists or keeps you from eating enough to gain weight. Many effective antacids (calcium carbonate, aluminum and magnesium hydroxides and trisilicates) are safe to take while you are pregnant. Do not take other kinds of antacids without checking with your health care provider first.

Self-care Steps for Heartburn

• Stay upright for at least two hours after eating.

• Eat small meals frequently throughout the day.

Hemorrhoids

Hemorrhoids -- swollen veins in the rectum -- affect half of all pregnant women. They occur when your enlarged uterus presses on the veins. Constipation, or straining during bowel movements, can make them worse. The symptoms include enlarged veins, painful defecation and, occasionally, bleeding during bowel movements.

Self-care Steps for Hemorrhoids

• Eat a fiber-rich diet and exercise regularly (with your doctor's advice).

• Apply ice packs.

• Reduce pressure on anal veins by lying on your side.

• Take warm baths each day.

Incontinence

Incontinence (uncontrolled urination) affects some women in the third trimester. Pressure on the bladder from the growing uterus and more relaxed pelvic muscles contribute to incontinence.

What to Do

Ask your doctor how to do Kegel exercises, which will strengthen your pelvic floor muscles.

Self-care Steps for Incontinence

Urinate frequently, as soon as you feel the urge.

Leg Cramps

Thigh or calf cramps are very common, particularly during the last trimester and often at night.

Self-care Steps for Leg Cramps

• Wear support hose.

• Rest with your feet up.

• Extend your leg and flex your foot when that leg cramps.

• Apply heat or gently massage the cramped area.

• Ensure adequate calcium intake either through diet or supplements (consult your doctor about supplements and dosage).

Morning Sickness

Morning sickness is poorly named. The nausea or vomiting that accompanies pregnancy can occur anytime during the day. It usually affects women during the first trimester, but it can continue throughout the pregnancy.

What to Do

If your vomiting is extensive, prevents weight gain or continues beyond the first trimester, contact your doctor. If severe, the condition might require intravenous fluid replacement and anti-nausea medication.

Self-care Steps for Morning Sickness

• Eat frequent, small meals.

• As soon as you awake, eat something light, like a soda cracker.

• Eat something light, such as crackers or soup. This minimizes hunger and restricts stimulation of digestive enzymes that trigger nausea.

• Avoid odors that make you nauseous. Odors that affect some pregnant women include greasy foods, household cleaners and perfumes.

Nasal Congestion

Increased levels of estrogen during pregnancy can inflame the mucous membranes of your nose and give you a stuffy feeling. Some women mistakenly think they have allergies. Hot air and dry conditions can contribute to the problem. This stuffiness can worsen as the pregnancy progresses, but usually goes away after delivery. The larger volume of blood during pregnancy can also swell tiny blood vessels in your nose, which are more apt to burst and cause a nosebleed with repeated nose blowing.

What to Do

If your problems are severe, see your doctor. He or she might recommend pregnancy-safe medications.

Self-care Steps for Nasal Congestion

• Use a home humidifier to moisten your environment.

• Gently blow your nose.

Skin Changes

Hormonal changes during pregnancy can cause a host of skin changes. These include a darkening of your areola (the dark areas around your nipples) and a dark line running from your navel to your pubic area. Other changes can include melasma, a mask-like change in skin color on the cheeks, forehead and above the lips that is worsened by sun exposure; red palms; blue, dappled feet; a short-lived form of acne; and heat rashes. All these usually fade away after delivery. The increased weight and enlarged size of your breasts and abdomen can also cause stretch marks, which can cause your skin to itch. Small harmless growths known as skin tags can also develop, usually on the neck, arms and in the groin area. Stretch marks and skin tags may persist after pregnancy; a doctor can remove skin tags.

What to Do

See your doctor about any skin changes that concern you, including skin that itches intensely all over.

Self-care Steps for Skin Changes

• Keep your skin clean and dry.

• Use cosmetics to cover changes that bother you.

• Use a moisturizer on itchy skin.

Sleep Problems

Changes in your body shape are just one of the reasons that pregnancy can cause sleep problems. Hormonal changes and other pregnancy discomforts can also cause sleep problems.

What to Do

Report any serious sleep problems to your doctor.

Self-care Steps for Sleep Problems

• Sleep on your side with your top knee bent and with that knee resting on a pillow. This position minimizes strain on your back.

Vaginal Discharge

Increased hormonal production triggers increased vaginal discharge during pregnancy. But be alert for differences between benign discharges and the kind that can indication an infection. Normal vaginal discharge during pregnancy is thin and white, with a non-offensive odor. As your pregnancy progresses, your discharge volume might increase.

What to Do

If your discharge is itchy or burns, otherwise causes you discomfort, has an unpleasant odor or is green or yellow, see your doctor. You might need to be tested for infection.

Varicose Veins

Varicose veins are veins that become swollen and visible through the skin. The result: Your legs might feel heavy and ache. During pregnancy, varicose veins can result from pressure the uterus exerts on the pelvis and legs, which causes blood to pool there. In addition, you have an increased volume of blood during pregnancy. This also puts extra pressure on the valves in the veins that usually keep blood from accumulating.

Self-care Steps for Varicose Veins

To keep blood circulating:

• Walk daily.

• Elevate your legs while sitting down.

• Don't stand in one place for a long time.

• Wear support hose.

Water Retention

An increased volume of fluid during pregnancy can cause your ankles and feet to swell because of water retention (edema). Your hands and fingers might also swell.

What to Do

Normally, water retention is harmless. But if you have swelling of the face, blurred vision or headache, call your doctor right away. You could have preeclampsia, a serious condition related to high blood pressure that can have serious effects on both you and your baby.

Self-care Steps for Water Retention

minimize normal water retention:

• Raise your feet while sitting or lying down.

• Don't stand for long periods of time.

• Wear support hose.

Decision Guide for Pregnancy Discomfort
Symptoms/Signs	Action
Discomforts that bother you	Call provider's office