Managing Symptoms of Pregnancy

IMAGE The journey to motherhood has begun. You feel a mixture ofanticipation, joy, hope, excitement, and perhaps a littleapprehension. Unfortunately, these euphoric moments may also include episodes of nausea, vomiting, constipation, and back pain.How do you get through the rest of the pregnancy without thesenagging 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 estrogen, progesterone, and the other hormones of pregnancy, and are often accompanied by numerous discomforts. These normal sideeffects, which vary among women and pregnancies, are not the same ascomplications. Complications of pregnancy include hypertension, anemia, gestational diabetes, pre-eclampsia, and vaginal bleeding.Here are some common pregnancy discomforts and tips on how tomanage 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. They 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, butavoid 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 when you can. Cut back on your work or daily activities, but engage in regular moderate activity, such as 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 maycry easily and worry about any number of things, such as yourpregnancy, the health of your baby, giving birth, your relationshipwith your partner, and your future. What may help : Keep in mind that it is normal to have thesefeelings. Talk openly with your partner, family, and friends. Join groups or classes for expectantmothers. You will find that sharing experiences can be helpful.

Constipation

Smooth muscles in the intestine may relax during pregnancy andlead to constipation.What may help : Eat plenty of high fiber foods such as whole grains, fruits, and vegetables. Make sure you drink plenty of fluidsand get regular exercise.

Frequent Urination

As the enlarging uterus puts pressure on your bladder, you mayneed 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, which can increase the frequency of urination in addition to increasing your blood pressure and heart rate.

Hemorrhoids

Varicose veins in the anus cause itchiness and pain. They are triggered by internal pressure from the baby andconstipation. What may help : Eat a high-fiber diet with whole grains, rawfruit, 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 weeksfollowing delivery.What may help : Remember that new hair will grow within afew months. Until then, you might try wearing a shorter, fluffierhairstyle. 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 spicy. Have small frequent snacks of bland food to keep your stomach from being empty. If you are nauseous when you wake 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 theareolae around the nipples. Some women develop a dark line from thenavel down to their pubic area, or darkened blotches on the face.What may help : These skin changes are caused by hormones and usually disappearafter delivery.

Bleeding Gums

Inflammation and swelling of the gums is often caused by poororal hygiene. During pregnancy, however, the gums may bleed easilyas the result of increased progesterone and expanded blood supplywhich softens the gums. This situation increases the risk of food collectingat the base of the gums, which could lead to tooth decay and gumdisease . What may help : Practice good oral hygiene. Brush your teethseveral times per day, especially after eating, and use dentalfloss. Make sure you visit the dentist during your pregnancy.

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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, keep 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 andbend your knees. Do not stay in the same position for too long—move around. Avoid heavy lifting. Try to develop good posture anddo not wear heels. Try back exercises for pregnant women. Supportive garments that support your back and abdomen may also be helpful.

Indigestion and Heartburn

Indigestion and heartburn are most common during the lasttrimester due to increased pressure on the stomach, which causes areflux of gastric juices into the esophagus. What may help : Avoid fried, spicy, or acidic foods anddrinks. Eat small, frequent snacks rather than several large meals.Avoid lying down after eating. Elevate your head with propped uppillows 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 awarm bath, relaxing music, stress-relieving exercises, andcomfortable bed clothing.

RESOURCES

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

Women's Health—US Department of Health and Human Services
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 Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/backpain.html. Updated March 2014. Accessed December 31, 2014.

Caffeine intake during pregnancy. American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancy-health/caffeine-during-pregnancy/. Updated April 2014. Accessed December 31, 2014.

Common symptoms, sgns and laboratory changes in pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.Updated January 23, 2013. Accessed December 31, 2014.

Insomnia during pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/insomnia.html. Updated March 2014. Accessed December 31, 2014.

Mood swings during pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/moodswings.html. Updated January 2014. Accessed December 31, 2014.

Morning sickness. American Pregnancy Association website: Available at: http://www.americanpregnancy.org/pregnancyhealth/morningsickness.html. Updated July 2011. Accessed December 31, 2014.

Pregnancy and hair loss. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/hairloss.html. Updated March 2014. Accessed December 31, 2014.

Swollen gums during pregnancy (also known as pregnancy gingivitis). American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancyhealth/swollengums.html. Updated March 2014. Accessed December 31, 2014.

Treatments of common complaints in pregnant women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.Updated July 11, 2014. Accessed December 31, 2014.

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.

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