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Common Discomforts During Pregnancy

The hormonal and physical changes of pregnancy result in enormous changes in a woman’s body. To give you some perspective, your body at the end of pregnancy produces more estrogen in one day than a non-­pregnant woman produces in 3 years! Following are some common discomforts experienced during pregnancy and what you can do at home to help alleviate symptoms.

Common Discomforts

Nausea & Vomiting

About 50% of all women experience some form of nausea and vomiting during pregnancy. While the cause is unknown, it is normal and usually self‐limiting. Most symptoms begin around 6 weeks of pregnancy, peak around 8-­10 weeks, and begin subsiding around 12 weeks. By 14 weeks most women are free from nausea and vomiting.

Prevention and Treatment
Sometimes small changes in your diet and daily routine can make a big difference. Try the following:

Diet
Eat a bedtime snack, preferably protein (cheese, peanut butter). Try keeping a juice box and some dry crackers at the bedside. Take a sip of juice and a bite of cracker before lifting your head off the pillow in the morning. Repeat every 5 minutes for 20 minutes before getting out of bed. Avoid drinking liquids with meals, instead, drink between meals. Try potato chips and lemonade, it works!

Rest
Try to nap whenever you can. Fatigue can make symptoms worse. This is why some women experience worsening symptoms in the evening.

Supplements
Vitamin B6 (pyridoxine) up to 200 mg per day and doxylamine 25 mg (Unisom) twice daily

Aromatherapy
Ginger, Peppermint, mandarin, pettigrain, sweet orange, lavender

Acupressure (Sea Bands)
Bracelets that put pressure on the Neiguan point of the wrist, 2 thumbs up from the hand on the inside of the wrist, and about 1cm deep.

Acupuncture

Chiropractic care

    Constipation & Hemorrhoids

    Progesterone slows down the mobility of the gastrointestinal (GI) tract during pregnancy. This can lead to gas and constipation. In addition, the extra iron in prenatal vitamins may also cause constipation. As the uterus grows larger it puts extra pressure on the intestines and interferes with circulation in the lower bowel, causing hemorrhoids. Hemorrhoids are actually swollen blood vessels like varicose veins.

    Prevention and Treatment
    Try the following suggestions and changes in your routine.

    Diet
    Drink lots of water or herbal tea (8-­10 glasses) and increase fiber by eating 2 servings of fresh fruit (especially dried fruit such as apricots and prunes) and 4 servings of vegetables every day. Try prune juice or hot tea; fiber supplements (such as Metamucil) with extra water or you may take Colace 100mg once or twice per day.

    Exercise
    Daily exercise in the form of walking or jogging can help a sluggish GI tract.

    Herbal Supplements
    Witch hazel pads (Tucks) or apply wet or dry baking soda to relieve itching, lemon juice or vinegar to reduce swelling or bleeding. You may also try compresses made of essential oils like Comfrey, Cypress, Frankincense, Lavender or Myrrh. Other options include ice packs, or warm sitz baths for 15‐20 minutes, followed by 1 minute of a cool sitz bath 4-­6 times per day. You can add the above mentioned essential oils or Epsom salts.

    Medications
    Stool softeners including Colace, Preparation H, and Anusol or their generic equivalent.

    Abdominal Pain

    Most abdominal discomfort during pregnancy is a result of the normal hormonal and physical changes that occur during pregnancy. A developing baby and rapidly growing uterus put pressure on the surrounding organs and moves them into new positions. In addition, the hormone relaxin, causes the ligaments and pelvic bones to become soft and flexible in preparation for birth which can lead to discomfort. Occasional isolated abdominal pain that does not persist or worsen is generally not a cause for concern. Normal causes of abdominal pain or discomfort include:

    Round Ligament Pain & Symphsis Pubis Pain
    Sometimes the ligaments that support the uterus can become overly relaxed and stretchy. Sudden movements like walking, standing or rolling over in bed can cause pain, pressure and generalized discomfort. These symptoms are more common and more severe the more babies you have.

    Round ligament pain is typically experienced as sudden, sharp, knife-­like, pulling or spasm-­like pains felt low on either side of the abdomen and move down toward the groin.

    Symphysis pubis pain is similar but usually felt more over the pubic bone and sometimes in the vagina. Many women experience this pain as a deep aching or bruising sensation.

    Prevention and Treatment
    Change positions slowly, especially from lying to sitting to standing. Prop a pillow or a small rolled towel under your belly when you lie on your side and put another pillow between your knees. Take a warm bath. Wearing a supportive pregnancy belt can be helpful in stabilizing the bones and ligaments of the pelvis. Performing daily pelvic tilt exercises can help strengthen your pelvic muscles. Chiropractic care by a practitioner who specializes in pregnancy can also help realign the pelvic bones.

    Braxton-Hicks Contractions

    Mild, irregular tightening of your uterus that does not increase in intensity or frequency, and disappears spontaneously. It may be more intense after intercourse or when you are dehydrated.

    Prevention and Treatment
    Accept them as normal. Keep yourself hydrated, with 8-­10 glasses of water a day. Take rest breaks during the day. Drinking a quart of red raspberry leaf tea every day can help maintain the tone of the growing uterus.

    Heartburn & Indigestion

    Progesterone and relaxin are hormones that slow down the movement through the gastrointestinal (GI) tract. Estrogen reduces the amount of gastric acid secretion, which leads to decreased fat absorption. In addition, the growing uterus puts pressure on the stomach and GI tract. All of this contributes to heartburn and indigestion.

    Prevention and Treatment
    Eat small, frequent meals, rather than 3 large meals; avoid drinking fluids with meals (drink them in between meals). Minimize acidic or greasy foods. Antacids that contain both magnesium and aluminum and are low in sodium - Mylanta, Gaviscon, or Tums (Tums contain only calcium and may cause rebound heartburn if used for long periods)

    Dietary supplements
    Papaya enzyme; peppermint or ginger tea

    Herbal remedies
    Slippery Elm

    Aromatherapy
    Lemon, orange or neroli essential oils – 4 drops each into teaspoonful grape seed oil base; massage into chest and upper back or put in bath to breathe in the vapors.

    Back/Sciatica Pain

    Low back pain is a common occurrence during pregnancy. The growth of the uterus changes your center of gravity and puts extra strain on your lower back. Weak muscles in the back and abdomen prior to pregnancy can lead to worsening symptoms.

    Prevention and Treatment
    Maintain good posture and use good body mechanics when changing positions or lifting heavy items; Pelvic rocking exercises; Chiropractic care; Warm bath or heating pad on low; Extra-­‐strength Tylenol 2 tablets as needed every 6 hours; wear a pregnancy support belt; try these exercises:

    • The Squat: Stand with your back against a wall. Lower your body slowly down the wall, with your hands against the wall, until you are in a squatting position. Keep you feet parallel and your heels flat against the floor. Then slowly raise yourself back up. A variation of this exercise is to place an exercise ball between your lower back and the wall while doing the squat. This can help maintain proper positioning during the exercise. This exercise will help strengthen your back and it is good practice for proper lifting of heavy weights. (Always lift heavy objects with your back straight, squatting and using your leg muscles to propel you up.)

    • Standing Pelvic Rock: Keep your back straight, tighten your buttocks, bend your knees slightly, and rock your pelvis back and forth. This is an actual belly dancing technique, called the hinge. To enjoy your daily exercising routine even more, put on some music and walk around slowly while doing this exercise. Your abdomen and bottom should work like a hinge, while the rest of your upper body remains upright. Once you get the hang of it, move to the music and enjoy!


    • All-Fours Pelvic Rock: Get on your hands and knees with your legs and hands parallel to the floor. Pull your buttocks down and slightly arch you back, tilting your pelvis forward. Then push your buttocks out and back, tilting your pelvis back. Don’t let you back curve in as you rock your pelvis; your back should be straight in the resting position.

    • Single Knee-to-Chest Stretch: Pull one knee up to the chest at a time, gently pumping the knee three to four times at the top of the range of motion. Do 10 repetitions for each leg.

    Headache

    Many women experience increased headaches during pregnancy, especially during the first trimester. Hormonal changes of pregnancy cause dilatation of the blood vessels in and around the brain. These enlarged blood vessels put pressure on the surrounding nerves, causing pain. Headaches can also be caused by sinus pressure from increased fluid retention or allergies or cold symptoms; and eye strain due to vision changes. They may also be triggered by stress and lack of sleep.

    Prevention and Treatment
    Extra rest; Extra-­strength Tylenol (or generic) 2 tablets every 6 hours as needed. Apply heat or cold packs to your head, eyes, or along the back of the neck. Seek chiropractic care if needed.

    Essential oils/aromatherapy/herbs
    Peppermint mixed with eucalyptus; Bergamot; lemongrass; lavender; ginger or ginger tea; chamomile or rose hip tea.

    For chronic migraine prevention
    Riboflavin (Vit B-­‐2) 200 mg tablets – take one every day + Magnesium 250 mg tablets – take one every day.

    Leg Cramps

    Impaired circulation in the legs and electrolyte imbalances (body salts like calcium, magnesium, potassium, sodium) can lead to leg cramps.

    Prevention and Treatment
    Stay hydrated, eat a well-­balanced diet rich in fruits and vegetables. Avoid excess dairy as this can lead to calcium, magnesium imbalance. Avoid excess phosphate intake (soft drinks, calcium phosphate). Increase potassium (eat a banana every day); try a magnesium supplement.

    Exercise daily
    Exercise is very important during pregnancy. In addition to sustaining your overall health, exercise can help ease some discomforts of pregnancy. Walking can improve circulation and prevent cramps. If you do experience cramps, stretch your leg out and bend ankle with toes toward your head. For muscle soreness after a severe cramp, try Arnica gel or lotion rubbed into the calves.

    Varicose Veins

    Progesterone causes the smooth muscle walls of the veins to relax. Gravity and the growing uterus put pressure on the veins in your pelvis and on the large blood vessels in the legs, causing varicose veins. Varicose veins also have a hereditary component -­‐ up to 80%. Obesity is also a significant risk factor.

    Prevention and Treatment
    Full-­length support hose can be helpful in preventing and/or minimizing the severity of varicose veins as can the use of a pregnancy support belt or vulvar support belt (see www.prenatalcradle.com for examples). If very severe, prescription hosiery can be helpful. Also see swelling below.

    Dizziness/Lightheadedness

    The changes in blood vessels during pregnancy can lead to sudden drops in blood pressure. This may cause dizziness and lightheadedness, especially when changing positions suddenly – from lying down to sitting or standing. Although less common, low blood sugar may also cause lightheadedness.

    Prevention and Treatment
    Move slowly, especially when rising; avoid prolonged standing or sitting; drink plenty of fluids; wear support hose to prevent blood pooling in the vessels of the lower legs; eat well-­balanced, small, frequent meals throughout the day rather than 3 large meals.

    Bleeding

    Small amounts of spotting may be normal in pregnancy. This may occur after a Pap smear, vaginal exam, intercourse, or when the embryo implants into your uterine wall, about the time you miss your first period. Light spotting that is not associated with cramping or abdominal pain, does not increase, and resolves spontaneously is often not a cause for concern. Bleeding like a heavy period or bleeding that is accompanied by clots or severe abdominal pain should be reported to the midwife.

    Fatigue

    Overwhelming fatigue is quite common during the first trimester of pregnancy and is thought to be caused by the metabolic demands and hormonal changes of early pregnancy. Most women experience a return of energy during the second trimester. Many women experience fatigue again during the last 4 weeks of pregnancy due to extra weight and difficulty sleeping.

    Prevention and Treatment
    Get extra rest, nap when possible and go to bed earlier. Intake adequate calories and limit fluids after 7 p.m. Exercise regularly -­take a daily brisk walk for 30 minutes, but not closer than 4 hours before bedtime. Decrease or avoid caffeine; experiment with extra pillows to sleep more comfortably.

    Supplements
    Melatonin 3-10 mg at bedtime and Chamomile tea

    Aromatherapy
    Lavender and vanilla

    Nasal Congestion/Cold/Allergies

    Some nasal congestion is normal in pregnancy due to the increase in blood volume and swelling of nasal blood vessels. You may also be more sensitive to the effects of seasonal allergies and to colds or upper respiratory infections (URIs) during pregnancy. Most “colds” or other URIs are caused by viruses and cannot be treated with antibiotics. The general rule is that if your symptoms last longer than 10 days or you develop a fever of 100.8 or greater that lasts longer than 48 hours and/or is NOT relieved with acetaminophen (Tylenol), you should come to the office for evaluation.

    Prevention and Treatment
    Get plenty of rest, eat well and drink lots of fluids. For symptomatic relief, take Vitamin C 500 mg twice per day. For relief from headache or sore throat, try taking 2 tablets of extra-strength Acetaminophen (Tylenol) every 6 hours as needed.

    Nasal congestion
    For relief from nasal congestion, try a hot, steamy shower or steam facial area with rosemary or eucalyptus essential oils. Use Saline nasal spray or drops as needed frequently throughout the day. A saline rinse with a Neti pot can bring much relief for severe nasal congestion. You can also rub Vicks Vapo-Rub or camphor on the outside of your nose.

    Over‐the‐counter medications
    -Sudafed 30 mg every 6-­8 hours as needed
    -Phenylephrine 10 mg every 4-­‐6 hours as needed
    -Oxymetazoline (Afrin) nasal spray. (May worsen congestion if used for longer than 48 hours)

    Allergy symptoms
    -Diphenhydramine (Benadryl) 25 mg every 6 hours as needed. (May cause drowsiness)
    -
    Loratadine (Claritin) 10 mg daily or 5 mg twice daily
    -
    Ceterizine (Zyrtec) 10 mg once daily
    -
    Antihistamine eye drops (Visine A, Naphon A) as directed

    Multi-Symptoms
    -Tylenol Cold & Flu (or generic)
    - Do not take aspirin, ibuprofen (Motrin) or naproxen (Aleve)

    Shortness of Breath

    Normal changes in your body’s levels of carbon dioxide make you feel as though you are short of breath. In late pregnancy, the growing uterus puts pressure on your diaphragm (the muscle in your chest that moves up and down during breathing).

    Prevention and Treatment
    Intentional relaxation breathing exercises while stretching your arms up above your head can help to ease symptoms. Sometimes sleeping with your head and chest elevated can also help.

    Skin Changes

    Pregnancy hormones cause changes in skin pigmentation such as darkening of the areolas of the breast, the line down the middle of the abdomen (“linea nigra”), and the skin over the cheeks and nose (“melasma, or “mask of pregnancy”). *Moles may also darken and new moles or skin tags may appear.

    Stretch marks are caused by rapid stretching of the collagen fibers under the skin. Genetics also play a role. Some women get stretch marks, others do not.

    PUPPS (Pruritic urticarial papules and plaques – a fancy name for itchy, patchy rash) is a condition that usually occurs in late in pregnancy (after 35 weeks) in about 1 in 200 pregnancies.

    Prevention and Treatment
    There is no way to prevent skin changes during pregnancy. The discomfort can be relieved with colloidal oatmeal baths and lotions such as Aveeno products. Other options to try include two cups of loose leaf organic nettle or dandelion tea per day. These teas have natural tonic and diuretic properties that help cleanse the kidney and liver. Also try chickweed gel applied every 3 to 4 hours to lessen itching. *Severe rashes or significant changes in moles or skin tags should be reported to your midwife.

    Swelling

    The amount of blood volume circulating in your body increases by 50% during pregnancy. Increased abdominal pressure from the growing uterus slows down the return of blood flow to your upper body. Progesterone causes relaxation of blood vessel walls. All of this can lead to fluid retention and swelling – especially in your feet and ankles.

    Prevention and Treatment
    Avoid prolonged standing or sitting. Elevate feet as frequently as possible throughout the day. Avoid tight shoes. Drink lots of water and herbal teas (8-­‐10 glasses per day). Eat foods that have natural diuretic properties (remove excess fluid from the body) such as watermelon, parsley, grapes, leafy greens and lemons. Drinking water or green tea with lemon is especially beneficial.

    Vaginal Discharge

    Estrogen causes increased blood flow and increased vaginal secretions throughout pregnancy. Discharge that is clear, white or pale yellow, does not have a foul odor or does not itch or burn is normal.

    Prevention and Treatment
    There is no prevention as this is normal. Normal hygiene measures for comfort are all that is necessary. Do not douche. Wear cotton underwear. Sleep without underwear. Do not wear constrictive clothing. Do not use irritating sprays or creams that have harsh chemicals or perfumes as these can upset the normal skin pH and cause rashes and infections.