• Common Discomforts and Bodily Changes During Pregnancy

    First Trimester

    PD  Fitness and WellBeing 67058 Pregnancy is an amazing time of growth—both for mother and baby. As a new life is growing within a woman, her body undergoes many changes due to hormones. Every pregnancy is different. But many women find that some bodily changes are uncomfortable. Fortunately, once the baby arrives, most women find relief from these symptoms. In the meantime, there are ways to decrease some of the discomforts.
    The first trimester of pregnancy can be easy for some women. For others, these first three months can be the most challenging time of pregnancy due to the following common symptoms:

    Tiredness

    It is common for many women to feel very tired in the first few months of pregnancy. Try to get at least eight hours of sleep and take naps if needed.

    Breast Tenderness

    As breasts change to prepare for breastfeeding, they often become tender within the first eight weeks of pregnancy. Throughout the pregnancy, the tenderness may come and go, especially as breasts get bigger. Colostrum, an early form of breast milk, may even leak out in the second and/or third trimesters.
    What to do about it:
    • Wear a supportive bra.
    • Avoid using soap on the breasts, as this tends to dry out the skin.
    • Wear breast pads if breasts are leaking.

    Nausea and Vomiting

    Many women have feelings of nausea and vomiting during pregnancy. It usually occurs between 6-16 weeks of pregnancy. Although it is often called “morning sickness,” women may have these symptoms at any time of the day.
    What to do about it:
    • Eat small, frequent meals.
    • Drink liquids in between meals, not with meals.
    • Eat dry crackers before getting out of bed in the morning.
    • Avoid smells, foods, or other stimulation that triggers your nausea.

    Constipation and Bloating

    Hormones cause the gut to slow down its normal movement, which can cause bloating and constipation . Iron supplements, which are often needed, may make constipation worse.
    What to do about it:
    • Drink plenty of water (and noncaffeinated fluids) daily.
    • Eat fiber-rich foods, such as fruits, vegetables, and whole grains.
    • Remain active.
    • Talk to your doctor before taking laxatives.

    Frequent Urination

    Hormones are to blame for frequent urination in the first trimester. As the pregnancy progresses, a growing uterus puts pressure on the bladder. Therefore, frequent urination is often a discomfort for many women throughout the pregnancy.

    Shortness of Breath

    As pregnancy progresses, a large uterus puts pressure on the diaphragm, making it less able to move freely during breathing. This causes some women to feel short of breath.
    Pregnancy hormones cause changes that lead to more rapid, shallow breaths. Many women also experience this as a feeling of shortness of breath. This can feel strange but usually will not endanger your health. However, if you are feeling like you are not getting enough air when you breathe, call your doctor.

    Second Trimester

    During the second trimester, or months 4-6, many women feel much better than they had in the first trimester. However, some women notice uncomfortable bodily changes in the second trimester, including the following:

    Nasal Congestion and/or Nosebleeds

    Blood volume increases by nearly 45% during pregnancy, which causes membranes in the nose to swell and sometimes bleed .
    What to do about it:
    • Drink plenty of fluids.
    • A humidifier may increase moisture in the air.

    Bleeding Gums

    Gums become sensitive and often bleed during pregnancy due to estrogen. Use a soft toothbrush and gentle toothpaste and floss daily. Continue to receive routine dental care. If you need more extensive dental work, such as a cavity filling or root canal, it may be best to do them during the second trimester. During the third trimester, it may be difficult to lay on your back for an extended period of time. Consider delaying optional dental procedures (eg, teeth whitening) until after pregnancy.

    Aches, Pains, and Backaches

    Weight carried in the abdomen in the later months of pregnancy affects balance and posture, putting strain on the lower back. Hormones also loosen joints and ligaments of the body, which can cause minor pains.
    What to do about it:
    • Wear low-heeled shoes.
    • Place a pillow at the lower part of your back when sitting.
    • Take breaks to rest your back.
    • Never sit straight up from a back lying position. First roll on your side, then push yourself up.
    • Try wearing an abdominal support, which will support your back and abdomen.

    Third Trimester

    Many women are excited to enter the “home stretch” of months 7-9. But this is also an uncomfortable time because a large uterus is squeezing all the organs within the abdomen, causing some of the following symptoms:

    Stretch Marks, Itching, and Skin Discolorations

    The skin of the abdomen may itch as it expands and forms stretch marks, especially if weight is gained quickly. Skin discolorations, such as dark areas on the face or a dark line below the naval, can also appear. This is because hormone levels increase the amount of skin pigment, melatonin. Stretch marks are not preventable. Other skin color changes usually go away soon after the baby is delivered.
    What to do about it:
    • Gain weight according to your doctor’s recommendations.
    • Use lotions to add moisture to dry, itchy areas of skin.
    • Avoid exposure to the sun.

    Heartburn

    More than 50% of pregnant women have heartburn in the third trimester. Pregnancy hormones loosen the muscle that closes off the esophagus from the stomach. When this happens, stomach contents can back up into the esophagus, causing the burning sensation known as heartburn. A growing uterus also squeezes the stomach, which contributes to heartburn.
    What to do about it:
    • Eat small, frequent meals.
    • Avoid high-fat foods, spicy foods, and caffeine.

    Leg Cramps

    Leg cramps usually occur in the calf muscles during the night and are thought to be related to inadequate calcium or magnesium intake. Talk to your doctor about whether you need increased amounts of these nutrients.

    Ankle or Leg Swelling

    Most pregnant women have some leg swelling due to the extra volume of blood providing circulation to the placenta and baby. The uterus puts pressure on the large blood vessels providing blood to the lower half of the body, which can cause fluid to pool in the legs.
    What to do about it:
    • Drink plenty of water (or noncaffeinated beverages) daily.
    • Limit sodium from foods.
    • Rest with feet up.
    • Do not cross your legs.
    • Do not wear knee-high or thigh-high nylons with a tight elastic band.
    • Lie on your left side when sleeping.

    Varicose Veins and Hemorrhoids

    Varicose veins on the legs and hemorrhoids , which like varicose veins that occur on the rectum, often occur during pregnancy due to increased blood volume.
    What to do about it:
    • Prevent constipation. Eat a high-fiber diet (eg, fruits, vegetables, whole grains).
    • Drink plenty of fluids without caffeine.
    • Avoid prolonged periods of standing or sitting.
    • Remain active.

    Difficulty Sleeping

    Some women have trouble getting comfortable when sleeping in the last few months of pregnancy. In addition, it may be hard to relax when you are worried about the baby, childbirth, and being a mother.
    What to do about it:
    • Take a warm shower before bedtime to relax.
    • Avoid caffeine.
    • Avoid exercise late in the day.
    • Try to get comfortable with pillows.
    Overall, keep in mind that once the baby arrives, these discomforts are typically forgotten.

    RESOURCES

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

    Women's Health.gov http://www.4woman.org/

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    Women's Health Matters http://www.womenshealthmatters.ca/

    References

    Boscaglia N, Skouteris H, Wertheim EH. Changes in body image satisfaction during pregnancy: a comparison of high exercising and low exercising women. Aust N Z J Obstet Gynaecol . 2003;43:41-45.

    Common symptoms, signs and laboratory changes in pregnancy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated February 2011. Accessed June 20, 2011.

    Michalowicz BS, DiAngelis AJ, Novak MJ, et al. Examining the safety of dental treatment in pregnant women. J Am Dent Assoc . 2008; 139(6):685-695.

    Hueston WJ, Eilers GM, King DE, et al. Common questions patients ask during pregnancy. Am Fam Physician . 1995;51:1465-1470.

    Murkoff H, Eisenburg A, Hathaway S. What to Expect When You’re Expecting. New York, NY: Workman Publishing; 2002.

    9/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 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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