Common Complaints During pregnancy you may experience a number of discomforts that are caused by a combination of hormonal changes and the extra strain that your body is experiencing. Most can be treated very simply, and are nothing to worry about. A few, however, can be serious, so be aware of the symptoms and be prepared to act promptly if you suspect all may not be well.
Backache*Complaint: Backache is usually a general discomfort across the lower part of the back, often with pain across the buttocks and down the legs. It can occur when you have been standing for too long with bad posture or after lifting a heavy weight, especially during the third trimester. Why it happens: High progesterone levels cause softening and stretching of the ligaments of the pelvic bones, allowing the baby to be born. The ligaments of the spine also relax, putting extra strain on the joints of the back and hips. What can be done: Massage may help. Do exercises to strengthen your spine. Make sure your mattress is firm. Lift heavy weights correctly. Try to improve your posture, and avoid high-heeled shoes. If the pain runs down your leg towards your foot, consult your doctor in case it’s a slipped disc. Risk to baby: None Intensely Painful Low Backache*Complaint: Intensely painful low backache may also occur when you rotate your spine and pelvis in opposite directions, such as when you turn over sideways in bed. Why it happens: The baby is resting against your sacroiliac joint which is located some 7½cm (3in) in from the top of your buttocks. Rotary movements of the spine and pelvis open and close the sacroiliac joint, causing pain. What can be done: Osteopathic manipulation can help you in even the most severe cases. Backache usually eases by itself in the fifth month when the foetus tips forward – although you may not be able to wait that long! Risk to baby: None Carpal Tunnel Syndrome*Complaint: Carpal Tunnel Syndrome is a sensation of pins and needles, mainly in the thumb and first finger, with numbness and sometimes weakness. Occasionally the whole hand and forearm are affected. It can occur from conception onwards. Why it happens: Pressure on the nerve that passes from the arm to the hand along the front of the wrist. The pressure is caused by swelling of the carpal tunnel (a ring of fibres around the wrist under which the nerve passes) owing to water retention. What can be done: Diuretics prescribed by your doctor may alleviate the symptoms. A splint on the wrist at night may help, as may holding your hand above your head and wiggling your fingers. Acupuncture may help. Sleep with your arm on a pillow. Symptoms usually disappear soon after delivery. Risk to baby: None Constipation*Complaint: Constipation is when you have dry, hard stools that are difficult to pass. It can occur from conception onwards. Why it happens: Progesterone relaxes the muscles in the intestinal walls, so there are fewer contractions to push the food along. Consequently much more water than usual is absorbed from the stool in the colon, making it hard and dry. Stools may be less frequent, too. What can be done: Drink lots of water. Eat as much roughage in the form of fruit, vegetables, and fibre as you can. Walk briskly for 20 minutes once a day or more. Don’t take a laxative without consulting your doctor. Natural fibre laxatives are best as they simply increase the amount of water in the stool, making it soft. Figs and prunes will also do the job. Risk to baby: None Cramps*Complaint: Cramps are a sudden pain in the thigh, calf, and/or foot, followed by a general ache that lasts for some time. They tend to be more common in the third trimester, and usually waken you from sleep. Why it happens: Cramps are thought to be caused by low calcium levels in the blood, or they may be due to salt deficiency. Check with your doctor. What can be done: Massage the area very firmly. Flex your foot up and push into the heel. You may be prescribed calcium or salt tablets if your levels are low, but don’t self-prescribe without first consulting your doctor. Risk to baby: None Diarrhoea*Complaint: Diarrhoea is when you have soft, watery stools, requiring frequent visits to the toilet. It can occur at any time. Why it happens: Usually because an infection by bacteria or a virus is present. What can be done: Increase your water intake to 12-14 glasses a day to replace lost fluid. This will ensure that your blood pressure remains normal. Consult your doctor, who will test your stools for infection and give you the appropriate treatment. Risk to baby: Diarrhoea can cause dehydration and loss of calories that can put your baby at risk if it goes untreated for a long time. If it is profuse and protracted, you will need to be hospitalised for intravenous feeding. Faintness*Complaint: Faintness is a feeling of dizziness or vertigo that occurs suddenly, making you unsteady on your feet. It can come on if you stand up too quickly, or have been on your feet for too long, especially in hot weather. Why it happens: A lack of blood supply to the brain, often caused by pooling of the blood in the legs and feet when standing, together with the demands of the uterus for an increased blood supply. What can be done: Avoid standing for long periods. Always sit or lie down when you feel dizzy. Don’t get up suddenly from sitting or get out of a hot bath too quickly. Keep cool in hot weather. If dizzy, sit with head between knees – if you still can – or lie down with your feet higher than your head. Risk to baby: None, unless you fall very heavily on your stomach. Heartburn*Complaint: Heartburn is a burning sensation just behind the breastbone, sometimes with regurgitation of stomach acid into the mouth. It happens most commonly on lying down, coughing, straining when passing a stool, and when you are lifting heavy weights. Why it happens: Early in pregnancy, the muscular valve at the entrance to the stomach relaxes under the influence of progesterone. This allows stomach acid to flow up into the oesophagus causing a burning sensation. Later in pregnancy, the baby can press up on the stomach, forcing the contents back into the oesophagus. What can be done: Keep meals small so that the stomach is never overfilled. Sleep propped up with several pillows. A glass of milk at bedtime will help to neutralise stomach acid. Your doctor may prescribe antacids, but only in the later pregnancy stages. Risk to baby: None High Blood Pressure*Complaint: High Blood Pressure (hypertension) is an increase in blood pressure. It can be mild or severe, and there may be no, few, or many symptoms including frontal headaches, visual disturbances, and vomiting. Water retention with swelling of the feet, hands, and ankles may also occur. It can happen at any time, but it is more likely to occur near term. It is more common in women having their first baby, especially if they are over 35, and also in women having more than one baby. It is always looked for because it may herald pre-eclamptic toxaemia (PET or pre-eclampsia). Why it happens: The cause is not fully understood. In some women, cells from the placenta produce chemicals called vasoconstrictors that may cause the blood vessels to constrict. This may cause the blood pressure to rise, and the kidneys to retain sodium, leading to water retention. What can be done: If you suffered from high blood pressure before you were pregnant, tell your doctor. Keep an eye on your weight. Always report persistent headaches and nausea. Your doctor will test your blood pressure and urine, and look for any swelling (oedema) of your hands, face and ankles at each antenatal visit. He or she will almost certainly increase the frequency of your antenatal visits. If your blood pressure goes up at any stage of your pregnancy, you will be advised to stay in bed and rest, and your doctor will suggest home visits. If the rise is severe, you will be admitted to hospital, where you can be monitored continuously. If the baby appears to be suffering, labour may be induced or you may have a Caesarean section. Your blood pressure will return to normal once your baby has been born. Risk to baby: Pregnancy-induced hypertension can slow the baby’s growth rate, owing to a reduced blood flow to the uterus. The baby may also be short of oxygen. Both these factors may lead to low birth weight. There is a severe form called eclampsia, which can be life threatening. Fortunately this is now very rare in the West, owing to excellent antenatal care that spots the signs very early. Insomnia*Complaint: Insomnia is the inability to sleep at night, making you tired and irritable during the day. It can happen at any time from conception onwards. Why it happens: Your baby lives on a 24-hour clock, and his or her metabolism keeps going even when you want to sleep. This can affect your body’s responses. Other causes include night sweats and a desire to empty your bladder more frequently, particularly during the third trimester. What can be done: A warm bath and a hot milky drink may help, as may a relaxing massage. Watch television or read until you feel tired and sleepy. Find a comfortable position, and try to stay cool. Your doctor will not prescribe sleeping pills until the third trimester, and then only if you are exhausted by lack of sleep, because they can cross the placenta and affect the baby. Risk to baby: None Mood Swings*Complaint: Mood swings describe rapid, uncharacteristic changes in mood, often with unexplained crying and anxiety attacks. They are common from conception onwards, but are especially likely to occur in the third trimester. Why it happens: Changes in your hormone balance during pregnancy have a depressant effect on the nervous system, causing symptoms similar to those that can occur pre-menstrually. Body image changes and identity crises may have a profound effect on you as your pregnancy progresses, and mixed feelings about pregnancy and parenthood can cause sudden shifts in your moods. What can be done: You should consider these feelings as natural. Depression, anxiety, and confusion can occur even in the easiest of pregnancies. Analysing such feelings may only serve to prolong them. Risk to baby: None Morning Sickness*Complaint: Morning sickness is a feeling of sickness and nausea, sometimes with vomiting. Contrary to its name, it can occur at any time of the day, but generally happens when you haven’t eaten, or after a long night’s sleep. These symptoms usually occur in the first trimester, and then abate. Why it happens: The main cause is low blood sugar, but pregnancy hormones may irritate the stomach directly. What can be done: Food will provide relief from nausea, so eat little and often. Eat high-carbohydrate foods such as wholemeal bread, potatoes, rice, and cereals, and avoid fried food and coffee, which trigger nausea. Keep glucose sweets in your car, desk, or handbag. To prevent morning sickness in the morning, put a glass of water and a plain biscuit by your bed before sleeping, and have them as a snack 15 minutes before you get out of bed. Cigarette smoke and other strong smells may also trigger nausea. Drink extra fluids such as fruit juice or skim milk – if you can keep them down. Risk to baby: In its severe form (called hyperemesis gravidarum), vomiting can deplete you of fluid and minerals, leading to low blood pressure. This is always harmful to your baby. Inform your doctor if you vomit more than three times a day for three days. In very severe cases, hospitalisation may be necessary to replace the fluids that you have lost. Piles*Complaint: Piles are dilated rectal veins (varicose veins) that may protrude through the anus. Usually they do not occur until the second trimester. Why it happens: Your increasingly larger baby presses down on your rectum and impedes venous flow to the heart. The blood therefore pools, causing the veins to dilate to accommodate the dammed-up blood. What can be done: Keep your bowels regular and stools soft by eating sufficient fibre – this will help you avoid straining down. Drink plenty of fluids. Don’t lift weights, as this increases intra-abdominal pressure and back pressure in the rectal veins. Have coughs treated promptly for the same reasons. Aromatherapy may be able to relieve symptoms. Risk to baby: None Rib Pain*Complaint: Rib pain can be felt as extreme soreness and tenderness of the ribs, usually on the right side, just below the breasts. The pain is more severe on sitting down. It tends to occur mainly during the third trimester. Why it happens: It is caused by compression of the ribs as the uterus rises in the abdomen. In addition, the baby can bruise your lower ribs with his or her head, or by excessive punching and kicking. What can be done: Wear loose clothes that won’t compress your ribs. Improve your posture. Prop yourself up on cushions when you lie down. The pain ceases when the baby’s head drops into the pelvic cavity prior to birth. Risk to baby: None Tender Breasts*Complaint: Tender, painful breasts, with a feeling of heaviness and discomfort, and a tingling sensation in the nipples, can be one of the first signs of pregnancy. Tenderness is present throughout, but may increase towards term. Why it happens: Hormones are preparing your breasts for lactation. The milk ducts are growing and being stretched as they fill with milk. What can be done: Wear a good supportive bra from early pregnancy. If your breasts are large, wear a bra at night as well. Wash your breasts gently once a day with mild soap and pat dry. Apply baby lotion or oil if your nipples are sore. Risk to baby: None Thrush*Complaint: Thrush is a yeast infection, characterised by a thick, white curdy discharge from the vagina, accompanied by dryness and intense itching around your vagina, vulva, perineum, and, sometimes, your anus. You may also have pain when passing urine. Thrush can happen at any time. Why it happens: It is an infection by the yeast Candida albicans, which occurs normally in the bowel. Infection occurs when the yeast grows uncontrolled by other bacteria, perhaps following a course of antibiotics. It is more common in pregnancy, probably because of the leakage of sugar into body fluids due to increased vaginal blood flow. Excess sugar intake often aggravates it. What can be done: Avoid wearing tight pants and trousers, as this encourages infection. Choose cotton instead of man-made fibres. The doctor will prescribe pessaries (solid, bullet shaped preparations used to treat vaginal infections) that you should place in your vagina, as directed. You will also be prescribed a cream that should be gently rubbed into the skin surrounding the vaginal opening, the anus, and on the thighs. This will stop the itching. Risk to baby: The baby can become infected as it passes down the birth canal on delivery. If this happens, white clumps like curds of milk will appear in the baby’s mouth. The baby must be treated promptly with a course of antifungal agents, which will quickly clear up the infection. Varicose Veins*Complaint: Varicose veins are swollen veins just below the skin. Although most common in the legs or anus, they can also appear in the vulva. Why it happens: See Piles. What can be done: Avoid standing for too long. Put your feet up. Wear pregnancy support tights. Gentle massage may help to prevent varicose veins, but do not massage the area if you develop them. Risk to baby: None Water Retention*Complaint: Water retention happens when there is an increase in the amount of fluid present in the tissues. This causes swelling (oedema), especially of the feet, face, and hands. Your rings may become tight. Why it happens: Standing all day, especially in hot weather, can cause fluid to pool in the ankles. High blood pressure, which is often associated with pregnancy, can force fluid from the bloodstream into the tissues, causing oedema. Pregnancy hormones can cause retention of sodium by the kidneys, which in turn cause the body to retain fluid. What can be done: Avoid standing for prolonged periods. Put your feet up. Avoid salty foods. Your midwife or doctor will check your hands, face, and ankles for any swelling at each antenatal visit, and occasionally diuretics may be prescribed. Risk to baby: Potentially dangerous. * Dr Miriam Stoppard MD FRCP, Conception, Pregnancy & Birth, Dorling Kindersley, Australia 2002 |
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