Info Centre - Pregnancy niggles and discomforts

The birth of a baby is usually anticipated with excitement, but the way your body is behaving may sometimes leave you feeling anything but celebratory. You may have heartburn, nausea and vomiting, and muscular and ligament pain. You may experience breathlessness, swelling and itching. You may wonder who described these symptoms as ‘minor ailments’ when they make you feel so uncomfortable and even miserable.

Hormones
Growth
Tissue relaxation
Nausea and vomiting
Back pain
Vaginal secretions
Itching
Carpal tunnel syndrome
Cramp
Saliva
Infection
Some symptoms to watch out for

Hormones

You won’t be surprised to hear that all these discomforts are caused by your hormones. The delicate balance in your body before pregnancy is now reset to a different position in order to nurture your baby and prepare for the birth.

Growth

Oestrogen and progesterone help your breasts and uterus grow. This extra weight, together with that of your growing baby, can lead to an aching back and legs. In later pregnancy the weight of your uterus can cause fluid to pool in your legs, ankles and feet, leading to swelling (oedema). This swelling generally increases throughout the day and is worse in hot weather; ways to make it better include taking some gentle exercise, flexing your calf muscles, wearing flat shoes and sitting with your feet raised whenever you can. Swelling is something which you should mention to your midwife as it’s important to make sure that it isn’t a sign of pre-eclampsia, especially if the puffiness is also present in your hands or face.

At around 12 to 16 weeks you may feel faint as your blood volume increases. This dilutes the constituents of your blood, including your iron levels. This can lead to anaemia (low iron) which can make you feel tired and breathless. Eating iron-rich foods like dark meat, green vegetables and pulses will help. Other foods such as pilchards, sardines, wholemeal bread, fortified breakfast cereals, dried fruit such as apricots, prunes, figs, and egg yolk also are good sources of iron.

Drinking orange juice also helps you absorb more iron from your diet; it is also a good idea to avoid tea and coffee at meal times, as they reduce absorption of iron.

Tissue relaxation

Progesterone and relaxin relax the tissues of the body. This relaxation, though, can lead to some other ailments such as headaches, varicose veins (painful distended veins in the legs, vulva or rectum (back passage) which are common in pregnancy because the weight of the baby can obstruct the circulation of blood around the body, and can be helped by wearing support stockings) and piles (varicose veins in the rectum or back passage). You can buy special cold pads that can be applied locally, and creams or paracetamol may help, but always read the labels or consult your midwife or GP before taking medication.

Relaxation in the digestive system can cause heartburn and constipation, as this relaxation allows acid from the stomach to track back up the food pipe (oesophagus), and in the bowel inhibits the normal rhythmic movements that pass the contents along. Eating a diet with plenty of fruit and vegetables, little and often, may help, as well as being healthy for you and your baby. Some women find drinking milk helps to alleviate heartburn, or nibbling plain biscuits. Indigestion remedies can also help.

Taking iron supplements can cause constipation. If you are affected, ask your midwife about alternative preparations, or find out if you can reduce the dose. Adopting the correct position for opening your bowels can help, with your knees above the level of your hips, mimicking the natural squatting position. When sitting on the toilet, using a step designed to enable small children to reach the sink will help you mimic this more natural position. The steps are also great for achieving a good breastfeeding position after your baby is born, if you don’t have a nursing chair.

The body tissue relaxation which hormones cause during pregnancy is also the reason why some women get nose bleeds during pregnancy (as these tissues include those in your nose). Having nose bleeds during pregnancy isn’t unusual or something to be worried about.

Dryness in your nose can also contribute to your getting nose bleeds, so it’s a good idea to drink more fluids and even dab a bit of petroleum jelly in each nostril. Using a humidifier inside your house is also an effective way of avoiding dryness.

To stop a nose bleed, pinch your nostrils under the bridge of your nose and lean forwards (not backwards).

Nausea and vomiting

The majority of pregnant women feel nauseous or sick in the early stages of their pregnancy. Some women just feel a bit queasy whereas others are actually sick, sometimes a few times a day. This sickness – usually called morning sickness, even though it can happen at any time of the day – often passes after three months or so, although it can, in some cases, last throughout pregnancy.

Unfortunately, it isn’t clear what causes morning sickness. Hormones, tiredness and anxiety have all been suggested as being involved, as has the idea that the nausea is the body’s way of making sure that harmful substances don’t reach your baby, though as morning sickness is much more common in women expecting twins or triplets it seems likely it is linked to pregnancy hormones.

Of the strategies which women have found helpful with morning sickness, only taking ginger and using acupuncture have been shown to be effective in reducing nausea and vomiting. Other unproven strategies include eating snacks every few hours, avoiding fatty foods, sucking peppermints and drinking plenty of water or fruit juice (even if you are sick, it is advisable to keep sipping fluids as some fluid will be absorbed).

One NHS study found that listening to a tape/CD – called ‘Morning Well’ – reduced or stopped morning sickness symptoms in 90% of women. This tape is available from NCTShop: http://www.nctshop.co.uk/MorningWell-CD/productinfo/1901/

If you find that you are being sick to such an extent that you can’t keep anything down, see your GP as you may become dehydrated and malnourished if the nausea goes untreated.

Backcare during pregnancy

Pregnancy can be a time for discomfort and intense lower back pain. The charity BackCare publishes a leaflet offering information which outlines the causes of back pain for pregnant women and suggests ways of reducing this pain during pregnancy and after giving birth.

http://www.backcare.org.uk/498-1722/Back-care,-pregnancy-and-children.html

Vaginal secretions

Pregnancy hormones increase your normal, mucous secretions, but any odour or discoloration should be investigated for infection. Thrush (a fungal infection that can affect the mouth, vagina or nipples) is more common in pregnancy because of the changed acidity of the vagina. Even if you aren’t suffering any irritation, get it treated to avoid your baby being infected at birth.

Particularly towards the end of pregnancy, some women are unsure if they have wet themselves, or whether their waters have broken. This wetness could be urine, due to the weight of your baby and the relaxation of tissues, meaning that you leak when coughing or laughing. Emptying the bladder can often help, or you might want to wear a pad to avoid embarrassment. Starting your pelvic floor exercises as early as possible, and continuing them for life, will help to avoid long-term problems. The leakage could be increased vaginal secretions, or even a show in the run-up to labour. Or it could be amniotic fluid following rupture of the membranes surrounding the baby. If you are unsure what it could be, then speak to your midwife.

Itching

Stretching of the skin, particularly your breasts, belly and thighs can cause itching. Moisturising the skin can help. Some women find that exposure to the sun in pregnancy causes skin irritation and have to cover up and stay in the shade.

Itching during pregnancy should always be reported to a midwife or doctor as it may be a sign of a serious disease called obstetric cholestasis. However, localized itching, such as over the site of an old operation scar, is usually normal.

Carpal tunnel syndrome

Carpal tunnel syndrome is the name given to compression of the median nerve as it passes from the forearm into the hand via the carpal tunnel at the wrist.

Symptoms include numbness, tingling and pain in the thumb and fingers of one or both hands, and occasionally reduced manual dexterity. Symptoms are usually worse at night. During pregnancy the condition is caused by fluid retention brought about by hormonal factors. This narrows the tunnel and puts pressure on the nerves, causing the pain or numbness in the fingers.

Most cases of carpal tunnel syndrome resolve within 4-6 weeks after birth. Treatment is usually aimed at relieving the symptoms. Simple analgesia, like paracetamol may help during pregnancy, while anti-inflammatory drugs can be used after your baby is born if the symptoms persist. A wrist splint used at night can also help to alleviate symptoms. In more extreme cases surgery may be presented as an option to provide relief from symptoms.

Cramp

A cramp is a painful, involuntary spasm. It is quite common for cramp to occur in your legs when you are pregnant. A good way to relieve leg cramp is to flex your foot at the ankle and then circle your ankle vigorously as this increases the blood-flow to the leg.

Saliva

It is fairly common for pregnant to women to produce more saliva than they do normally, especially early on in pregnancy. Doctors don’t really know why this is, and it doesn’t seem to be a cause for concern; the medical term for this is ptyalism.

Infection

It is thought that the immune system is less effective in pregnancy, to prevent the mother rejecting her baby. This may make women more susceptible to infection. Urine infections are more common because tissue relaxation may prevent complete emptying of the bladder, and the urine left behind can become infected. You may be more susceptible to cystitis (an infection of the bladder that makes passing urine painful, often with a burning sensation) or sometimes infections can back-track to the kidneys, causing pain and nausea. Gum infection (gingivitis) is more likely, as the gums tend to swell during pregnancy so that toothbrushing causes bleeding more readily. Use a soft brush, and speak to your dentist if you are concerned.

It is well known that some infections can cause problems with the development of the baby, particularly in early pregnancy.

If you are worried about exposure to german measles (rubella) or chickenpox, discuss your immunity with your midwife. If you have any symptoms of chickenpox, seek medical help immediately, as an antiviral drug can be given.

If you have a cold or flu, get plenty of rest and fluids. Lower your temperature with cold flannels, and with paracetamol, as long as you do not exceed the stated dose over 24 hours. Some cold and flu preparations contain other drugs, so check with the pharmacist as to their suitability for use in pregnancy. If in doubt about pregnancy symptoms or infections, always consult your midwife or GP.

Some symptoms to watch out for

Most niggles in pregnancy are nothing to worry about, but you should be aware of warning signs that mean you need to contact your midwife or doctor (see also ‘Health problems and pregnancy’).

Abdominal pain can be caused by trapped wind, indigestion, heartburn or ligament strain. Contact your midwife if there is also:

Bleeding, with or without tight abdomen – risk of miscarriage or haemorrhage (i.e. heavy bleeding)
Severe pain in upper right abdomen, especially if also have headache or swelling

Bleeding can occur:

in early pregnancy around the time you would have had a period. Usually this is slight.
after sex if there is a lesion on the cervix
if the membranes around the baby become slightly separated from the wall of the womb
with urine infections
with a placental abruption
with a show
with placenta praevia at the onset of labour
Always consult a midwife or GP about bleeding. Before 37 weeks bleeding can indicate risk of miscarriage, haemorrhage or premature labour.

Headaches can be caused by dilated blood vessels, stress or dehydration. Call your midwife if accompanied by: