Common Pregnancy Discomforts & Finding Comfort
Trust your body! It will tell you what it needs.
Now is the time to get used to staying hydrated! This will be a new habit that you will find is essential for pregnancy and infant feeding. You now need about 2 liters of water per day, with added electrolytes.
When the nausea, exhaustion and food aversions lift, that is your green light to get back to business as usual for the next phase of your pregnancy. Until then, try your best to schedule in 15 minute breaks or rest periods every 2-3 hours, which will help you get through the first trimester in a much more enjoyable way.
Hormonal changes can cause:
Joint & pelvic instability
Move slowly
Be careful when getting in and out of the car, bed, etc
Rotate and stretch your hips on a birthing ball
Seek support from a pelvic floor physiotherapist
Fatigue
Exhaustion is experienced between approximately 4-12 weeks. This is when the pregnancy is establishing itself and your body is expending a lot of energy, wanting you to be down and resting. Pushing through the exhaustion contributes to nausea and headaches. Put your exercise regime on hold until the exhaustion lifts, allowing yourself to take the time your body needs to build a new human.
Rest as often as you can
Seek support with household and childcare tasks when needed
Eat well and engage in self care
Remember that you don't have to do everything
Morning sickness
Nausea and vomiting can be experienced any time of the day, not just in the morning hours. Usually this is limited to the first trimester, from approximately week 4 through 15. Hormonal changes and hypoglycemia (low blood sugar) are thought to be the main contributors to morning sickness.
Check with your care provider if your prenatal vitamins are causing nausea and digestive upset. Consider finding an alternative like an herbal infusion drink until the first trimester nausea lets up. It is good to remember that supplements are called supplements because they are to be used in addition to good nutrition. If your supplements are making you feel so sick that you cannot eat food, they will not be doing the job that you need them to.
Drink plenty of water & seek medical help if you become dehydrated
Let yourself rest
Eat often, snacking every hour or two. Include protein. Low blood sugar = nausea and headaches
Keep snacks handy for middle of the night wakes. Try sips of smoothie, cheese sticks, 1⁄4 of a nut butter sandwich and other easy to eat, simple snacks.
If the smell of food cooking makes you nauseas, think of ways that you can be out of the house while someone else takes cooking duty, or possibly have food prepared at a friend or family member’s house. *Activate community!
Treat yourself to acupuncture. Acupuncture can do wonders to help alleviate morning sickness ie: all day sickness for some!
Your own personal comfort foods are often what you need:
Baked potato/butter/sour cream
Rice or polenta with preferred choice of fat such as ghee, butter, coconut milk, or stock
Macaroni and cheese
Toast with butter, ghee or nut butter and honey
Sweet potatoes
Oat porridge
Oranges
Bagels and cream cheese
Tortillas with any topping that sounds good.
Dates stuffed with ghee/nut butter and topped with cardamon
Smoothies with some fat and protein content
Lemonade (homemade or fresh, made from real lemons) add ginger (optional)
Ginger candies or tea
Mint tea or red raspberry leaf tea
Popsicles made from your favorite teas, juices, or smoothies
Don’t stress. You will not harm your baby if what you can keep down is limited for the first 12 weeks. The health of the first trimester of pregnancy draws on the months before you even got pregnant.
Hyperemesis gravidarum
Hyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy. It can lead to dehydration , weight loss, and electrolyte imbalances.
Morning sickness can cause decreased appetite, low level nausea, or vomiting. This is different from true hyperemesis because people are typically still able to eat and drink fluids some of the time.
Symptoms of hyperemesis gravidarum are much more severe. They may include:
Severe, persistent nausea and vomiting during pregnancy
Salivating a lot more than normal
Weight loss
Dehydration: Signs are dark urine, dry skin, weakness, lightheadedness or fainting
Constipation
Inability to take in adequate amounts of fluid or nutrition/Unable to tolerate any fluids for over 12 hours
Blood in the vomit
Abdominal pain
Do not hesitate to get help if you have any of the symptoms listed. The treatment usually includes an IV for hydration and anti-nausea medication.
Headaches
Headaches are common in the first trimester due to changes in the hormonal and circulatory systems.
Take preventative measures by
Listening to your body
Don’t push yourself to do more than you have energy for
Rest and nap often
Stay hydrated with water and electrolytes
Avoid sugary drinks
Coconut water is great for hydration
Eat often, snacking every hour or two. Include protein. Low blood sugar = nausea and headaches
If you are in pain from cold turkey caffeine withdrawal, consider letting yourself have a small amount of coffee or tea per day, weaning yourself off over the period of a week or two.
If you have headaches and migraines when you are not pregnant, there is a chance you may have a bothersome increase in early pregnancy.
Constipation
Constipation often occurs in early pregnancy due to slowing of the digestive system. The body has an increased need for hydration, which can result in dry hard stool.
Stay hydrated with water and electrolytes
Iron supplements can be a culprit. Consider taking a food based brand that your body can more easily utilize
Eating 3-6 dried apricots and/or prunes and steamed or roasted beets are also very effective.
Bleeding gums
Bleeding gums when brushing and flossing are also a side effect of your hormonal changes and blood volume increase, which makes the gums slightly softer and puffy. Adding 500-1000mg of bioavailable Vitamin C with bioflavonoids daily can help alleviate this problem.
Hemorrhoids and varicose veins
Veins that are distended and swollen can be a result of expanded blood volume and progesterone, which dilates the veins. Often this is temporary, though some vessels that have lost their elasticity may remain enlarged and visible after pregnancy.
Legs are the most common area to experience this discomfort, and rarely vulvar varicosities.
Hemorrhoids are varicose veins of the rectum. Vessel relaxation, as well as the added weight and pressure from the pregnancy, can sometimes cause hemorrhoids.
Take preventative measures:
Stay hydrated. Straining from constipation is a risk factor for their development.
Using a footstool, which puts you in a squatting style position while moving your bowels, is a healthy life habit that can greatly aid in prevention.
Avoid sitting or standing in one position for long periods of time, which takes pressure off of your bottom and keeps circulation moving.
Get regular exercise.
Elevate your legs periodically through the day
Compression socks especially for long hours on your feet
Most hemorrhoids and varicose veins will shrink significantly within three months post birth.
Leg cramps
“Charley horses” are common in pregnancy and they usually occur during the night, waking you from sleep.
Try getting an added serving of magnesium or calcium with magnesium before bed. *Bonus this can also remedy constipation!
Make sure you are hydrated and have consumed enough salt every day
Take an epsom salt bath before bed. Use 1-2 cups of salts in your bath for the best effect; also helping you have a good night’s sleep.
Eat a banana before bed
Avoid fatty and spicy foods.
Eat smaller meals that are gentle on your stomach.
Take an over the counter antacid.
Heartburn
Heartburn affects most pregnant people at some point during the pregnancy as a result of elevated progesterone levels. This hormone relaxes smooth muscle in pregnancy, but also relaxes the valve at the bottom of the esophagus that normally keeps acid from moving backward from the stomach. In addition, the growing uterus crowds the stomach, which can push acid into the esophagus.
Some tricks that may help to alleviate the burn:
Limit what you drink with meals. Liquid dilutes your digestive juices, and can lengthen digestion time.
Sip on a drink of live/raw apple cider vinegar and water
Take a walk after meals; even a short 5 minute walk will aid in digestion
Take digestive enzymes to support efficient digestion. Digestive enzymes play a key role in breaking down the food you eat. Try Papaya enzymes or a combination digestive enzyme.
These enzymes work naturally with your body’s digestion and do not have any harmful side effects.
TUMS are not the best remedy. The low grade calcium in TUMS is not easily utilized by the body, and it is an antacid, which does not actually help with the digestion process. Research TUMS and other antacids and consider risk factors and contraindications before using.
Shortness of breath
Mild breathlessness and feeling winded are common in pregnancy.
First trimester hormones relax your lung muscles and bronchial tubes, making you have to actually work to fill the lungs.
In the second trimester it is a result of your brain being stimulated to increase the frequency and depth of your breaths, allowing you to take in more oxygen for you and baby.
In the third trimester the baby gets larger and puts pressure on your diaphragm, which makes less room for your lungs to fully expand.
Towards the final weeks or days, your baby will start the drop into the pelvis, giving you a reprieve from this feeling, as there is now more room for your lungs to expand.
As baby, placenta, and uterus grow, the uterus moves more into the abdominal space, presses up into the respiratory diaphragm and the rib cage and your diaphragm shifts.
Relaxin is responsible for allowing this shift to happen, for the space to be made to accommodate a growing human
Chest changes
This can be one of the first signs you are pregnant.
Chest changes are caused by a surge of hormones that stimulate the growth of milk ducts.
First pregnancies experience this symptom more dramatically than multiparas (those who have been pregnant before).
You may feel soreness, swelling, tingling, increase in warmth, throbbing sensations, and sensitivity to touch. The soreness usually lets up in the second trimester.
Your areoles may enlarge and darken in color and the veins in your chest become more noticeable.
You may or may not experience a wet sticky fluid leaking from the ducts in your areola.
Expect your chest size to increase 2 sizes by the end of the pregnancy, but know that some people do not experience an enlargement of chest tissue and go on to have normal milk production.
If you are nursing a little one when you get pregnant, you will most likely have the initial soreness, and may not want to be touched for a while. Early in the pregnancy, your milk will also go through changes and your nursing counterpart may notice a decrease in volume and a change in flavor. This might lead to a voluntary end to nursing or being satisfied with nursing only for comfort through the changes.
Remember, chest feeding is a relationship; it needs to work for both participants.
Increased urination
The hormones of pregnancy along with the growing uterus pressing against your bladder will send you to the restroom frequently in the first trimester.
You will get some relief in the second trimester when the uterus rises out of the pelvis and takes the pressure off.
Toward the end of the pregnancy, when the baby drops into the pelvis you will find yourself planning your days around where bathrooms are closest!
Round ligament pain
Two uterine supporting ligaments are located on the left and right side of your uterus and attach to the groin, or ‘inguinal’ area. As the uterus grows, these ligaments stretch and cramp.
The sensations can be quite a shock, but only last seconds up to a couple minutes in length.
You may feel twitches, as well as sharp or cramping pain on either side of your lower belly and/or groin.
Some of the movements that can bring on this cramping are coughing, laughing or standing up too quickly. You can bend and flex your hips, which can reduce the pull on the ligaments.
When you feel these sensations, lean into them and breathe. It should subside very quickly. If there is lingering pain, a hot water bottle or warm bath can be soothing.
If you experience pain that does not go away with breathing, stretching, and heat, contact your care provider.
Swelling/Edema
As your pregnancy progresses your blood volume increases. By the end of your pregnancy you will have a blood volume expansion of 50 -60%. A big blood volume expansion happens at 28-32 weeks. You can expect to look and feel puffy. This is a sign of a healthy pregnancy.
You may have to remove your rings until after the baby is born.
Your shoes may not fit.
During the last trimester your ankles and feet may be very swollen by the end of the day. This is within the range of normal, however can be very uncomfortable. One way to tell if the swelling that you are having is normal is that the swelling goes down with elevating the legs for 30 minutes to an hour during the day, and is less swollen in the morning when you rise.
Call your provider to check in with them if you notice a very rapid and marked increase in swelling, especially in the chest, face and hands, or very sudden unexplained weight gain. These may be warning signs of preeclampsia.
Self care suggestions for edema:
Do not sit for long periods of time. Stand up, stretch & walk (even to the restroom and back) every 20-30 minutes. Set an alarm to remind you every 20 minutes, until this becomes a habit.
Elevate your feet and legs for 30 minutes to 1 hour, once or twice a day.
Stay hydrated with water and electrolytes.
Eat salt to taste. The salt helps keep the fluid (plasma) part of your blood in your circulatory system. When there is not enough salt, this fluid is pulled out of the circulatory system and into the tissues, causing extra swelling.
Getting in cool water: bathtub or swimming pool. This will help redistribute the fluid in your body.
Peppermint oil on the soles of the feet can give some relief.
Ice packs on feet and ankles
Put compression socks/tights on before getting out of bed in the morning.
Lower back pain
Your growing uterus exerts a downward and forward pull on the lower spine causing discomfort in the lower back. Another contributing factor is the pregnant body’s release of the hormone relaxin, which results in loose ligaments, making your joints less stable and more easily stressed. This is more common in late pregnancy, but can happen any time.
Prevention and coping strategies:
Proper posture and pelvic alignment
Chiropractic care
Ergonomic seating devices and bolsters
Pillows for support while sleeping and resting
Swimming
Prenatal yoga
Cat cow yoga pose or pelvic rocks throughout the day
No reclined postures in late pregnancy
Use a pregnancy support band.
Do small exercises and stretching.
Massage therapy
Pelvic floor health
Your pelvic floor is impacted by perinatal changes and experiences.
Increased weight and pressure on pelvic floor
Incontinence
Pressure/discomfort
These sensations can be normal but should not be ignored if they are regularly interrupting daily life.
Oversimplification of “kegels” can cause more harm than good, seeing a pelvic floor PT during pregnancy and postpartum is the standard of care in many countries, but not in the US, when possible, the added care of a pelvic floor PT can improve experiences and overall pelvic floor health.
Practice contractions
Also called Braxton Hicks contractions, do not cause cervical change, but can be uncomfortable.
Why am I told to not lie on my back?
After 20 weeks, a small percentage of people feel dizzy or nauseous when they lie on their backs. The weight of your uterus and baby can occlude blood flow to the upper half of your body and lower your blood pressure by compressing the inferior vena cava (major blood vessels in your abdomen). This sounds really scary, but there is really no way you can hurt yourself or your baby, as your body will respond to the lowered blood pressure with dizziness and or nausea. Your body will wake you up from sleep to have you change positions if you need. The key is, listen to your body when it speaks to you. If lying on your back feels fine, then it is! Please note that if you are taking any medications, or alcohol or drugs you may not get these messages from your body to change positions or wake up. If you are using any of these, it is a good idea not to lie on your back.
