Are you blooming? Pregnancy is great but it can have its health downsides; here are some of the most common ones
by Radhika Holmström
Even the most straightforward pregnancy has its off-moments. After all, over those 40 weeks your body goes through spectacular changes. Not only is it growing an entire baby from a single cell; it’s also preparing for childbirth and breastfeeding. Your shape, internally as well as externally, alters: ligaments soften, your pelvis widens, extra litres of blood circulate around your system and you’re flooded with a cascade of hormones. Under the circumstances, it’s hardly surprising that midwife and pregnancy expert Zita West says frankly, “Everyone gets something at some point. And of course, it’s a time when most of us don’t want to take medication.”
Here’s our guide to six of the most common complaints.
Vomiting
Some lucky women never get a single twinge of nausea from pregnancy hormones. Others feel dreadful for a while but then, as the pregnancy gets underway, start feeling considerably better. And still others are retching all the way to the delivery room. Like so many other things about fertility and pregnancy, much of this is down to luck.
If you’re one of the unlucky ones, try ‘charting’ your symptoms, says Dr Roger Gadsby, who’s Associate Clinical Professor at the University of Warwick and chair of trustees for the charity Pregnancy Sickness Support. “Try keeping a daily symptom diary, because there may be a little bit of time when you feel better. From our research, certainly in the mild to moderate stage the symptoms often come in two to four hour bouts and in between there are periods when you can feel slightly better. Try and eat and drink at those times.” Rather than ginger – for which there’s not much evidence – he recommends fluids which have some nutrition and electrolytes. “Try flat cola or diluted orange juice. Ideally you don’t want just plain water, nor do you want sugar-free drinks: there’s some evidence that glucose reduces nausea and vomiting.” And apart from that, rest. “If you are working, you’re not ‘giving in’ if you reach the point where you need a couple of weeks off work.”
If you do reach that point, or if you’re losing weight because you’re vomiting so much and can’t keep anything down, it is definitely time to talk to the professionals because you could be becoming dehydrated.
Heartburn
It’s one of those things that people don’t really tell you about. It is one of those unfortunate side-effects of your body squashing up to accommodate the growing baby, hormones relaxing your digestive tract, and the ‘splashback’ effect of stomach acid being pushed back up onto delicate digestive tissues. The result is extremely painful, and feels like an additional insult on top of the fact you can’t eat quite a lot of interesting things in any case.
If you do think anything in particular sets you off, cut that out of your already limited diet, obviously. Overall, try and avoid hammering your digestive tract further, says Gail Johnson of the Royal College of Midwives. “Go for little meals, and often: don’t binge on the calories but do keep a snack to hand. Don’t eat just before going to bed, either. You can take antacids safely as well but do follow the guidelines (don’t just swig them down!). If you do that, though, be aware that they can affect your absorption of vitamin C so make sure you’re getting a balanced diet.”
Sleeping propped up can help as well. “Acupuncture can make a bit of difference sometimes,” adds West. “But sadly, it’s often just one of those things we can’t do much for.” On the other hand, Johnson warns, if you’re getting headaches or your fingers or ankles are swelling along with the heartburn, talk to the professionals because it could signal pre-eclampsia.
Backache
Lower back pain is usually caused by a combination of two things. One is correctable – it’s the huge tendency to stand with your back curved in as your bump expands and your centre of gravity shifts. The other isn’t – it’s the fact that your ligaments are being softened by the hormone relaxin in preparation for childbirth, which makes it easier to stretch but also means it’s easy to over-stretch and cause damage. A third reason could also be a urinary tract infection, which you may experience as severe back ache late in pregnancy (say 30 weeks onwards) so again, get it checked out.
Adjusting your posture can make a huge difference, advises Vicky Keates, who’s a senior women’s health physiotherapist, working in the NHS and privately (womens-health-physio.co.uk). “Sit or stand tall, so that your tummy muscles have to work harder (you need those in good order to support your back). If you’re slumping, you’re putting all the forces through the wrong part of your back, and also the whole weight of the baby is on your spine. Sit up, and the baby’s weight will be off it. Think about how you get in and out of bed too: go onto your side and roll onto your back with your thighs down, in a nice smooth rolling movement, rather than lurching down using your back as a lever. Do that in reverse to get up.” This is the time to put into practice all those times you’ve been told ‘bend with your knees, not your back’ – and every time you lift anything heavier than a full kettle, add one or two pelvic floor exercises too, to keep everything braced.
Piles
Piles always sound like a joke, till they happen to you. Like so many other pregnancy ailments, they’re the result of the relaxin hormone (which is quite indiscriminate in the number of things it affects). The veins round your anus become enlarged and swollen; and what’s more, your gut is relaxed too, leading to the constipation which leads to straining and thus makes the piles far, far worse than before.
“It’s back to diet again here,” says Gail. “You really do want to avoid further constipation, so make sure you’re getting plenty of fluids and that you’re also keeping active. Pelvic floor exercises will help keep everything ‘tighter’, too. Above all, do try not to get into a vicious cycle where you’re too scared to go to the loo.” If natural methods don’t work, there are some good over-the-counter creams, and even gentle laxatives if that’s part of the problem, that can help.
Bleeding gums
This is another pregnancy niggle that people don’t talk about much: swollen, tender gums, as the result of yet more hormones. But, says Karen Coates of the British Dental Health Foundation reassuringly, “It’s not gum disease and your gums will go back to normal afterwards. However, in the meantime you really must make sure that you clean off all plaque, which will make the bleeding worse.” It is well worth making an appointment both with the dentist and with the hygienist; and don’t switch to a softer brush (which will be gentler but may not clean as effectively) till you’ve talked to them. The other thing you need to do, Coates adds, is try to keep the acid levels in your mouth low in order to protect the enamel. “If you’re afflicted with sickness, don’t brush your teeth straight afterwards; rinse with fluoride mouthwash or even just water instead, or try sugar-free chewing gum.”
Stretchmarks
Every woman’s heard about stretchmarks. In fact for quite a surprising number it’s the thing they dread most of all; there’s a thriving market in oils and creams promising to stop the red crinkly marks expanding over your bump (and possibly underneath it). Unfortunately, there is a limited amount you can do about this – the stretching goes deep into the dermis (the middle layer of the skin). “It’s purely dependent on your skin,” says West. There is some, limited, evidence that massaging cream into your skin may help a bit – whether it’s the product or the massage itself isn’t clear – and it should also help your stretched skin feel far less sore and dry too. If you’re itching very badly, especially over the bump, talk to your professionals (as this could be a sign of obstetric cholestatis) but otherwise, stretchmarks are to a great extent non-negotiable; though they do fade over time, changing from angry red marks to much fainter white scars.