9 Problems
        our body has a great deal to do during pregnancy. Sometimes
        the changes taking place will cau...

           CONSTIPATION                         CRAMP

           You may become constipated very      Cramp i...


During pregnancy you’re likely to          or highly spiced ones, but make
feel warm...

                                                    • Remedi...

can empty it properly. Then you
won’t need to pass water again quite

It might be more comfortable
to lie on one side with a
pillow under your tummy and
another between your knees...

VAGINAL DISCHARGE                                                                      TI R E D N E S S


                                     HIGH BLOOD PRESSURE AND                        Bleeding after about five m...
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Pregnancy problems


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this file contains all the problems and its solutions encounters during pregnancy.

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Pregnancy problems

  1. 1. 9 Problems Y our body has a great deal to do during pregnancy. Sometimes the changes taking place will cause irritation or discomfort, and on occasions they may seem quite alarming. There is rarely any need for alarm but you should mention anything that is worrying you to your doctor or midwife. If you think that something may be seriously wrong, trust your own judgement and get in touch with your doctor or midwife straight away. We have listed, in alphabetical order, the changes you are most likely to notice and their causes – where these are known – plus suggestions on how to cope. COMMON M I N O R P RO B L E M S BACKACHE If during or after birth you During pregnancy ligaments become softer and stretch to prepare you for • work at a surface high enough to prevent you stooping; have pain in the hips, groin, lower abdomen and inner labour. This can put a strain on the thighs and have difficulty joints of your lower back and pelvis • between two baskets if you are try to balance the weight walking or climbing stairs, which can cause backache. As the you should inform your GP, carrying shopping; baby grows, the hollow in your midwife or hospital doctor. lower back may increase and this may also cause backache (see box). • well supported. straight and sit with your back This may be due to a gap in a joint in the pelvic girdle not closing up. This gap To avoid backache: A firm mattress can help to prevent appears naturally during the and relieve backache. If your birth to allow for the baby’s mattress is too soft, a piece of • avoid heavy lifting; hardboard under its length will head. This condition is known as Symphysis Pubic • back straight when lifting or bend your knees and keep your make it firmer. Massage can also help, or you Dysfunction (SPD). It affects very few women picking up something from the might like to try a support corset – but early diagnosis and floor; these can be prescribed by your appropriate treatment will doctor. Make sure you get enough • heavy, do haveclose to your body; if you hold it to carry something rest, particularly later in pregnancy. help to minimise the pain and avoid long-term If your backache is very painful, discomfort. If you are • round your feettwistingturningspine; move to avoid when your ask your doctor to refer you to an obstetric physiotherapist at your diagnosed with SPD, you can contact The Pelvic hospital. He or she will be able to Partnership (see page 150) • weight toshoes as these allow your wear flat be evenly distributed; give you some advice and suggest for support and information. some helpful exercises. 77
  2. 2. Problems CONSTIPATION CRAMP You may become constipated very Cramp is a sudden, sharp pain, early in pregnancy because of the usually in your calf muscles or feet. hormonal changes going on in your It is most common at night, but body. It will help to: nobody really knows what causes it. It usually helps if you pull your toes • fibre in your diet through eating make sure you include plenty of hard up towards your ankle or rub the muscle hard. Regular, gentle foods like wholemeal breads, exercise in pregnancy, particularly wholegrain cereals, fruit and ankle and leg movements, will vegetables, and pulses such as improve your circulation and may beans and lentils; help to prevent cramp occurring. • muscles toned up;to keep your exercise regularly LEAKING FROM YOUR NIPPLES • water;sure you drink plenty of make This is colostrum and is the first milk your breasts make in preparation to feed your baby. • constipation – askthey cause avoid iron pills if your doctor However, see your doctor or midwife if it becomes bloodstained. whether you can manage without them or change to a different type; if not, you may have to FAINTNESS accept having constipation. Pregnant women often feel faint. This happens when not enough blood is getting to the brain. If the oxygen level gets too low, you may actually faint. It’s more common in pregnancy because of hormonal changes taking place in your body. You’re most likely to feel faint if you stand still for too long or get up too quickly from a chair or hot bath. It often happens when you are lying on your back. • or lyingget up slowly after sitting Try to down. • still, find a faintquicklystanding If you feel seat when and the faintness will pass. If it doesn’t, lie down on your side. • your back, faint while lying onIt’s If you feel turn on your side. better not to lie flat on your back in later pregnancy or during labour. 78
  3. 3. Problems FEELING HOT IN PREGNANCY During pregnancy you’re likely to or highly spiced ones, but make feel warmer than normal. This is sure you are still eating well due to hormonal changes and to an (see pages 8–12 for information increase in blood supply to the skin. on healthy eating). You’re also likely to sweat more. It helps if you: Heartburn is more than just indigestion. It is a strong, burning • natural fibres, as these are more wear loose clothing made of pain in the chest. It is caused by the valve between your stomach and the absorbent and ‘breathe’ more tube leading to your stomach than synthetic fibres; relaxing in pregnancy, so that stomach acid passes into the tube. • using your room cool – consider keep an electric fan; It is often brought on by lying flat. To avoid heartburn you could: • wash frequently to stay fresh. • raisingwell propped your– bed with sleep the head of up try bricks or have plenty of pillows; HEADACHES Some pregnant women find they get • onedrinking bed in of milk –wake try by your a glass case you have a lot of headaches. A brisk walk may with heartburn in the night; be all you need, as well as a little more regular rest and relaxation. Although it is wise to avoid drugs in • few hourseating oryou go to bed;a avoiding before drinking for pregnancy, an occasional paracetamol tablet is generally considered safe. If you often have bad headaches, • advice; doctor or midwife for ask your tell your doctor or midwife so that they can advise you. Severe headaches may be a sign of high • mixture before checking that they don’t take antacid tablets or blood pressure (see page 84). are safe in pregnancy. INDIGESTION AND HEARTBURN ITCHING This is partly caused by hormonal Mild itching is common in pregnancy changes and later by the growing because of the increased blood womb pressing on the stomach. supply to the skin. In late pregnancy If you suffer from indigestion: the skin of the abdomen is stretched and this may also cause itchiness. • often; smaller meals more try eating Wearing loose clothing may help. Itching can, however, be a sign of a more serious problem called obstetric • eating straighttakes the pressure sit up as this when you are cholestasis (see page 84). If itching becomes severe, or you develop off your stomach; jaundice (yellowing of the whites of the eyes and skin), see your doctor. • cause trouble, forfoods which avoid particular example fried Itching which is associated with a rash may also need treatment if it is severe. 79
  4. 4. Problems NAUSEA AND MORNING SICKNESS • Remedies containing ginger may be helpful. Nausea is very common in the early weeks of pregnancy. Some women • Wear comfortable clothes.feel waistbands can make you Tight feel sick, some are sick. Some feel worse. sick in the mornings, some at other times, some all day long. If you are being sick all the time and The reasons are not fully cannot keep anything down, inform understood, but hormonal changes your doctor or midwife. Some in the first three months are probably pregnant women experience severe one cause. Nausea usually disappears nausea and vomiting. This condition around the 12th–14th week. Nausea is known as hyperemesis gravidarum. can be one of the most trying (See page 149 for the support group problems in early pregnancy. It Blooming Awful.) comes at a time when you may be feeling tired and emotional, and NOSE BLEEDS when many people around you may not realise you are pregnant and Nose bleeds are quite common in expect you to be your normal self. pregnancy because of hormonal changes. The nose bleeds are usually • morning, give yourself time to If you feel sick first thing in the short but can be quite heavy. To help the bleeding stop, press the sides of get up slowly. If possible, eat your nose together between your something like dry toast or a plain thumb and forefinger just below the biscuit before you get up. Your bony part of your nose for ten partner could bring you some minutes. Repeat for a further ten sweet tea. minutes if this is unsuccessful. As long as you don’t lose a lot of blood, • whenever yourest and sleeptired Get plenty of can. Feeling there is nothing to worry about. Blow your nose gently and try to can make the sickness worse. avoid explosive sneezes. You may also find that your nose gets more • thansmall amountsmeals, but don’t Eat several large often rather blocked up than usual. stop eating. PASSING WATER OFTEN • Drink plenty of fluids. Needing to pass water often is an early sign of pregnancy. Sometimes it • support. close to you for extra Ask those continues right through pregnancy. In later pregnancy it’s the result of the baby’s head pressing on the • can. Often the nausea getsasworse Distract yourself as much you bladder. If you find that you’re having to the more you think about it. get up in the night, you could try cutting out drinks in the late • make you feel worse.smells that Avoid the foods and It helps if evening but make sure you keep drinking plenty during the day. someone else can cook but, if Later in pregnancy, some women not, go for bland, non-greasy find it helps to rock backwards and foods, such as baked potatoes, forwards while they are on the toilet. pasta and milk puddings, which This lessens the pressure of the 80 are simple to prepare. womb on the bladder so that you
  5. 5. Problems can empty it properly. Then you won’t need to pass water again quite • your regular exercise to improve take circulation; so soon. If you have any pain while passing water, or pass any blood, you may • slightly raised on booksthe bed sleep with the foot of or bricks; have a urine infection which will need treatment. Drink plenty of water to dilute your urine and • discomfort,pack to ease gently use an ice holding this reduce irritation. You should contact against the piles, or use a cloth your GP within 24 hours. wrung out in iced water; Sometimes pregnant women are unable to prevent a sudden spurt of urine or a small leak when they • gentlypiles stick out, push them if the back inside using a cough, sneeze or laugh, or when lubricating jelly; moving suddenly or just getting up from a sitting position. This may be temporary because the pelvic floor • pharmacist if theymidwife or a ask your doctor, can suggest If you sometimes can’t help wetting or soiling yourself, muscles relax slightly to prepare for suitable ointment; you can get help. the baby’s delivery. Incontinence is a very The growing baby will increase pressure on the bladder. If you find • where thegiving birth in a position consider pressure on your back common problem. It can affect anyone, sometimes this a problem, you can improve the passage is reduced – kneeling, for during and after pregnancy. situation by doing exercises to tone example. In many cases it is curable, up your pelvic floor muscles (see so if you’ve got a problem page 16). Ask a midwife or obstetric talk to your doctor, physiotherapist (see pages 62 and 63) SKIN AND HAIR CHANGES midwife or health visitor, for advice. or ring the confidential Hormonal changes taking place in Continence Foundation PILES pregnancy will make your nipples helpline on 0845 345 and the area around them go darker. 0165, Monday to Friday, Piles, also known as haemorrhoids, Your skin colour may also darken a 9.30am to 1pm. are swollen veins around the back little, either in patches or all over. www.continence- passage which may itch, ache or feel Birthmarks, moles and freckles may foundation.org.uk sore. You can usually feel the also darken. Some women develop a lumpiness of the piles around the dark line down the middle of their back passage. Piles may also bleed a stomachs. These changes will little and they can make going to the gradually fade after the baby has toilet uncomfortable or even painful. been born, although your nipples They occur in pregnancy because may remain a little darker. the veins relax under the influence If you sunbathe while you are of pregnancy hormones. Piles usually pregnant, you may find you tan go shortly after delivery. If you suffer more easily. Protect your skin with from piles you should: a good, high-factor sunscreen. Don’t stay in the sun for very long. • fibre, like wholemeal bread, fruit eat plenty of food that is high in Hair growth is also likely to increase in pregnancy. Your hair may and vegetables, and you should also be greasier. After the baby is drink plenty of water – this will born, it may seem as if you’re losing prevent constipation, which can a lot of hair. In fact, you’re simply make piles worse; losing the increase that occurred during pregnancy. • avoid standing for long periods; 81
  6. 6. Problems It might be more comfortable to lie on one side with a pillow under your tummy and another between your knees. SLEEPLESSNESS to gather in the lowest parts of the body. You should: Late in pregnancy it can be very IF YOU AREN’T SLEEPING WELL difficult to get a good night’s sleep. You’re uncomfortable lying down, • periods; standing for long try to avoid or just when you’re beginning to get • you.not to let it bother it Try Don’t worry that comfortable, you have to get up to go to the toilet. Some women have • wear comfortable shoes; will harm your baby – it won’t. strange dreams or nightmares about the baby and about the birth. Talking • – tryyourrest for an muchaasday with put to feet up as hour you can about them can help you. Just because your feet higher than your heart; • comfortable to lie on It might be more you dream something, it doesn’t mean one side with a pillow it’s going to happen. The relaxation and breathing which are taught in • pageto17) –your foot exercises (see try do these will help. under your tummy and antenatal classes might be helpful. another between your knees. TEETH AND GUMS STRETCH MARKS • Relaxation techniques may help. Your antenatal These are pink or purplish lines Bleeding gums are caused by a build-up of plaque (bacteria) on the class (see pages 64–5) which usually occur on the tummy teeth. During pregnancy, hormonal may teach relaxation or sometimes on the upper thighs or changes in your body can cause the techniques, or you could breasts. Some women get them, plaque to make the gums more borrow a cassette from some don’t. It depends on your skin inflamed. They may become swollen your library. type. Some people’s skin is more and bleed more easily. To keep your elastic. You are more likely to get teeth and gums healthy, you should: • warm bath, somedrink, a A warm, milky stretch marks if your weight gain is gentle exercise or some restful more than average. It’s very doubtful whether oils or • yourspecial attention to cleaning pay teeth. Ask your dentist to music before bedtime may creams help to prevent stretch marks. show you a good brushing help. After your baby is born, the marks method to remove all the plaque; should gradually pale and become • canrest duringtothe day A help you feel less noticeable. • foods too often. Try drinks and avoid having sugary to keep them less tired. only to meal times; SWOLLEN ANKLES, FEET • Talk to your partner, a friend, doctor or AND FINGERS • is free whilethat dentalpregnant remember you are treatment midwife. Ankles, feet and fingers often swell a and for a year after your baby’s little in pregnancy because the body birth, so have a check-up now; holds more water than usual. Towards the end of the day, especially if the weather is hot or if you have been • any newwithreplacement fillings discuss or your dentist whether standing a lot, the extra water tends should be delayed until after your 82 baby is born.
  7. 7. Problems VAGINAL DISCHARGE TI R E D N E S S Almost all women have more vaginal discharge in pregnancy. It should be • crossed;to sit with your legs try not In the early months of pregnancy you may feel tired clear and white and it should not or even desperately smell unpleasant. If the discharge is coloured or smells strange, or if you • weight as this increasesmuch try not to put on too the exhausted. The only answer is to try to rest as much as feel itchy or sore, you may have a pressure; possible. Make time to sit vaginal infection. Tell your doctor or with your feet up during the midwife. The most common infection is thrush, which your • youwith your legs updiscomfort; sit can to ease the as often as day and accept any offers of help from colleagues and doctor can treat easily. You can help family. Towards the end of prevent thrush by wearing loose cotton underwear. • alsosupport tights,the muscles of try help support which may pregnancy, you may feel tired because of the extra If vaginal discharge, of any colour, your legs – you can buy them at weight you are carrying. increases a lot in later pregnancy, most pharmacists; Make sure you get plenty tell your doctor or midwife. of rest. • thansleeping with your legs–higher try the rest of your body use VARICOSE VEINS pillows under your ankles or put bricks or books under the foot of Varicose veins are veins which have your bed; become swollen. The veins in the legs are most commonly affected. You can also get varicose veins in • andfoot exercises (see page 17) do other antenatal exercises, the vulva (vaginal opening). such as walking, cycling and They usually get better after delivery. swimming, which will all help You should: your circulation. • periodsavoid standing for long try to of time; MORE S E R I O U S P RO B L E M S SLOW-GROWING BABIES Many of the tests in pregnancy check In the last weeks of pregnancy you the growth of your baby. If you have may also be asked to keep track of previously had a very small baby, or if your baby’s movements. If you you smoke heavily, the midwives and notice your baby’s movements doctors will already be monitoring becoming less frequent or slowing your pregnancy closely. Blood down, or if they stop, contact your pressure checks may also pick up midwife or doctor immediately. signs of trouble. If there is concern If tests show that your baby is not about your baby’s health, further tests growing well in the womb, early may be carried out and more delivery by induction of labour or frequent monitoring of your baby Caesarean section (see pages 101–2) may be recommended. may be recommended. 83
  8. 8. Problems HIGH BLOOD PRESSURE AND Bleeding after about five months OTHER SYMPTOMS PRE-ECLAMPSIA may be a sign that the placenta is implanted in the lower part of the You should contact your GP During pregnancy your blood uterus (placenta praevia) or that it if you have a sudden ‘acute’ pressure will be checked at every has started to separate from the illness like diarrhoea, antenatal appointment. This is uterus (placental abruption). Both of vomiting, abdominal pain or because a rise in blood pressure can these can be dangerous for you and a high fever. be the first sign of a condition the baby, so contact your midwife or known as pre-eclampsia – often doctor immediately. called pregnancy-induced The cells on the surface of the hypertension (PIH) or pre-eclamptic cervix often change in pregnancy toxaemia (PET) – which can run and make it more likely to bleed, in families and affects 10% of particularly after intercourse. This is pregnancies. Your urine will also called a cervical erosion. Vaginal be checked for protein. If you do have pre-eclampsia, you infections can also cause a small will probably feel perfectly well. amount of vaginal bleeding. Some women experience such Some causes of vaginal bleeding symptoms as headaches, visual are more serious than others, so it’s disturbances, swelling and abdominal important to find the cause straight pain. Pre-eclampsia can still be away. The most common sort of bleeding in late pregnancy is the DEEP VEIN severe, however, without any small amount of blood mixed with THROMBOSIS (DVT) symptoms at all. Although most cases are mild and cause no trouble, mucus, known as a ‘show’. This is a DVT is a serious condition it can get worse and be serious for sign that the cervix is changing and where clots develop, often in both mother and baby. It can cause becoming ready for labour to start. It the deep veins of the legs. It fits in the mother (eclampsia) and may happen a few days before can be fatal if the clot travels affect the baby’s growth, and be contractions start or during labour from the legs to the lungs. life-threatening if left untreated. itself. You should always report this That is why routine antenatal to your doctor or midwife as soon as Flights over five hours where it occurs. you sit still for a long time checks are so important. may increase the risk. Pre-eclampsia usually happens SEVERE ITCHING AND towards the end of pregnancy, but OBSTETRIC CHOLESTASIS Pregnant women and women problems can occur earlier. Rarely, it who have recently had a baby can happen after the birth. The earlier Although itching is very common are amongst those more at in pregnancy it starts, the more severe in normal pregnancy, severe risk. If you intend to travel by it is likely to be. If it does get worse, generalised itching, without a rash, air, consult your GP or mid- the treatment ranges from rest at particularly in the last four months wife before the trip. Get advice home or in hospital to drugs to lower of pregnancy, may be the only sign on in-seat exercises to keep the high blood pressure, or, of an uncommon condition called your circulation active. After occasionally early delivery of the baby. obstetric cholestasis. This is a the 28th week of pregnancy, potentially dangerous liver disorder most airlines require a letter VAGINAL BLEEDING which seems to run in families, from your GP or midwife to Bleeding from the vagina at any time although it can occur without any say that you are fit to travel. in pregnancy can be a danger signal. In family history. It is important to early pregnancy, bleeding may be a contact your doctor if you have If you develop swollen troublesome itching because sign of an ectopic pregnancy or a mis- painful legs or have breathing obstetric cholestasis may lead to carriage (see pages 104–5), although difficulties after the trip, go to premature labour, stillbirth or serious many women who bleed at this time your doctor or your nearest health problems for the baby, and go on to have normal and successful Accident and Emergency to an increased risk of maternal pregnancies. If you have bleeding with department immediately. haemorrhage after the delivery. pain, contact your GP straight away. 84