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
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,
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
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;
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;
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
be evenly distributed;
give you some advice and suggest for support and information.
some helpful exercises.
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
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
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
• still, ﬁnd a faintquicklystanding
If you feel
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
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
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
the head of
bricks or have plenty of pillows;
Some pregnant women ﬁnd they get
• onedrinking bed in of milk –wake
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
pregnancy, an occasional paracetamol
tablet is generally considered safe.
If you often have bad headaches,
• advice; doctor or midwife for
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
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
Itching which is associated with a rash
may also need treatment if it is severe.
NAUSEA AND MORNING
• 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
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
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
often rather blocked up than usual.
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
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
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
can empty it properly. Then you
won’t need to pass water again quite
• your regular exercise to improve
If you have any pain while passing
water, or pass any blood, you may
• slightly raised on booksthe bed
sleep with the foot of
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
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
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,
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
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
• avoid standing for long periods; 81
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
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
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
strange dreams or nightmares about
the baby and about the birth. Talking
• – tryyourrest for an muchaasday with
feet up as
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
these will help.
under your tummy and antenatal classes might be helpful.
another between your
knees. TEETH AND GUMS
• 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
exercise or some restful
more than average.
It’s very doubtful whether oils or
• yourspecial attention to cleaning
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
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
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
your dentist whether
standing a lot, the extra water tends should be delayed until after your
82 baby is born.
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
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;
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
• alsosupport tights,the muscles of
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
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)
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
MORE S E R I O U S P RO B L E M S
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.
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
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.