Physical Changes and Pregnancy in Southern New England

Sharp, shooting pains on either side of your stomach might result from the stretching of tissue supporting your uterus. These pains might also travel down your thigh and into your leg.

The muscles in your uterus will contract (tighten) from about the fourth month of pregnancy. Irregular infrequent contractions are called Braxton Hicks contractions (also known as false labor pains).

• Change your position or activity until you are comfortable. Avoid sharp turns or movements.
• If you have a sudden pain in your abdomen, bend forward to the point of pain to relieve tension and relax the tissue.
• Apply a hot water bottle or heating pad, or take a warm bath or shower
• Try massage
• Make sure you are getting enough fluids
• Contact your health care provider if the pain is severe or constant, or if you are less than 36 weeks pregnant and you have signs of pre-term labor.

Signs of preterm (premature) labor:

• More than four to six contractions in an hour.
• Regular tightening or pain in your back or lower abdomen
• Pressure in the pelvis or vagina
• Menstrual-like cramps
• Bleeding
• Fluid leak

Backaches are usually caused by the strain put on the back muscles, changing hormone levels and changes in your posture.

• Wear low healed (but not flat) shoes
• Avoid lifting heavy objects
• Squat down with your knees bent when picking things up instead of bending down at the waist
• Don’t stand on your feet for long periods
• Sit in a chair with good back support. Place your feet on a footstool
• Check that your bed is firm. If needed, put a board between the mattress and box spring
• Sleep on your left or right side with a pillow between your legs for support
• Apply a hot water bottle or heating pad, take a warm bath or shower or try massage
• Perform exercises as advised by your health care provider
• Maintain good posture
• Contact your health care provider if you have a low backache that goes around your stomach and does not go away within one hour after you change position or rest. This might be a sign of premature labor.

The increase in your volume of circulation and supply of certain hormones might cause tenderness, swelling and bleeding of gums.

• Take proper care of your teeth and gums. Brush and floss regularly.
• Get a dental checkup early in your pregnancy to make sure your teeth and mouth are healthy. See your dentist if you have a problem.

Your breasts will increase in size as your milk glands enlarge and the fatty tissue increases, causing breast firmness and tenderness in the first and last few months of pregnancy. Bluish veins might also appear as your blood supply increases. Your nipples will also darken and a thick fluid called colostrum might leak from your breasts. All of these changes are normal.

• Wear a bra that provides firm support
• Choose cotton bras or those made from other natural fibers
• Increase your bra size as your breasts become larger
• Wear your bra night and day
• Tuck a nursing pad into your bra cup to absorb leaking fluid
• Clean your breasts with warm water only. Do not use soap or other products.

Your hormones, as well as vitamins and iron supplements, might cause constipation (difficulty passing stool, or incomplete or infrequent passage of hard stools). Pressure on your rectum from your uterus might also cause constipation.

• Add more fiber to your diet
• Drink plenty of fluids daily
• Drink warm liquids, especially in the morning
• Exercise daily
• Set a regular time for bowel movements. Avoid straining when having a bowel movement
• Discuss the use of a laxative with your health care providers. They might recommend natural fiber laxatives or stool softeners

Finding a comfortable resting position can become difficult later in pregnancy.

• Don’t take sleep medicine
• Try drinking warm milk at bedtime
• Try taking a warm shower or bath before bedtime
• Use extra pillows for support while sleeping. Lying on your side, place a pillow under your head, abdomen, behind your back and between your knees to prevent muscle strain and help you get the rest you need. You will probably feel better lying on your left side. This improves circulation of blood throughout your body.

• Move around often when standing for long periods of time.
• Turn on your side before rising from a lying down position.
• Try to move slowly when standing from a sitting position. Avoid sudden movements.

Your growing baby requires extra energy, which might make you feel tired. Sometimes, feeling tired might be a sign of anemia (low iron in the blood), which is common during pregnancy.

• Get plenty of rest. Go to bed early at night and try taking naps during the day.
• Maintain a regular schedule, when possible, but pace your activities.
• Exercise daily to increase your energy level.
• If you think anemia might be a concern, ask your health care provider to test your blood

During the first trimester, your growing uterus and growing baby press against your bladder, causing a frequent need to urinate. This will happen again when the baby’s head drops into the pelvis before birth.

• Avoid tight-fitting underwear, pants or pantyhose.
• Contact your health care provider if your urine burns or stings. This can be a sign of a urinary tract infection and should be treated right away.

How often headaches occur and how bad they are can vary.

• Apply an ice pack to our forehead or the back of your neck.
• Rest, sit or lie quietly in a low-lit room. Close your eyes and try to release the tension in your back, neck and shoulders.
• Try Tylenol or acetaminophen. Ask your health care provider before taking other medicines for your headache.
• Contact your health care provider if you have nausea with your headaches; if your headache is severe and does not go away; or if you have blurry vision, double vision or blind spots.

Heartburn (indigestion) is a burning feeling that starts in the stomach and seems to rise to the throat. It occurs during pregnancy because your digestive system works more slowly due to changing hormone levels. Also, your enlarged uterus can crowd your stomach, pushing stomach acids upward.

• Eat several small meals each day instead of three large meals.
• Eat slowly.
• Drink warm liquids such as herbal tea.
• Avoid fried, spicy or rich foods.
• Don’t lie down directly after eating.
• Keep the head of your bed higher than the foot of your bed. Place pillows under your shoulders to prevent stomach acids from reaching your chest.
• Try heartburn relievers such as Tums, Maalox, Titralac, Mylanta, Riopan or Gaviscon.

Hemorrhoids are swollen veins that appear as painful lumps on the anus. They might form as a result of increased circulation and pressure on the rectum and vagina from your growing baby.

• Try to avoid constipation. Constipation can cause hemorrhoids or make them more painful.
• Try to avoid sitting or standing for long periods of time. Change position frequently.
• Make an effort not to strain during a bowel movement.
• Apply ice packs or cold compresses to the area.
• Avoid tight fitting underwear, pants or pantyhose.
• Discuss the use of a hemorrhoid treatment with your health care provider.

Pressure from your growing uterus can cause leg cramps or sharp pains down your legs.

• Be sure to eat and drink foods and beverages rich in calcium.
• Wear comfortable, low-heeled shoes.
• Try wearing support hose but avoid legwear that is too tight.
• Elevate your legs when possible. Avoid crossing your legs.
• Exercise daily.
• Stretch your legs before going to bed.
• Avoid lying on your back.
• Gently stretch any muscle that becomes cramped by straightening your leg, flexing your foot and pulling your toes toward you.
• Try massaging the cramp, or apply heat to the sore area.

You might have a “stuffy nose” or feel like you have a cold. Pregnancy hormones sometimes dry out the lining in your nose, making it inflamed and swollen.

• Apply a warm, wet washcloth to your cheeks, eyes and nose to reduce congestion.
• Don’t use nose sprays. They can aggravate your symptoms.
• Drink plenty of fluids (At least 6 to 8 glasses of fluids a day).
• Elevate your head with an extra pillow while sleeping.
• Use a humidifier or vaporizer to add moisture to the air.

Nausea can occur at any time of the day but might be worse in the morning when your stomach is empty (this is often called morning sickness) or if you are not eating enough.

Nausea is a result of hormonal changes and most often occurs early in pregnancy until your body adjusts to the increased production of hormones.

• If nausea is a problem in the morning, eat dry foods such as cereal, toast or crackers before getting out of bed. Try eating a high-protein snack such as lean meat or cheese before going to bed (protein takes longer to digest).
• Eat small meals or snacks every two to three hours rather than three large meals. Eat slowly and chew your food completely.
• Sip on fluids throughout the day. Avoid large amounts of fluid at one time. Try cool, clear fruit juices such as apple or grape juice.
• Avoid spicy, fried or greasy foods.
• If you are bothered by strong smells, eat foods cold or at room temperature and avoid odors that bother you.
• Contact your health care provider if your vomiting is constant or so severe that you can’t keep fluids or foods down. This can cause dehydration and should be treated right away.

You might feel short of breath when walking upstairs or walking briskly.

• The first thing to do is slow down and rest a few moments.
• Raise your arms over your head. This lifts your rib cage and allows you to breathe in more air.
• Avoid lying flat on your back and try to sleep with your head elevated.

Stretch marks are a type of scar tissue that forms when the skin’s normal elasticity is not enough for the stretching required during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks or thighs. While they won’t disappear completely, stretch marks will fade after birth. Stretch marks affect the surface under the skin and are usually not preventable.

• Be sure your diet contains enough sources of the nutrients needed for healthy skin (especially vitamins C and E).
• Apply lotion to your skin to keep it soft and reduce dryness.
• Exercise daily.

Pressure from the growing uterus on the blood vessels carrying blood from the lower body causes fluid retention that results in swelling (edema) in the legs and feet.

• Try not to stay on your feet for long periods of time.
• Drink plenty of fluids.
• Avoid foods high in salt.
• Elevated your legs and feet while sitting.
• Avoid crossing your legs.
• Wear loose, comfortable clothing.
• Don’t wear tight shoes.
• Keep your diet rich in protein.
• Notify your health care provider if your hands or face swell.
• Rest on your side to increase blood flow to your kidneys.

Increased blood supply and hormones cause your vagina to increase normal secretions. Normal vaginal discharge is white or clear, non-irritating and odorless and might look yellow when on your underwear or panty liners.

• Choose cotton underwear.
• Avoid tight-fitting jeans or pants.
• Do not douche. It can cause your bag of water to break or introduce air into your circulatory system.
• Clean the vaginal area often with soap and water.
• Wipe yourself from front to back.
• Contact your health care provider if you have burning, itching, irritation, swelling, odor, bloody discharge or yellow/green discharge. These symptoms could be a sign of infection.

An increased volume of blood and the pressure of your growing uterus can slow your circulation sometimes causing the veins in your legs to become larger or swollen.

Although varicose veins are usually hereditary, here are some preventive tips:

• Avoid standing or sitting in one place for long periods.
• Avoid remaining in any position that might restrict the circulation in your legs.
• Elevate your legs and feet while sitting.
• Exercise regularly.
• Wear support stockings but avoid any leg wear that is too tight.