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Concerns & Discomforts of Pregnancy

During pregnancy, you may have some concerns and discomfort as your body changes. Try these basic tips and talk to your doctor or nurse for more advice. Do not use any over the counter medicine or herbs without talking to your doctor first.

Nausea

Nausea or feeling sick to your stomach is often called morning sickness. Some women also have heartburn or a burning sensation in their stomach, throat or chest. This is common during the first 14 weeks of pregnancy. If you were in good health before pregnancy, your baby will not be affected by morning sickness. To improve your signs:

  • Eat smaller meals more often instead of 3 large meals to avoid an empty stomach. Keep toast, saltine crackers, pretzels or dry cereal by your bedside. It may help to eat before you get out of bed in the morning.
  • Drink liquids between meals, but not during meals.
  • Take sips of clear liquids such as soft drinks, apple juice, tea or broth, or small amounts of Jell-0 when vomiting occurs. As nausea passes, increase liquids to a ½ cup or 120 milliliters every hour.
  • Avoid lying down, sleeping or exercising for 1 hour after eating.
  • Avoid high fat, fried, spicy, acidic or greasy foods. Avoid caffeine.
  • Sleep with your head raised up on a pillow.
  • When bending over, bend at your knees and not your waist.

Keep notes of when vomiting occurs and anything that makes it worse, such as certain foods, odors, activities or stress. Share this information with your doctor.

Call your doctor right away if you:

  • Cannot keep liquids or food down for 24 hours.
  • Have stomach pain, fever, dizziness, severe weakness or feel faint.
  • Have a weight loss of more than 5 to 10 pounds or 2 to 5 kilograms.
  • Have very dark yellow urine or do not urinate for long periods.

These are signs that your body does not have enough fluid. This can be harmful to both you and your baby if untreated. An IV (intravenous) with fluids and nutrients may need to be given. Your doctor may order over the counter or prescription medicines.

Diabetes During Pregnancy

If you have diabetes, your body cannot properly use the food you eat for energy. When you have diabetes during pregnancy, it is called gestational diabetes.

  • When you eat, your body breaks down the foods into a form of energy called glucose. Glucose is another word for sugar. The glucose goes into your blood and your blood sugar rises.
  • Insulin is a hormone made by your pancreas. It helps glucose move from your blood into your body's cells so your body can use it for energy. You cannot live without insulin.

Diabetes while you are pregnant

With diabetes, you and your baby do not get the energy you need from the food you eat. High blood sugar during pregnancy can be harmful to you and to your baby. You will have blood tests done to check your glucose level.

If not treated, gestational diabetes can cause:

  • A large baby, which can cause a hard delivery
  • Birth defects
  • Low blood sugar in your baby right after birth, which is not good for your baby
  • Breathing problems for your baby

Signs

You may have no signs that your blood sugar is high. Ask your doctor about glucose testing during your pregnancy.

Your Care

The goal is to keep your blood sugar under control. Your doctor will follow your pregnancy closely to check you and your baby.

If you have high blood sugar:

  • Eat a well-balanced diet. A dietitian or nurse will help you plan your diet.
  • Exercise each day.
  • Check your blood sugar often and write it down. You will be taught to check your blood sugar using a glucose meter.
  • You may need to give yourself insulin shots. If so, a nurse will show you how to do this.

Your health after your baby is born

After your baby is born, your blood sugar will likely go back to normal. Your blood sugar will be checked 6 weeks after delivery or after you have stopped breastfeeding. Women who have had gestational diabetes have a high rate of Type 2 diabetes later in life. Reduce your risk by staying at a healthy weight, exercise, and eat healthy foods. Have your blood sugar tested at least once a year or as directed.

High Blood Pressure During Pregnancy (Pre-eclampsia)

Blood pressure is the force put on the walls of your blood vessels as blood travels through your body. Blood pressure helps pump blood to your body.

Normal Blood Pressure

Normal blood pressure is 120 over 80 or less. Blood pressure varies from person to person. Each person's blood pressure changes from hour to hour and day to day.

High Blood Pressure

High blood pressure is also called hypertension. High blood pressure is 140 over 90 or higher. A diagnosis of high blood pressure is not made until your blood pressure is checked several times and it stays high.

High blood pressure can be dangerous for pregnant women and their unborn babies. Women with high blood pressure before pregnancy may have more problems during pregnancy. Some women get high blood pressure while they are pregnant. High blood pressure during the second half of the pregnancy is called gestational hypertension. Without treatment, high blood pressure during pregnancy can cause a small or ill baby and problems for the mother. Most people do not have any signs, so it's important to have your blood pressure checked.

Your Care

If you have high blood pressure:

  • Check your blood pressure often.
  • Go to your regular doctor visits to check you and your baby.
  • Take your blood pressure medicine as ordered by your doctor. Take your medicine even if you feel well.
  • Limit salt intake.
  • Exercise almost every day.
  • Get plenty of rest. Lie on your left side to give your baby the most oxygen.
  • Ask for help if you work or have other small children.
  • Reduce stress.

Gestational Hypertension

Your doctor will check your health during pregnancy to watch for gestational hypertension. Gestational hypertension can progress to pre-eclampsia or eclampsia. This can affect the placenta, and the mother's kidneys, liver, and brain.

Signs of Pre-eclampsia

  • Headache
  • Heartburn
  • Blurred vision or seeing spots
  • Difficulty breathing or shortness of breath
  • Pain in the upper right side of the stomach

If you have high blood pressure and seizures, it is called eclampsia.

Treatment for gestational hypertension may include lowering your blood pressure with bed rest or medicines, a hospital stay or delivery of your baby.

Group B Strep (GBS)

GBS is one of many common bacteria that live in the human body without causing harm to healthy people. GBS develops in the intestine from time to time, so sometimes it is present and sometimes it is not. It can be found in the intestine, rectum, and vagina in about 1 in 4 pregnant women. GBS is NOT a sexually transmitted disease, and it does not cause discharge, itching, or other symptoms.

How Does GBS Cause Infection?

At the time of birth, babies are exposed to the GBS bacteria if it is present in the vagina, which can result in pneumonia or a blood infection. Full-term babies who are born to mothers who carry GBS in the vagina at the time of birth have a 1 in 200 chance of getting sick from GBS during the first few days after being born. Occasionally, moms can get a postpartum infection in the uterus also.

How Do You Know if You Have GBS?

Five-three weeks before your due date, during a regular prenatal visit, you or your clinician will collect a sample by touching the outer part of your vagina and just inside the anus with a sterile Q-tip. If GBS grows in the culture that is sent to the lab from that Q-tip sample, your clinician will make a note in your chart and you should be notified so you can share this information when you go into labor. Using the test results box printed on the back of this page will help you keep this record.

How Can Infection from GBS Be Prevented?

If your GBS culture is positive within five weeks before you give birth, your clinician will recommend that you receive antibiotics during labor. GBS is very sensitive to antibiotics and is easily removed from the vagina. A few intravenous doses are given up to 4 hours before birth and almost always prevents your baby from picking up the bacteria during birth. It's important to remember that GBS is typically not harmful to you or your baby before you are in labor.

Do You Have to Wait for Labor to Take Antibiotics?

Although GBS is easy to remove from the vagina, it is not easy to remove from the intestine where it lives normally and without harm to you. Although GBS is not dangerous to you or your baby before birth, if you take antibiotics before you are in labor, GBS will return to the vagina from the intestine, as soon as you stop taking the medication. Therefore, it is best to take penicillin during labor when it can best help you and your baby. The one exception is that, occasionally, GBS can cause a urinary tract infection during pregnancy. If you get a urinary tract infection, it should be treated at the time it is diagnosed, and then you should receive antibiotics again when you are in labor.

How Will We Know if Your Baby Is Infected?

Babies who get sick from infection with GBS almost always do so in the first 24 hours after birth. Symptoms include difficult breathing (including grunting or having poor color), problems maintaining temperature (too cold or too hot), or extreme sleepiness that interferes with nursing.

What Is the Treatment for a Baby with GBS Infection?

If the infection is caught early and your baby is full-term, most babies will completely recover with intravenous antibiotic treatment. Of the babies who get sick, some can have serious complications. Some very seriously ill babies will die. In the large majority of cases if you carry GBS in the vagina at the time of birth and if you are given intravenous antibiotics in labor, the risk of your baby getting sick is 1 in 4,000.

What If You Are Allergic to Penicillin?

Penicillin or a penicillin-type medication is the antibiotic recommended for preventing GBS infection. Women who carry GBS at the time of birth and who are allergic to penicillin can receive different antibiotics during labor. Be sure to tell your clinician if you are allergic to penicillin and what symptoms you had when you got that allergic reaction. If your penicillin allergy is mild, you will be offered one type of antibiotic, and if it is severe, you will be offered a different one.

Exercise, Energy and Sleep

Feeling tired is common, but exercise can help to strengthen muscles during pregnancy and for delivery. To improve your energy:

  • Exercise each day if allowed by your doctor. Talk with your doctor about the type of exercise you are doing.
  • Exercise for at least 30 minutes 4 to 5 days of the week, if you are allowed to exercise. Talk with your doctor before starting a new exercise program.
  • Rest often. Lie down on your left side for at least 1 hour during the day to increase blood flow to your baby. A pillow between your legs and under your abdomen may increase comfort.
  • If you have trouble sleeping, try a warm (not hot) bath or shower before bedtime. You may also want to practice relaxation exercises such as meditation, deep breathing and stretching.

Oral Health

  • Visit a dentist at least 1 time during pregnancy.
  • Tell your dentist if you have gum or teeth problems.
  • Use a soft toothbrush and brush gently. Floss each day.
  • If you have vomiting from nausea, rinse your mouth with 1 cup of water mixed with 1 teaspoon of baking soda. This will get rid of stomach acid in the mouth.
  • Do not use tobacco products.

Headaches and Dizziness

  • For a headache, call your doctor or nurse for over the counter medicines that are safe to take. Do not take aspirin, ibuprofen (Advil or Motrin) or naproxen (Aleve).
  • If you feel dizzy, sit or lie down to avoid falling. Get up slowly after 15 minutes to see if the dizziness has passed.
  • Change positions slowly when you have a headache or feel dizzy.

Call your doctor if your headache or dizziness does not go away or gets worse, or you have blurred vision, eye pain or pressure, or a lot of swelling in your hands or feet.

Nose Stuffiness and Nose Bleeds

  • You may put saline drops or gel into your nose. Talk with your doctor before taking any other over the counter medicines.
  • To stop a nosebleed, sit up, lean your head forward and apply firm pressure with your: fingers to the side of the nose that is bleeding. Get medical care if the bleeding lasts longer than 20 minutes.

Skin, Hair and Nails

  • Your hair and nails may grow faster. If you plan to get your hair treated with chemicals, tell your hairdresser that you are pregnant.
  • Common skin problems include changes in skin color, itchy skin, acne and stretch marks. Topical lotions or ointments may be used for itchy skin or reduce the appearance of stretch marks.
  • Do not use Accutane or Retin-A products when pregnant.

Call your doctor if you have any concerns.

Breasts are tender or leak milk

  • Wear a support bra that fits comfortably, such as a sports bra. Some women also wear a bra without underwire to bed at night.
  • If your breasts leak milk, wear nursing pads in your bra and change them when you feel or think you are damp.

Urinating Often or Urine Leaks

You may have to pass urine more often throughout your pregnancy. Leaking urine is common during the last months of pregnancy. Urine leaks happen with coughing, sneezing, picking up heavy objects or sexual activity during pregnancy.

  • Do not limit liquid or water intake, but drink less before bedtime.
  • Urinate often.
  • Avoid liquids with caffeine.
  • Do Kegel exercises to strengthen and control the muscles around the vagina.
  • To locate these muscles, stop and start your urine when you use the toilet.
  • Try to tighten the muscles a small amount at a time. Then release very slowly.
  • As you tighten the muscles, you should feel the area from your urethra, where urine leaves your body, lift slightly.
  • Practice these exercises while you sit, stand, walk, drive or watch television.
  • Do these exercises 10 times, 5 to 10 times a day.

Call your doctor if you have burning or pain when urinating or have a fever or if you think you may be leaking amniotic fluid and not urine. Lie down for 30 minutes with an absorbent pad. If you feel liquid when standing up, and it is yellow, pink or brown in color, call your doctor.

Vaginal Drainage

A change in vaginal drainage is normal.

  • Bathe the outer vaginal area often. Use soap without perfume. Rinse well.
  • Do not use tampons, vaginal sprays, douches, powders and colored or perfumed toilet paper.
  • Wear cotton underwear. Avoid nylons or pantyhose and tight pants.

Call your doctor if drainage has a bad odor, causes itching or there is blood.

Constipation or Diarrhea

Constipation is very common in pregnancy from changes in body hormones. Diarrhea can be from changes in diet, exercise or prenatal vitamins, or an infection.

Constipation

  • Drink 6 to 8 cups of liquids each day. Choose water, juices and milk.
  • Eat high fiber foods such as raw fruits and vegetables, whole grains, high-fiber bran cereals and cooked dried beans.
  • Do not use laxatives, enemas or over the counter medicines unless your doctor says that it is okay.

Call your doctor if your constipation does not get better in 2 days.

Diarrhea

  • Drink 8 to 12 cups of water, broth, or sports drinks that are low in sugar. Avoid juices and milk that can make diarrhea worse. Avoid caffeine and alcohol.
  • Eat bananas, rice, applesauce, toast, yogurt, non-milk based soups, potatoes, crackers, oatmeal, low sugar and low fiber cereals, and lean protein, such as chicken, turkey, beef, pork, cooked eggs or tofu.

Call your doctor if diarrhea does not get better in 2 days, have pain or cramps that get worse, or are bleeding from the rectum. If you have diarrhea 2 days or more, use an oral rehydration product, such as Pedialyte®.

Hemorrhoids

Hemorrhoids are swollen blood vessels in the rectal area from constipation or pressure of the baby on the body during pregnancy.

  • Eat whole grain and high fiber foods, such as raw fruits and vegetables. Drink more water and fruit juice in moderation to keep your bowel movements regular and soft.
  • Do not strain or push when having a bowel movement.
  • Use cold compresses to relieve pain or swelling.
  • Talk with your doctor about using a topical cream to reduce pain

Call your doctor if your pain increases or if you have bleeding.

Back Pain and Leg Cramps

Most women have back pain as the body changes with your baby's growth. Leg cramps are common during pregnancy.

Back pain

  • When resting or sleeping, use a supportive mattress. Lie on your left side with pillows between the knees, behind the back and under the stomach.
  • Stand up straight. Do not slump or slouch.
  • Wear low heeled, walking shoes.
  • Do not stand in one place for too long. Change body positions every 30 minutes.
  • Squat to pick up objects rather than bending at the waist. Do not bend over at the waist. Bend your knees.

Leg cramps

  • Increase fluid, calcium and potassium intake in your diet. Eat foods such as milk, yogurt, bananas and orange juice.
  • Rest often with your legs up during the day. Place a pillow under knees and ankles when sitting or laying down.
  • During a leg cramp, straighten your leg and bend your foot up toward the front of your leg.

Call your doctor if only one leg is hurting all the time, if there is a hot or red area on the leg, or if the leg hurts when you bend your foot toward the front of your leg.

Varicose Veins

Varicose veins are enlarged veins you may see on your legs. They can itch, be painful or cause tingling in the legs.

  • Avoid nylons or pantyhose with elastic bands.
  • Wear low heeled or athletic shoes. Avoid high heels.
  • If you must stand for long amounts of time, consider wearing support hose to improve blood flow from the legs back to the heart.
  • Take short rest breaks with your legs raised higher than your heart. Lie on your left side with a pillow between your legs and under your abdomen.
  • Do not cross your legs when sitting.

Swelling of Hands and Feet

  • Avoid standing or sitting for long periods of time.
  • Lie on your left side for 30 to 60 minutes, 3 to 4 times each day.
  • Exercise if allowed by your doctor.
  • Avoid foods high in salt.

Call your doctor if you wake up in the morning a few days in a row with swelling in your hands and feet.

Cold, Flu or a Virus

  • Talk with your doctor about getting a vaccine to protect you from the flu. When pregnant, you need the injection (shot) and not the nasal spray.
  • Call your doctor or nurse for over the counter medicines that are safe to take if you get a cold or have the flu.
  • Avoid being around people who are ill. Wash your hands often.

Call your doctor if you have a fever, shortness of breath or are coughing up sputum.

Abdominal Pain or Contractions

You may feel some pain in the groin area as your uterus grows. This pain can get worse with sudden movements or prolonged walking.

  • Call your doctor right away if you have severe pain.
  • Braxton Hicks Contractions are mild contractions that are painless and irregular. These are common and do not need treatment.
  • When you have a contraction, lie on your left side and rest. Place your hands on your abdomen and feel when the contraction begins and ends. Time how long and how often the contractions are corning.
  • If you are less than 9 months pregnant and are having contractions, drink 8 to 10 glasses of water in one hour. If you still have 4 or more contractions in one hour after drinking the water, call your doctor.
  • If you are in your ninth month of pregnancy, call your doctor if your contractions are occurring more than 6 per hour, last longer than 15 to 30 seconds, become painful, or you have vaginal bleeding or leak fluid.
  • Your doctor may tell you to call right away if you have any contractions.

Sexual Activity

It is common to have some changes in your sexual desire during pregnancy.

  • Sexual intercourse is allowed during your pregnancy unless your doctor has told you otherwise. Tell your partner what feels comfortable.
  • Practice safe sex if you or your partner has a sexually transmitted infection.
  • You may feel some cramping for a few minutes after sexual intercourse.

Call your doctor if after sexual intercourse you have vaginal bleeding, leak urine or your water breaks.

Changes in Mood and Memory

It is common to have mood swings from hormones, changes in sleep or eating patterns, or stress during pregnancy.

  • It is normal to have different emotions during pregnancy. You may be excited about the birth of your baby, but worry about how your life will change. Ask your partner, family and friends for emotional support.
  • Manage stress in your life. Deep breathing, meditation, listening to music, exercise, and massage can help to reduce stress.
  • If you have trouble eating and sleeping, this can change how you feel. Talk with your doctor and a dietitian to get help.
  • You may notice that you are more forgetful. Make notes for yourself to help you remember important things. This should improve after the birth of your baby. ·

Call your doctor if you have thoughts of harming yourself or others, or feel you may have depression.

Food Cravings and Aversions

You may crave foods during pregnancy while the smelt or taste of other foods may cause nausea.

  • Eat a variety of healthy foods at meals and for snacks, including fresh fruits and vegetables, whole grains and lean protein. Avoid foods high in sugar, fat or salt and make healthier choices.
  • Take a prenatal vitamin each day.

Talk to your doctor or nurse if you have any questions or concerns.