Baby and You

Easing the discomfort

pregnant woman scratching an itching stomach from stretching skin
Every woman hopes for a smooth pregnancy, but there is no predicting who will have a ‘good pregnancy’ and who a bad one. Lianne Kolirin outlines some minor and more serious ailments and how to treat and avoid them

While the likelihood is nine months will pass without incident, there are some ailments – from the irksome to the more serious – that could occur.

Janet Fyle, midwife advisor at the Royal College of Midwives, says: “Many women will experience a normal pregnancy, however a tiny percentage might have some minor ailments, while others might experience more serious conditions. Most of these conditions pass once the baby is born.”

She adds: “Whatever it is, be it morning sickness or itchy arms, always feel free to talk to your midwife.”

Here Baby & You outlines some common complaints, but the message from the health professionals is clear – if in doubt, check it out.

BLEEDING GUMS

Hormonal changes can make women vulnerable to plaque, which can lead to inflammation and bleeding gums. Dental care is free during pregnancy and for a year after delivery to help maintain good oral hygiene. Brush and floss regularly to remove plaque. Sugary drinks are best avoided, as are sugary snacks between meals. If you are vomiting, wash your mouth out with water and wait an hour before brushing teeth to prevent damage from your stomach acid.

CARPAL TUNNEL SYNDROME

Up to half of women may experience carpal tunnel syndrome during pregnancy. This occurs when one of the main nerves becomes compressed by fluid retention as it passes from the arm into the hand at the ‘carpal tunnel’ in the wrist. Symptoms, which tend to be worse at night, include numbness in the hands and tingling and pain in the thumb and fingers. Paracetamol may relieve the symptoms, as will a wrist splint. Your doctor or midwife might recommend physiotherapy. Carpal tunnel syndrome is reversible once pregnancy is completed.

CONSTIPATION

Once again, those changing hormones are to blame. The best way to treat constipation is by trying to avoid it. It is important to maintain a high fibre diet, including wholemeal grains, fruit and vegetables and pulses, washed down with plenty of water. Regular exercise should also help. Iron supplements, taken for anaemia, can cause constipation so speak to your doctor about natural alternatives.

CRAMP

Cramp is often experienced in the legs and feet and commonly at night. It is a sudden sharp pain brought on by an involuntary spasm. The best way to avoid cramp is with regular gentle exercise and stretches, particularly in the ankles and legs. Rotate your feet in both directions several times daily and bend and stretch your feet up and down. You can ease an attack by rubbing hard on the muscle or pulling your toes firmly up towards you and rotating your foot.

GESTATIONAL DIABETES

Specific to pregnancy, gestational diabetes occurs when there is excess sugar in the blood. If undetected, it can increase the risk of complications. It most commonly occurs in the latter half of pregnancy, but generally disappears after your baby’s birth, although it is often a warning sign that you will develop diabetes later in life. Many women control diabetes with diet and exercise, though some require medication or insulin injections. Women who develop gestational diabetes will require a growth scan and will receive specialist clinic monitoring. You may also need to have your baby born earlier than expected. Your midwife will test for gestational diabetes with a glucose tolerance test if you’re high-risk (you are from a particular ethnic group, have close relatives with the condition or you are obese).

NOSEBLEEDS

Hormonal changes in pregnancy can trigger nosebleeds. They can be alarming, especially at night, but there is generally nothing to worry about. The best way to stop a nosebleed is to sit down and firmly pinch just above your nostrils. Lean forward and breathe through your mouth, maintaining this upright position for 10 minutes. You may want to use an icepack and avoid strenuous activity and blowing your nose for at least 12 hours. Seek medical advice if bleeding persists.

HAEMORRHOIDS (PILES)

Haemorrhoids are large and swollen veins in the anus area that can feel itchy or painful. You may also experience some bleeding and it can become uncomfortable or even painful. Symptoms usually disappear after childbirth, but there are some things you can do to ease the discomfort. Constipation can cause or aggravate piles, so eat plenty of fibre to avoid them. Exercise regularly and avoid standing for long periods. If painful, soothe with a cold, wet cloth. If the pain persists, speak to your midwife about available ointments.

Vaginal bleeding

If you experience vaginal bleeding in pregnancy, discuss this with your midwife, GP or obstetric team as soon as possible. If the bleeding is heavy, make sure you attend the hospital for a review. Bleeding may be triggered by having sex or an infection, and if ongoing, or severe, it’s important to get checked. Important causes of bleeding in pregnancy can also include a low-lying placenta (placenta praevia) or placental abruption, where bleeding occurs from the placenta. There’s little evidence to show lifestyle changes can prevent bleeding in pregnancy, but smoking and drug misuse are known to trigger unprovoked bleeding in pregnancy.

HEARTBURN AND INDIGESTION

Indigestion is caused partly by the pressure exerted by your growing womb on your stomach, leaving you feeling full and sick. Heartburn is usually experienced as a strong burning pain in the chest as stomach acid passes into the oesophagus. If symptoms are mild, your midwife may recommend simple diet and lifestyle changes. Often women are advised to eat little and often and to sit up straight when eating. A glass of milk at night may also relieve symptoms. Cut down on caffeine, as well as rich, spicy and fatty foods. Your midwife may recommend an antacid.

IRON DEFICIENCY AND ANAEMIA

Many women are iron deficient during pregnancy. This is because you use a large supply of iron to develop the baby’s blood supply. Boosting your diet with iron-rich foods such as beans, nuts, dried fruit like apricots, fortified cereals and dark leafy vegetables can help prevent anaemia. If you become anaemic you will be prescribed with iron supplements, though some herbal preparations can be good. Vitamin C aids the absorption of iron, so wash it down with some orange juice. Speak to your midwife for details.

ITCHING AND OBSTETRIC CHOLESTASIS (OC)

The increased blood supply to the skin can cause itchiness, which can be aggravated as it stretches. Opt for loose clothing in breathable materials that are less likely to cause irritation. Moisturisers and lotions may also help. Severe itching can be a sign of OC, which occurs when bile salts don’t flow properly from liver to gut. Usually experienced in the last trimester, the irritation can be worse at night and more severe on hands and feet. Jaundice, dark urine and pale stools are also signs. The potentially serious condition can run in families and is more common in women of Indian or Pakistani origin. Research shows some women with OC are more likely to deliver prematurely or stillborn so women will be advised to have regular check-ups and may be induced early.

PELVIC GIRDLE PAIN (PGP)

Sufferers experience pain in the pubic area, but the hips, groin, lower abdomen, buttocks, lower back and inner thighs can also be affected because of the pregnancy hormone relaxin which opens the pelvis up for childbirth. Bad posture and the baby’s weight can aggravate symptoms, which are particularly noticeable during motions that separate the legs, like getting in and out of the car and walking up stairs. To minimise discomfort, wear flat shoes, avoid weight-bearing activities and sit up straight. PGP may also may be alleviated by wearing a girdle in the middle stage of pregnancy (i.e. second trimester).

NAUSEA AND VOMITING

Despite the name, morning sickness can strike at any time. Although you may not feel like it, eating something is likely to help. Try eating little and often, avoiding fatty foods and perhaps having something dry like toast in the morning. Some women find sucking mints or ice chips and drinking ginger tea can help. Be sure to speak to your midwife if symptoms are more severe, as this could be an indicator of the more serious Hyperemesis gravidarum, which can lead to weight loss and dehydration. Keeping well hydrated by drinking plenty of water is important in cases of hyperemesis.

PRE-ECLAMPSIA

Potentially very serious, pre-eclampsia can prove fatal to a small percentage of women and babies. Contact your doctor immediately if you experience any of the following: sudden swelling of hands, feet and face; severe headache; vomiting; severe pain below the ribs; disturbed vision. Risk factors for pre-eclampsia include: age, high blood pressure, family history, being overweight and pre-existing conditions like diabetes and kidney problems. Those at risk may be prescribed aspirin and regular growth scans may be required. Sufferers will be closely monitored, may require medication and may be induced early to prevent more serious symptoms developing.

SWOLLEN FEET, ANKLES AND FINGERS

Water retention means feet, ankles and fingers can swell during pregnancy. This is often worse after a long day standing up. In most instances it is not dangerous, but can cause discomfort. Try and minimise swelling by wearing comfortable shoes, regularly putting your feet up and avoiding long periods of standing. Rotate your feet in both directions several times daily and repeatedly point and flex your feet. Dramatic swelling can indicate pre-eclampsia, so see your midwife or GP if this occurs.

VARICOSE VEINS

Most commonly found in the legs, these are veins that have swelled because of the extra blood in your body. They may be unsightly and itch or ache, but are generally not harmful. To ease the discomfort and lessen the severity, avoid long periods of standing, sitting cross-legged and putting on excessive weight. Sit with your legs up when you can and prop your legs on pillows at night. Rotate and stretch your feet regularly. Exercise will help your circulation, as should wearing support tights.

Varicose veins can increase the risk factor of a deep vein thrombosis (DVT) or pulmonary embolism (PE), therefore contact your doctor immediately if pain develops. Further information is available from RCOG’s patient information leaflets Reducing the risk of venous thrombosis in pregnancy and after birth at: www.rcog.org.uk/en/patients/patient-leaflets/reducing-the-risk-of-venous-thrombosis-in-pregnancy-and-after-birth and Air Travel and Pregnancy at www.rcog.org.uk/en/patients/patient-leaflets/air-travel-pregnancy

TOXOPLASMOSIS

Toxoplasmosis can be very serious as it potentially leads to birth defects, miscarriage or stillbirth. There are often no symptoms, but it may present like mild flu. However, the risk of developing toxoplasmosis in pregnancy is very low and there are clear guidelines on how to prevent it. Experts recommend you avoid raw and under-cooked meat, stick to pasteurised milk products, do not change cat litter and wear gloves when gardening. If you are infected, your doctor will prescribe antibiotics.

About the Author
Lianne Kolirin is a freelance journalist who writes for the Daily Express and the Mail on Sunday. Lianne has three sons, who have given her plenty of inspiration for parenting articles. She also blogs about family-friendly events for www.visitlondon.com and is the editor of the What’s On section for Baby London.

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