Common Discomforts of Pregnancy

This occurs throughout pregnancy as a result of increased blood flow.

• Brush regularly with a softer toothbrush.
• Floss regularly.
• Extra Vitamin C may be helpful (not more than 500-1000C, and not in the first trimester). During regular dental care, inform your dentist of your pregnancy.
• For nasal stuffiness, drink 1-2 liters of water a day and use a humidifier.

The uterus normally contracts and relaxes from 16 weeks of pregnancy on, but most women who become aware of Braxton-Hicks contractions do so in the final month or 2 of pregnancy. Normally, these contractions are irregular and often painless. These contractions are common and usually more painful in your second or subsequent pregnancy.

• Fatigue or dehydration causes them to become more noticeable and painful. Drink at least one liter of water per day.
• A long, active day may promote more of these contractions. A warm bath or hot water bottle may help.
• Braxton-Hicks contractions will change in frequency or disappear if you hydrate, change positions, take a hot bath, or rest, and are typically irregular in frequency and last longer than 60 seconds.
• Page your midwife: If you are less than 37 weeks pregnant and your contractions are regular or last 60 seconds or less, you may be in labour.

This is often the first sign of pregnancy, due to increasing amounts of estrogen. The nipples darken, stretch marks may occur, small bumps on the areola (Montgomery’s Glands) appear, and colostrum is present from about 16 weeks. In subsequent pregnancies, the breasts are usually less sore than in the first.

• Wear a good-fitting bra, particularly if you have heavy breasts.
• The breasts will feel less tender after the first trimester.
• Nipples do not require “preparation” (ie rubbing with a rough towel, etc.)

Constipation is defined as hard stool that is difficult to pass, regardless of frequency. In early pregnancy, constipation is due to the hormonal changes that occur; in later pregnancy, the bowels have much less space in which to operate.

• Drink at least two liters of water a day.
• Coffee, tea and pop should be avoided.
• Eat whole grains and legumes, raw fruits and vegetables (8-10 servings daily), and lots of fiber.
• Aim to walk a kilometer or more a day.
• RAB (rice, applesauce, bananas) foods are good for diarrhea, but not for constipation.
• Prune juice is helpful with the added benefit of being high in iron.
• A glass of hot water with 1-2 tsp of lemon juice first thing in the morning works well.
• Rest feet on a small footstool during bowel movements. Avoid straining.

Mild swelling of the hands or feet is a common occurrence in pregnancy. It normally worsens in warm weather, or late in the day.

• Elevate your feet when you sit or lie down.
• Lie on your left side.
• Drink extra water.
• Foods that may be helpful include watermelon or cucumber.
• Do NOT take diuretics – your body needs the extra fluids to maintain the pregnancy.
• Page your Midwife: If sudden or significant swelling, especially in the face occurs, this may be a sign of preeclampsia (toxemia)

The demands of a rapidly growing fetus are extremely tiring in early pregnancy. Your baby is growing a central nervous system, internal organs and neurological pathways…the works! Even though your baby is tiny, this is a tremendous amount of work for your body to accomplish. In late pregnancy (about 24-30 weeks), the baby undergoes a major growth spurt and your body is busy increasing your blood supply – all of which is tiring. This period will pass, but some women will also feel tired toward the end of pregnancy due to the added weight of the baby. Your body is working hard to grow this baby – make sure that you and those around you acknowledge this.

• Sleep more – take naps, go to bed earlier, get up later. Listen to your body’s needs.
• Get exercise, as this improves your body’s oxygenation.
• Get help with your work, other children, or demands.
• Eat well and avoid refined sugars and caffeine

Due to the increased use of computers, Carpal tunnel syndrome is becoming more common. Finger tingling/swelling/ numbness may also be due to enlargement of breast tissue high in the underarm area.

• Place your hands on your shoulders and rotate your elbows in a circle.
• Increase B complex vitamins. Vitamin B6 can be taken on an as needed basis.
• Wearing wrist splints at night may help. Drugstores sell cheaper models, but if your pain is pronounced you should be assessed by an occupational therapist or a physician.

This may be due to poor posture, standing too long, or pressure of the baby on the pelvis.

• Do light circular massage in the groin area, giving a slight lift as the hands come upward. Do not use pressure on the down stroke.
• For relief of sudden spasm, pull up the leg on the same side as the spasm (as if tying a shoe) or lie down on the affected side with the leg drawn up.
• If the pain extends from the hip and down the back of the leg, the problem might be sciatica.
• See Back Pain and Round Ligament Pain for more relief ideas.

Heartburn is common in pregnancy due to hormonal changes and the pregnancy pushing the stomach up into a small space.

• Tums, Maalox, and Gaviscon in moderate amounts are fine during pregnancy.
• Avoid greasy and spicy foods and avoid caffeine
• Avoid drinking with your meal (aim to drink 15 minutes before you eat)
• Avoid eating close to bedtime – if you are eating at this time, crackers and bread are good choices
• If severe at night, try sleeping in a semi-sitting position, propped up on pillows (you can try placing a phone book under the head of your mattress)
• “Papaya enzyme” from health food stores might be helpful
• Pineapple, celery, or raw almonds may be helpful

These are a varicosity, or bulging, of the wall of the rectum through the anal sphincter. If you have hemorrhoids going into pregnancy, they will likely worsen. Hemorrhoids are often sore, itch and may bleed with a bowel movement.

• Refer to constipation for helpful dietary advice.
• Spend some time during the day off your feet, or lying on your side with a pillow elevating your hips for 10-15 minutes, to reduce pressure on this area.
• A cloth soaked in Witch Hazel, or Tucks pads (from the drug store), or ice packs can help reduce swelling and discomfort.
• Baking soda, wet or dry, can help reduce the itch.
• Hemorrhoids may only appear after the birth, especially if you had a long pushing stage. Your first bowel movement may take place up to 2-4 days after the birth. Laxatives or suppositories can soften the stool, making the passing of stool easier.
• Topical ointments such as Anusol can help to reduce swelling. Lubricate your finger with the product, try to push the hemorrhoid back in, and then tighten your pelvic floor muscles. Anusol also has a product with a local anesthetic for very painful hemorrhoids.

• Use what normally works for you – relaxation, massage, warm baths, chamomile tea, or hot milk.
• Calms Forte (at the drugstore) is a homeopathic preparation. Take one tablet under the tongue as needed before bed, or upon waking in the night.
• Increase your calcium intake
• Health Canada recommends a daily intake of 1000mg to 2500mg in pregnant or lactating people aged 19 to 50 years old
• If under 19 years of age ask your midwife for your recommended daily calcium intake range
• Consume daily fluids before 6 pm to reduce trips to the toilet. If you are up to void in the night, leave the lights off.
• If insomnia occurs around 24-30 weeks of pregnancy, it may be due to the baby undergoing a growth spurt, and you might require more calories. A snack at night may help.

Pain in the calf of the leg can be due to increased pressure on the blood vessels, reducing the flow of blood to the legs. It can also be due to: overextension of the foot, inadequate calcium/magnesium intake, or excess phosphorus in the diet.

• Helpful Stretching
  • For cramps in the calf: Avoid pointing your toes – flex your toes back toward your shin. This stretch should be gentle and constant. If you can’t reach your foot, stand facing a wall, straighten your leg, place toes on the wall and your heel on the floor. Lean in towards the wall from the hips, keeping your leg straight.
  • For cramp in the front of the thigh: ensure you are well supported standing, grasp ankle in hand on same side, gently pull ankle towards the buttocks until you feel a stretch in the front of the thigh
  • For cramp in the back of the thigh: bend forward in an attempt to touch toes, only bend as far as is comfortable and to achieve a gentle stretch in the back of the thigh
  • Reduce your phosphorus sources (ie bananas) and increase your dietary calcium and magnesium intake.
    • See ‘Insomnia’ above for calcium intake recommendations
    • Magnesium: 120mg of magnesium orally twice a day
• Never deeply massage a cramped muscle – it can cause tenderness that lasts for days.
• Page your Midwife: if an area on your leg is red, sore or inflamed. Phlebitis (an inflamed varicose vein) could be present.

Nausea and vomiting are often most severe in early pregnancy, and can range from mild to severe. Medication is available to treat severe forms of nausea and vomiting. If your nausea is severe, please talk to your midwife.

• Nausea is often worse if your blood sugar is low – try to snack /eat every 2 hours to avoid this.
• Eating protein (ie an egg) first thing in the morning may help.
• Sour foods – green mango, green apple, tamarind, sour candy, can reduce nausea.
• Carbohydrates, such as crackers or bread, are helpful to some.
• Consumption of ginger may be helpful (tea or foods)
• Eating watermelon may help.
• Sea bands (acupressure wrist bands) may be useful – best used intermittently.
• Foods containing Vitamin B6 are helpful, as it decreases nausea
• Page your midwife: If you are unable to keep down fluids for an extended period of time and are becoming increasingly dehydrated

These can include a dark line up the abdomen, the facial “mask” of pregnancy, and darkening of the nipples. These will fade after the birth.

• For the mask of pregnancy, stay out of the sun, or use a strong sunblock, as exposure can make these patches worse
• You may need more B vitamins in your diet

The hormone estrogen can affect the soft cartilage in the middle of the pubic bone, causing discomfort. Delivery of the baby is the “cure” for this discomfort.

• Tylenol may provide some pain relief
  • Taking up to 1g (two extra strength) tylenol is safe in pregnancy
  • Take as needed at least 6h apart
• If the pain increases with movement, then decrease movement.
• Guard the pubic bone by avoiding large movements – take stairs one at a time, keep knees together when getting out of the car, or rolling over in bed.
• You may find it soothing to apply moist heat, or ice.
• A chiropractor, physiotherapist or registered massage therapist may be able to help with additional treatments. Ensure you inform the provider you are pregnant and that they are experienced treating pregnant clients.

A sharp pain on either or both sides of the uterus can occur with standing quickly, sneezing, coughing when urinating, or when turning over in bed. The round ligaments attach at the top of the uterus and end at the vulva. As the uterus grows, these ligaments are forced to stretch, causing momentary cramping. This can also occur postpartum.

• Try not to move quickly.
• Persistent pain may indicate a urinary tract infection, appendicitis, or ectopic pregnancy.
• Page your Midwife: If the pain is accompanied by fever/chills, faintness, nausea/vomiting, bleeding, or unusual vaginal discharge

Pain that travels across the buttock or down the back of the leg is usually due to sciatic nerve irritation. This generally occurs with the loosening of the joints of the pelvis, due to high estrogen levels. Prolonged standing, stooping and lifting, and shoes with poor support will aggravate this condition.

• Wear running shoes or shoes with good support
• Apply ice to the area that hurts. Use a heating pad if ice doesn’t work
• When sitting, put your feet up on a stool to reduce the arch of your back
• Get up from your chair and move around every hour, for about 5 minutes
• See a chiropractor experienced with pregnant clients
• See ‘Back Pain’ for more information

This is known as stress incontinence, due to the weight of your growing baby and weakening pelvic floor muscles. Urine may leak out when you laugh, sneeze, or cough.

• Wear a panty liner to protect your clothes.
• Do Kegels to strengthen your pelvic floor.

Increased vaginal discharge is very normal in pregnancy, but it may be difficult to tell sometimes if you have an infection or not.

• Page your midwife: If you experience itching, burning/redness, a foul odour, or a change in the consistency or colour of the discharge. Your midwife can do a swab to determine the nature of the infection.

Pregnancy can weaken the valves that return blood back to the heart, and these weakened valves then bulge, causing a varicose vein. They occur most commonly in the legs and to a lesser extent in the vulva. If you think you have varicosities, ask your midwife to assess them.

• Page your Midwife: If your varicose veins become red, hot, or very painful at any time in the pregnancy or postpartum.