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Expect Some Changes
Of course, you can expect to gain weight, but expect some
other changes too, both physical and mental...right from the start!
Let’s go over the physical changes first.
Weight Gain
Your mother may tell you that HER doctor
said to gain only 10 lbs., but times have changed…we know more about
fetal needs and development now and you should try to gain about 25 to 35
lbs. during pregnancy if you were average
weight before pregnancy. This weight gain seems to best nurture you and
your growing baby.
Mothers who are underweight before
pregnancy may gain 28-40 pounds. Women carrying twins may gain as much
as 45 pounds. Mothers who are very overweight should limit their weight
gain to 15-25 pounds. Fifteen pounds should be a minimum weight gain for
any pregnant woman.
Don’t panic! So many women have problems
keeping their weight down without being pregnant, that the thought of
gaining 25 lbs. seems horrible. But you will lose most of the gain when
the baby is born, or right afterward.
Keep a weight chart and weigh yourself
weekly. We’ll be weighing you at every appointment, but you should also
keep track of your weight.
If you are simply ravenous, and start to
gain weight quickly...talk to us. We can suggest some foods that you can
eat a lot of and still not gain those pounds that will make labor
difficult. Refer to the Diet Section for a
complete outline of suggestions.
Breasts
Right from the beginning, your breasts may be larger,
firmer and more tender than usual. The areola, the dark area around the
nipples, may get larger and grow darker in color. Halfway through your
pregnancy, your breasts may start to secrete fluid (colostrum) in small
amounts. Be sure to keep them clean with frequent washings, and toward
the end of your pregnancy, you may want to put gauze pads inside your
bra to protect your clothes. The veins right under your skin may become
more noticeable, too. This is caused by an increased blood supply
preparing your breasts for milk production. If you are planning to
breastfeed your infant, no special nipple preparations are required. It
is recommended that you keep your nipples dry and wash with warm water
with no soap.
Urination
When your uterus expands, it
puts pressure on your bladder. The need to urinate is common in the
first stages of pregnancy, and in the last weeks. Don’t try to control
this issue by drinking less fluids. Your baby needs for you to drink at
least two quarts of liquids a day. Just plan to stay near a restroom for
the first three months and near delivery.
Nausea
Some women suffer with “morning sickness”
and some women are rarely, if ever, nauseated. “Morning sickness” isn’t
necessarily confined to the morning hours. Try eating smaller meals of simple
foods, avoiding spicy and highly acidic foods, and lie down immediately after eating for just a few minutes. If
your nausea is more severe than this, try eating a dry saltine cracker just before getting
up in the morning. Sometimes a little bland food in the stomach will
help you keep down a breakfast later. Few women suffer with nausea after
the fourth month, but if it is unusually severe, call us. You need to keep some food down to grow a
healthy baby. Medication is usually reserved for those who have
significant vomiting or dehydration. Take your prenatal vitamins or iron
during the day when nausea is not a problem.
Excessive Salivation
This condition is frequently confused with vomiting in
pregnancy. It is caused by excessive secretion of the salivary glands in
the mouth and is quite annoying and difficult to treat. It tends to
diminish in the latter half of pregnancy. Mints, chewing gum, frequent
small meals and cracker snacks can be helpful.
Heartburn
Heartburn is another common complaint of pregnant women. It isn’t your
heart that is burning, it’s your stomach! This is common indigestion,
but
it
can still be an aggravation. It is all right to use an antacid
preparation, but do not use baking soda or sodium bicarbonate
preparations for your heartburn.
Before you buy
an over-the-counter remedy, ask us which we recommend. In severe cases
of heartburn, you might want to elevate the head of your bed to
encourage your stomach fluids to stay put! (Add 4” of books beneath the
headposts to elevate the head of the bed temporarily.)
Constipation
As we mentioned earlier, you need to drink
lots of fluids while you are pregnant. This is one way to avoid
constipation, a common complaint of pregnant women. Exercise every day
and eat plenty of fruits and raw vegetables. Try all the natural
remedies first, including the addition of bran and bran products to your
diet. If these don’t work, let us prescribe a very
mild laxative or stool softener. Don’t be shy about discussing this
problem because it
is a common problem during pregnancy.
Shortness of Breath
This should only be a problem (if indeed it is a problem for you at all) during the
last month or two when the baby is large enough to interfere with your
breathing muscles. Slow down your movements and practice deep breaths
from the chest. If you have trouble sleeping due to shortness of breath,
prop yourself up on pillows.
Backache
With all that weight hanging out in front,
no wonder your back aches! But that isn’t the only reason your back may
hurt. As your womb grows, your pelvic bone joints relax, which can also
cause pain in your lower back. Comfortable shoes may help a little, good posture may
help, too, but exercise will probably relieve your backache more than
anything else. Strong muscles can take more stress without hurting.
Develop a routine of back exercises every day from the
beginning of your pregnancy. There are many good books available about
exercising and pregnancy.
Toward the end of the pregnancy, some women feel that the
baby is pushing on a nerve in their back...or that the baby has positioned
itself so that pain is radiating in their back. Get on your hands and
knees and let the baby’s weight fall toward the floor. This will relieve
the pressure on your back as the baby shifts, and may give you a lot of
backache relief.
Insomnia
Early in your pregnancy, you may be very
sleepy and sleep all the time...then at the end of your pregnancy,
you’ll wish those days were back again. Usually, trouble with sleeping
comes from the difficulty of finding a comfortable sleeping position. If
you’ve always slept on your stomach, after a while you’re going to have
a few problems! Exercising a few hours before you go to bed, or taking a warm bath, may
help you rest easier. It is important not to take alcohol or sleeping
pills to try to solve this problem... let’s work together to find a safer
way. Shortness of breath or heartburn may aggravate this situation, so
prop yourself up at night. Also, an active fetus can help keep you
awake, so don’t drink caffeinated beverages after dinner.
Skin Changes
Many women get very upset about changes in
the color of their skin, but these changes are common. Your skin may
simply look “flushed,” like you are blushing. Or if you have especially
pale skin, you may develop brownish markings on your face. Some women
get a dark line down the middle of their abdomen, where the skin darkens
considerably from the navel to the pubic hair. Acne crops up to plague
some, or acne may actually be helped by pregnancy in others. Changing
hormone levels probably cause all of these skin color changes, but one
thing is certain, they usually all go away or fade dramatically after
the baby is born.
Varicose Veins
Varicose veins, ‘varicosities,” are caused
when the veins in your legs get weak and enlarge with blood. They have
to work harder to carry blood back up your legs to your heart. Sometimes
pregnancy can aggravate this problem. The swelling uterus partially cuts
off circulation from your legs. Exercise will help. Don’t stand for
long periods of time without moving. When you sit, try to prop your
legs up to make return circulation easier.
Varicose veins are more of a problem for
women having their second or third child. But even if you are having
your first baby, try to do as much as you can to aid instead of hinder
the circulation in your legs. Veins that simply look bad this pregnancy
could be throbbing with pain next pregnancy if you don’t try to help the
situation now. Rest periodically with your legs up.
Short walks at different times during the
day will help pump your blood faster. Support pantyhose help
tremendously, but avoid all tight clothing like round garters or knee
highs that will only cut off circulation more.
The
vulvar area can also suffer from varicosities during pregnancy. Again,
rest periods spread out during your day will help. This time, place a
pillow under your buttocks to elevate your hips and aid circulation.
Hemorrhoids
Many
women suffer with hemorrhoids, or get hemorrhoids for the first time
while they are pregnant, but this doesn’t necessarily have to happen to
you. Hemorrhoids are enlarged veins right at the opening of the rectum.
Though they are sometimes due to the blockage of circulation caused by
the increased size of the baby you are carrying, they are also
frequently caused by the straining due to constipation.
If you do suffer with
hemorrhoids, try lying on your side with your hips elevated on a pillow.
Soaking in a warm tub can help, too. But before you use any
over-the-counter ointments and remedies, be sure to ask us if they are
safe for your baby. The medication in ointments is frequently absorbed
through the skin and may affect your baby’s system. If you suspect your
hemorrhoids are bleeding, call us. Prevention is the word here!
Eat correctly and add fruits, raw vegetables, bran products and lots
of water to your diet every day.
Vaginal Discharge
You may notice more vaginal discharge
during your pregnancy. This Mucus secretion occurs from the cervix in
response to the hormones of pregnancy. All
this is quite normal and there really isn’t much that can be done to
change the situation. Of course, excessive discharges that itch or have
a bad odor, should be evaluated. Many women seem to get yeast or other
vaginal infections that need treatment while they are pregnant, but
these are not harmful to the baby.
Abdominal Pain
During the latter half of pregnancy, you
may suffer with lower abdominal pain. This pain can come on one or both
sides of the lower abdomen, and it is usually caused by the stretching
of ligaments that support the uterus (round ligament pain). This
may occur early in pregnancy and feels like “menstrual cramps.”
Constipation can also cause abdominal pain. Resting with a heating pad
may help, and you might want to try a maternity support girdle. If abdominal pain is severe and continues,
please call
us! There can be other more serious causes.
Pica
This is the medical term for the unusual
cravings for strange foods that you might have while pregnant. We don’t
quite know why this happens, but many women experience it.
It is important to keep eating your balanced diet, no matter what your
cravings are. If you feel like eating a pot of spinach at 2 o’ clock in
the morning, go ahead. But if you feel like eating hot chili or a half
dozen of your favorite candy bars... that’s another issue! A desire to
eat strange foods might mean a nutritional deficiency.
Dizzy Spells
During the early months of pregnancy, you
may feel like you are the star of an old Class B movie, if you get faint
and light-headed all of a sudden. Some pregnant women really do faint.
This is caused by the circulation changes happening in your body and
usually goes away by the second half of pregnancy. Lying on your back
toward the end of pregnancy may also cause dizziness; so, lying on your
left side is recommended. Don’t change positions suddenly. When you are
lying down, ease yourself up to a standing position in stages. If you
pass out on the floor, you could injure yourself!
Arthritis
Not infrequently, later in
pregnancy, swelling can occur in the joints and cause pain that feels
like arthritis. This is especially seen with women who develop leg
swelling during the day and notice stiff, sore finger joints the
following morning after resting overnight.
A similar situation occurs in Carpal
Tunnel Syndrome where a nerve that supplies sensation to the hands
becomes entrapped in a tunnel of tissue because of swelling. The
involved nerve produces numbness in one or both hands more frequently at
night. Both conditions are improved by bed rest and salt restriction
during pregnancy and the natural fluid loss that occurs after delivery.
A hand splint may also be helpful.
Swelling
Again, pressure from the growing uterus and your changing hormones can
cause swelling, especially in your legs. Some of this is blockage of
drainage pathways and some is caused by water retention. Support
pantyhose and resting with your legs elevated will help a little. Be
sure to avoid excessive salt intake, which will only make you retain
more water.
Stretch Marks
Oh, those discolored zigzagging lines that no
woman wants to see on her body.., they can be expected right along with
pregnancy, and there really isn’t anything that can be done about them.
Stretch marks may show up on breasts, buttocks and the lower abdomen.
They can also appear on other areas of the body as well.
Moisturizing creams probably won’t do much
to help because stretch marks are caused by the breakdown of elastic
tissue right below the skin’s surface. Excessive weight gain will make
matters worse, so keeping your weight gain under control will do more to
avoid stretch marks than any single thing you can do. The good news is
that stretch marks usually pale and become less noticeable after
pregnancy.
Nose Bleeds
Some women have frequent nose bleeds
during pregnancy caused by extra blood supply in the nasal lining. Treat
with finger pressure on the side of the nose that is bleeding. Call if
the bleeding is heavy and you are unable to stop with pressure. Nasal
congestion is also common. Avoid nose drops unless discussed with us.
Round Ligament Pain
You may experience sharp pain in either or both groin regions from
stretching and spasms of the round ligaments. These cordlike structures
originate beneath the groin regions and extend to the top of the uterus
on both sides. Round ligament pain may be aggravated by sudden movements
like rolling over in bed or walking. Reducing physical activity and the
application of warm heat can help.
Headaches
Headaches are one of the most common complaints along with nausea in the
first few months of pregnancy. Most headache remedies are not helpful.
These headaches arc caused by blood circulation changes and will usually
quit after the first half of the pregnancy. If you notice the headaches
are associated with sensitivity to light, excessive nausea or vomiting,
fever, or other neurological signs, call our office.
Contractions
The uterine muscle contracts spontaneously
from early pregnancy until the onset of real labor. Usually the
contractions are irregular and painless (Braxton-Hicks contractions) and
may produce “false” labor if they become painful. If they become
progressively closer together, last longer and become more painful,
notify us so we can make certain you are not in early labor.
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