Every woman is different and each pregnancy differs from one to another. Some mothers get most symptoms, find pregnancy quite uncomfortable while others experience less discomforts and “bloom” throughout their pregnancy. Neither circumstance is an indication of the outcome of pregnancy. “The nitty gritty” symptoms to expect are a normal part of pregnancy and are described below plus a guide to relief of symptoms where possible:
50–60% of women suffer from this ailment in the early months of pregnancy. As a rule, it begins around the sixth week and eases off soon after the twelfth week. However, it can start even before the first period is missed and in rare cases may persist throughout pregnancy. Generally, it does not have any serious effect upon health; however it is an extremely unpleasant symptom for the expectant mother.
The severity and type of symptoms tend to vary from one woman to another and although it generally occurs in the morning, it may also occur at other times of the day. Some women suffer from nausea while others suffer from both nausea and vomiting. Once the symptoms ease off, the woman often feels quite well and can have her breakfast and other meals throughout the day.
In rarer cases, nausea may persist with occasional bouts of vomiting throughout the day, relieved only on retiring to bed at night. These symptoms usually call for medical surveillance should the condition drift unnoticed into a definite pathological case of excessive vomiting (Hyperemesis gravidarum ) which in almost all cases requires hospitalisation.
Relief of Morning Sickness
On first waking and if possible before getting out of bed, try eating a piece of dry toast or a couple of plain biscuits with a cup of light tea. Fruit is a good alternative to toast/biscuits. Rest for a while before rising and dress slowly. Adjust your schedule a little and plan to wake slightly earlier so you can work gradually throughout the morning so you won’t have to rush around.
Feeling weak, irritable and tired is common, therefore rest during the day is essential and if working outside the home use meal breaks sensibly, resting in an easy chair with your feet up. If this regime brings little or no relief, consult your doctor.
Appetite is usually poor and “a little of what you fancy” may help to relieve some of the unpleasantness associated with this ailment. Bland foods are usually more agreeable during morning sickness i.e. mild foods predominantly carbohydrates – bread, biscuits, jam, jelly, custard, ice-cream, yoghurt, potatoes, rice and pasta. Some fruits – bananas, oranges and pears may also be easily tolerated and sucking hard sweets or fruit gums may help.
At least three pints of fluid should be taken daily – weak tea, fruit juice, milk or milk and water. Milk has an easing effect on the stomach especially low-fat milk which is as nourishing as whole milk. Natural spring water may also help to relieve troublesome symptoms. Resume a well-balanced diet when the symptoms subside. If the condition persists for longer than usual, advice on nutrition from a dietician or doctor may be necessary.
The breasts begin to prepare almost at once for their function of lactation. (producing milk). The breasts become tender with a prickling or tingling sensation around the third or fourth week of pregnancy. The breasts enlarge slightly and the superficial veins on both the chest and the breasts are more visible. The nipples gradually become larger and more projectile, and become darker in colour due to pigmentation. The areola (area around the nipple) also darkens and what appear to be “pale raised spots” scatter over the areola.
These are sebaceous glands which play a large part in the production of milk following childbirth. In the fourth month, a few drops of thin oily fluid may be expressed from the breast by hand or may be seen as a dry scaly substance on the nipples. This is “colostrum” or early milk.
A good support maternity bra should be worn from early pregnancy as breasts have virtually no muscle to support their weight. A good bra also helps to prevent over-stretching of the skin (striae), undue sagging and helps to relieve breast tenderness. A lightweight bra may be worn while sleeping and can be useful after delivery as a night bra if breastfeeding. A small amount of milk may leak during late pregnancy and again when you start feeding; breast-pads placed inside your bra will absorb this.
Heartburn feels like a bout of acute indigestion or a burning sensation in the area of the sternum bone or mid chest and is unimportant in itself. It usually occurs about the seventh month and persists throughout the remainder of pregnancy.
Relief is somewhat similar to the treatment of mild morning sickness. Milk is an ant- acid and may be more beneficial than for the latter. Small meals eaten frequently are easier to digest, omitting fried, fatty, spicy foods, citrus fruits and very cold liquids. Smoking, alcohol, strong caffeinated drinks – tea, coffee, chocolate, cocoa and cola should be avoided as these tend to increase irritation of the oesophagus and stomach and aggravate heartburn.
Simple antacids can relieve heartburn. However some of these may be contraindicated in pregnancy, therefore it is best to check with your doctor or if buying across the counter; let the pharmacist know that you are pregnant. Relief may be obtained at night, by sleeping well propped up on extra pillows. Some women may wish to use Shiatsu or homeopathic remedies to relieve heartburn.
Because of the vast increase in the demand for calcium during pregnancy, the teeth are more prone to decay, or if already in bad shape, will deteriorate rapidly. Some women develop gingivitis (swelling of the gums). If the gums bleed use a soft toothbrush. Gingivitis is not harmful and consists of proper care of the teeth and good mouth hygiene Regular dental check-ups are advisable during pregnancy.
This condition is very common particularly in late pregnancy and in those already prone or where morning sickness upsets normal habits. Treatment – the simplest and safest way to prevent/relieve constipation is to develop good eating habits in early pregnancy, including lots of roughage in the daily diet. Drink lots of water and take regular exercise appropriate to the stage of pregnancy. Iron supplements may aggravate the problem and may need to be changed to an alternative. Aim for a daily bowel movement if possible.
Medicinal measures should not be taken except on your doctor’s advice, as the effect of these may increase the risk of miscarriage or premature birth.
Caution – If previously in the habit of taking a laxative, you should check with your doctor if this is safe to continue during pregnancy. Some may opt for the use of Shiatsu or abdominal massage for the treatment of constipation.
Stretch marks or “striae gravidarum” may develop on the breasts, abdomen, thighs and buttocks. This is due to tension of the skin, to accommodate the increased stretching required during pregnancy and appears as pink or bluish lines or streaks. These gradually fade in colour after the birth, remaining as white or silvery scars. Striae may be absent, even after the birth of several children in women with extra collagen (a natural protein component of skin) which makes skin more “elastic.”
Development of striae can be greatly reduced by regular massage of these areas with olive oil or anti-stretch mark creams available from pharmacists. Massage should begin at about the fourth month. Undue stretching of the tummy region is also reduced by good posture.
During early pregnancy the bladder becomes slightly displaced by the growing womb. As the womb requires more space it tends to physically compress the bladder creating a sensation to empty. As the pregnancy advances and the womb progresses to grow upwards the pressure is reduced and the frequency eases. However frequency reappears close to full term as the baby’s presenting part (normally the head) enters the pelvis causing upward pressure on the bladder. At this stage the output of urine is also increased.
Drinking less fluid especially towards evening may reduce sleep being disturbed by frequent trips to the toilet.
Clearly, all women are more emotionally vulnerable during pregnancy. Women with a nervous or highly strung nature may develop a surge of emotional and psychological feelings of moodiness, depression, tiredness, cravings and such like, during early pregnancy. Those with social problems e.g. an unplanned pregnancy, financial or domestic difficulties, tend be less tolerant of pregnancy. Physical symptoms such as morning sickness and nausea add to their problems and many women find early pregnancy a trying and difficult time. Many become anxious about certain symptoms particularly that of mood swings and depression and may be embarrassed to discuss their feelings, lest it wrongly reflects their desire or ability for motherhood. These feelings are very normal and occur to many women regardless of their circumstances.
From about the fourth month onwards, the body and mind usually adjust to most of the changes and most women feel well, often indeed, better than usual and the majority of women have a happy and fulfilling pregnancy. The support of a loving partner, family and friends is invaluable and where this is absent a woman may find pregnancy a greater burden. Inform the doctor/midwife of any special difficulties. Trained social workers can help and advise on social problems.
Article by Nancy Murphy, Midwife & Antenatal Teacher author of Preparing for Pregnancy, Birth and Motherhood published by Austin Macauley (2017). A comprehensive guide to a mother’s care in pregnancy, preparation for feeding baby, being ready for labour, your postnatal care and early days of parenting plus much more.