Common Discomforts and Bodily Changes During Pregnancy
by Diane Voyatzis Norwood, MS, RD, CDE
First Trimester
Pregnancy is an amazing time of growth—both for mother and baby. As a new life is growing within a woman, her body undergoes many changes because of hormones. Every pregnancy is different, but many women find that some bodily changes can be uncomfortable. Fortunately, after the baby arrives, most women find relief from these symptoms. In the meantime, there are ways to decrease some of the discomforts.
The first trimester of pregnancy can be easy for some women. For others, these first 3 months can be the most challenging time of pregnancy because of the following common symptoms:
Tiredness
It is common for many women to feel very tired in the first few months of pregnancy. Try to get at least 8 hours of sleep and take naps if needed.
Breast Tenderness
As breasts change to prepare for breastfeeding, they often become tender within the first 8 weeks of pregnancy. Throughout the pregnancy, the tenderness may come and go, especially as breasts get bigger. Colostrum, an early form of breast milk, may even leak out in the second and/or third trimesters.
What to do about it:
- Wear a supportive bra.
- Avoid using soap on the breasts, as this tends to dry out the skin.
- Wear breast pads if breasts are leaking.
- Use of certain pain relievers, such as acetaminophen. It is important to talk to your doctor before taking any medications to avoid harm you and your baby.
Nausea and Vomiting TOP
Many women have feelings of nausea and vomiting during pregnancy. It usually occurs between 6-16 weeks of pregnancy. Although it is often called morning sickness, women may have these symptoms at any time of the day.
What to do about it:
- Eat small, frequent meals.
- Drink liquids in between meals, not with meals.
- Eat dry crackers before getting out of bed in the morning.
- Avoid smells, foods, or other stimulation that triggers your nausea.
- Stay hydrated. Drink plenty of water.
Constipation and Bloating TOP
Hormones cause the gut to slow down its normal movement, which can cause bloating and constipation. Iron supplements, which are often needed, may make constipation worse.
What to do about it:
- Drink plenty of water and noncaffeinated fluids each day.
- Eat fiber-rich foods, such as fruits, vegetables, and whole grains.
- Remain active.
- Talk to your healthcare provider before taking laxatives.
Frequent Urination TOP
Hormones are to blame for frequent urination in the first trimester. As the pregnancy progresses, a growing uterus puts pressure on the bladder. Therefore, frequent urination is often a discomfort for many women throughout the pregnancy. Kegel exercises help strengthen pelvic floor muscles. This may help with controlling incontinence.
Shortness of Breath TOP
As pregnancy progresses, a large uterus puts pressure on the diaphragm, making it less able to move freely during breathing. This causes some women to feel short of breath.
Pregnancy hormones cause changes that lead to more rapid, shallow breaths. Many women also experience this as a feeling of shortness of breath. This can feel strange, but usually will not endanger your health. However, if you are feeling like you are not getting enough air when you breathe, call your healthcare provider.
Second Trimester TOP
During the second trimester, or months 4-6, many women feel much better than they had in the first trimester. However, some women notice uncomfortable bodily changes in the second trimester, including the following:
Nasal Congestion and/or Nosebleeds
Blood volume increases during pregnancy, which causes membranes in the nose to swell and sometimes bleed.
What to do about it:
- Drink plenty of fluids.
- Use a humidifier to increase moisture in the air.
- Avoid taking medications if possible. Nasal strips that go over the bridge of the nose and saline nasal spray may help.
Bleeding Gums
Gums become sensitive and often bleed during pregnancy due to estrogen. Use a soft toothbrush and gentle toothpaste and floss daily. Continue to receive routine dental care. If you need more extensive dental work, such as a cavity filling or root canal, it may be best to do them during the second trimester. During the third trimester, it may be difficult to lay on your back for an extended period of time. Consider delaying optional dental procedures, such as teeth whitening, until after pregnancy.
Aches, Pains, and Backaches TOP
Weight carried in the abdomen in the later months of pregnancy affects balance and posture, putting strain on the lower back. Hormones also loosen joints and ligaments of the body, which can cause minor pains.
What to do about it:
- Wear low-heeled shoes.
- Place a pillow at the lower part of your back when sitting.
- Take breaks to rest your back.
- Never sit straight up from a back lying position. First roll on your side, then push yourself up.
- Try wearing an abdominal support, which will support your back and abdomen.
Third Trimester TOP
Many women are excited to enter the home stretch of months 7-9. But this is also an uncomfortable time because a large uterus is squeezing all the organs within the abdomen, causing some of the following symptoms:
Stretch Marks, Itching, and Skin Discolorations
The skin of the abdomen may itch as it expands and forms stretch marks, especially if weight is gained quickly. Stretch marks are not preventable. Skin discolorations, such as dark areas on the face or a dark line below the naval, can also appear. This is because hormone levels increase the amount of skin pigment, melatonin. Other skin color changes usually go away soon after the baby is delivered.
What to do about it:
- Gain weight according to your healthcare provider’s recommendations.
- Use lotions to add moisture to dry, itchy areas of skin.
- Avoid exposure to the sun.
Heartburn
Many pregnant women have heartburn in the third trimester. Pregnancy hormones loosen the muscle that closes off the esophagus from the stomach. When this happens, stomach contents can back up into the esophagus, causing the burning sensation known as heartburn. A growing uterus also squeezes the stomach, which contributes to heartburn.
What to do about it:
- Eat small, frequent meals.
- Avoid high-fat foods, spicy foods, and caffeine.
Leg Cramps TOP
Leg cramps usually occur in the calf muscles during the night and are thought to be related to inadequate calcium or magnesium intake. Talk to your healthcare provider about whether you need increased amounts of these nutrients.
Ankle or Leg Swelling TOP
Most pregnant women have some leg swelling due to the extra volume of blood providing circulation to the placenta and baby. The uterus puts pressure on the large blood vessels draining blood from the lower half of the body, which can cause fluid to pool in the legs.
What to do about it:
- Drink plenty of water or noncaffeinated beverages each day.
- Limit sodium from foods.
- Rest with feet up.
- Do not cross your legs.
- Do not wear knee-high or thigh-high nylons with a tight elastic band.
- Lie on your left side when sleeping.
- Bend, stretch, and rotate your feet several times per day. You can do this while standing or sitting up. The light exercises will help circulate blood.
Varicose Veins and Hemorrhoids TOP
Varicose veins on the legs and hemorrhoids often occur during pregnancy also due to increased blood volume and uterine pressure on the large blood vessels draining blood from the lower half of the body.
What to do about it:
- Prevent constipation. Eat a high-fiber diet fruits, vegetables, whole grains.
- Avoid straining during bowel movements.
- Use a sitz bath after bowel movements to soothe hemorrhoids.
- Drink plenty of fluids without caffeine.
- Avoid prolonged periods of standing or sitting.
- Remain active.
- Ask your doctor about using compression stockings.
Difficulty Sleeping TOP
Some women have trouble getting comfortable when sleeping in the last few months of pregnancy. In addition, it may be hard to relax when you are worried about the baby, childbirth, and being a mother.
What to do about it:
- Take a warm shower before bedtime to relax.
- Avoid caffeine.
- Avoid exercise late in the day.
- Try to get comfortable with pillows.
Most discomforts associated with pregnancy are not permanent. The good news is once the baby arrives, these discomforts are typically forgotten.
RESOURCES:
Office on Women's Health
https://www.womenshealth.gov
The American Congress of Obstetricians and Gynecologists
http://www.acog.org
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca
Women's Health Matters
http://www.womenshealthmatters.ca
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Last reviewed April 2017 by Michael Woods, MD, FAAP
Last Updated: 4/18/2017