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The Fibromyalgic Pregnancy and Beyond - Common Changes During Pregnancy

Common Changes During Pregnancy

Pregnancy is a miraculous time of constant change for you and your baby. During the second and third trimester of your pregnancy you will continue to experience physical and emotional changes. Some symptoms are natural while others may be warning signs of complications.

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 colour. Halfway through your pregnancy, your breasts may start to secrete fluid (colostrum) in small amounts. 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. For most women, if you are planning to breastfeed your infant, no special nipple preparation is required. It is recommended that you keep your nipples dry and wash with warm water - 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 by drinking less fluid. Your baby needs you to drink at least one and half litres of liquids a day. You may find it more comfortable to have a readily accessible restroom during the first three months of your pregnancy and when you are nearing birth, when the baby suddenly pressing on your bladder may mean you need a toilet… FAST!

 Nausea

Some women suffer with “morning sickness" and some women are never nauseated. “Morning sickness” isn’t necessarily confined to the morning hours. For some women it is an all-day problem and for some very unlucky women, it doesn’t pass until after their baby is born. Happily, for most women, the nausea has passed by four months of pregnancy. Try eating smaller meals of simple and somewhat bland foods, avoiding spicy and highly acidic foods, and rest in a semi reclined position immediately after eating for just a few minutes.

If your nausea is more severe than this, try eating a dry cracker (rye is very nourishing) just before getting up in the morning. Sometimes a little bland food in the stomach will help you digest a breakfast later. You need to eat well to grow a healthy baby. Medication is usually reserved for those who have significant vomiting or dehydration. Take your antenatal vitamins or iron during the day when nausea is less of a problem and always try to take iron with a piece of fruit or small glass of fruit juice as the vitamin C helps you to absorb the iron more efficiently.

 “Morning” sickness survival tips:

  • Ginger fizzy (with the fizz stirred out) and crackers are a traditional remedy. Ginger fizzy with a stronger “bite” seems to work better. Drinking lemonade (or smelling a lemon) may help settle your stomach if ginger fizzy does not work. If you are too nauseated to stomach anything then you can sprinkle a few drops of ginger essential oil on a flannel and inhale the vapours until the nausea eases and then try to drink something.
  • If crackers do not work or get boring, try potato chips. They are a good source of potassium but be aware of their high salt content.
  • Quench your thirst and settle your stomach with anything you are craving. You need the fluids and nutrients.
  • Try to drink 10 cups of fluid a day to avoid dehydration. A cup of ice chips or a cup of watermelon cubes counts for about a half cup of fluid.
  • Make a running list of odours which trigger nausea and post it on your refrigerator to alert others. You may want to get help with tasks like grocery shopping or changing diapers, if you have young children.
  • Summer heat, humidity and stale air seem to aggravate morning sickness. Try to stay in a cool room whenever possible.
  • During winter months if you are chilly, put on layers instead of turning up the heat. An overly warm house will make you lose fluids through perspiration.

 Excessive salivation

This condition 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 and frequent small meals and dry cracker snacks can be helpful.

 Heartburn

Heartburn is another common complaint of pregnant women although 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 alright to use antacid preparations such as Gaviscon but do not use baking soda or sodium bicarbonate preparations for your heartburn. Before you buy an over-the-counter remedy, ask your midwife, GP or pharmacist which product is recommended. In severe cases of heartburn, you might want to elevate the head of your bed to encourage your stomach fluids to stay put! (Ask your partner to add 4" of books or bricks beneath the head posts to elevate the head of the bed).  You can reassure your partner that this will not affect their restful sleep, it looks high but it isn’t noticeable once you are lying down.

 Constipation

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 to help your body process food more efficiently. Try all the natural remedies first including extra water, dried and fresh fruit and lots of vegetables, including the addition of bran and bran products to your diet.  If none of these work, ask your GP to prescribe a very mild laxative or stool softener. Don’t be shy about discussing this problem it is a by-product of your pregnancy.

 Uncomfortable breathing

This may be a problem once the baby is large enough to interfere with your breathing muscles. It can sometimes be caused by things other than your growing baby, such as low iron levels so you may need to ask your midwife to test your blood.  First try slowing down your movements and practice deep breaths from the chest. If you still have trouble breathing, or if you have any chest pain, contact your local maternity hospital.

 Backache

You may experience backaches due to the added weight gain from your pregnancy, 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 will help too, but exercise will probably relieve your backache more than anything else. Strong muscles can take more stress before they become strained. Develop a routine of back exercises every day from the beginning of your pregnancy. Your midwife or GP will be happy to advise you.

 Sciatica

Toward the end of the pregnancy, some women feel that the baby is pushing on a nerve in their back, which is often called sciatica. This pain can be concentrated in your back or shoot down one or both legs making walking more difficult. To try and relieve this pressure you can get on your hands and knees and let the baby’s weight fall toward the floor. You can also try getting on your knees and resting your forearms on the floor or sitting straddled on a chair so your arms rest on the back.  Use this position when you are watching telly or reading to encourage your baby into the optimum position for late pregnancy and delivery. This will relieve the pressure on your back as the baby shifts, and may give you a lot of backache relief. A warm bath, hot or cold compresses (hot water bottle, wheat bag or bag of frozen vegetables) sometimes work too.

 Insomnia

Early in your pregnancy, you may be very sleepy and feel as if you are sleeping all the time ...then at the end of your pregnancy; you’ll wish those days were back again! Most often trouble with sleeping comes from the difficulty of finding a comfortable sleeping position. For example, if you’ve always slept on your stomach, you won’t be able to do so by the middle of your pregnancy!

 However even the simple act of turning over at night, later on in your pregnancy can become a task of monumental proportions as it may take you several separate motions to do what used to be one fluid movement.  Most annoying, I agree, but it is all because your hips are loosening up in preparation for allowing your baby to pass through during birth. 

 Shortness-of-breath or heartburn may aggravate this situation, so prop yourself or your bed head up at night. Also, an active foetus can help keep you awake, and you are much more aware of your baby’s movements at night as you have time to concentrate on them.  To keep your baby and yourself, as calm as possible at night; don’t drink caffeinated beverages in the evening after supper. Try a soothing herbal tea such as camomile and honey after your 3rd month of pregnancy, before this very few herbs are safe so avoid drinking or eating herbs without advice from a qualified practitioner.

 Exercising a few hours before you go to bed may help you rest easier...or a warm bath may do the same thing. Unfortunately nothing except giving birth will make turning over in the night easier. It is important not to take alcohol or sleeping pills to try to solve your insomnia...there are safer solutions, just ask your midwife or GP for more advice.

 Skin changes

Many women get very upset about changes in the colour of their skin, but these changes are common. Your skin may simply look “flushed,” like you are blushing or 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 this will fade or disappear entirely after birth. Acne crops up to plague some, or acne may actually be improved during pregnancy in others. Changing hormone levels are responsible for these skin colour changes, but they usually all go away or fade dramatically after your 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, honest, and you have probably noticed that I can’t recommend exercise enough!

 Try not to stand without moving for long periods of time. When you sit, try to prop your legs up to make return circulation easier and paddle your feet back and forth and swirl them round from time to time. 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. Rest periodically with your legs up. Short walks at different times during the day will help move your blood around your body faster.

 Support tights help tremendously, but avoid all tight clothing such as knee highs that will only cut off circulation more. The vulval 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 although I wouldn’t advise this at the same time as propping yourself up on pillows, unless you want to know what it feels like to fold yourself in half!

 Haemorrhoids

Ever heard the facetious saying “Pregnancy is very glamorous”?  Read on to find out more of potential “delights” (albeit usually only temporary), in store for some of you.  Many women suffer with haemorrhoids, or get haemorrhoids for the first time while they are pregnant, but this doesn’t necessarily have to happen to you.

 Haemorrhoids 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 can also be caused by the straining due to constipation. Keep your fluid intake up to help avoid this. 

If you do suffer with haemorrhoids, try lying on your side with your hips elevated on a pillow. Soaking in a warm tub can help, too. You can use over-the-counter ointments such as witch hazel moistened wipes. 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. If you suspect your haemorrhoids are bleeding, call your GP or midwife.

Prevention is the word here! Eat correctly and add fruits, raw vegetables, bran products and lots of water to your diet every single day. See the section on diet for more information.

 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 and helps to keep harmful bacteria at safe levels. Mucus secretion is different from leaking of amniotic fluid. All this is quite normal and there really isn’t much that can be done to change the situation. Of course, excessive discharges that have a bad odour should be evaluated by your GP.

 Many women seem to get yeast or other vaginal infections while they are pregnant that need treatment (have I mentioned how glamorous pregnancy is?)  but they are not harmful to the baby. A simple safe treatment for yeast infections during pregnancy is plain active yogurt. Spread it on the itchy area and enjoy the soothing relief.  Use this treatment as often as you need, in conjunction with wearing cotton underwear and loose clothing for at least three days; if you are not completely better then see your GP.   If you experience discharge that is watery or comes in gushes, put a sanitary pad on and call your local maternity hospital.

 Abdominal pain / round ligament pain

Especially during the latter half of pregnancy, when the uterus and your baby are growing larger, you may experience lower abdominal discomfort. One source is round ligament pain. Round ligaments are cord-like structures that originate beneath the groin region and extend to the top of the uterus on both sides.

 Round ligament pain is described as sharp pain in either or both groin regions and is caused by stretching and spasms of the round ligaments. Sudden movements like rolling over in bed or walking may aggravate round ligament pain. Reduced physical activity, application of warm heat or use of a pregnancy support strap may help. Constipation can also cause abdominal pain. If abdominal pain is severe or continues, please call your local maternity hospital. There can be other more serious causes which are discussed in the complication in pregnancy section.

 Cravings

It’s 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, wash it well, and eat it raw or cooked. On the other hand, if you feel like eating hot chilli or a half dozen of your favourite candy bars...that’s another issue! A desire to eat strange foods or non-food items might mean a nutritional deficiency that needs correcting.

 Pica

This is the medical term for the unusual cravings for non-food items such as clay, ice or laundry detergent that you might have while you are pregnant. No one knows quite why this happens, but some women experience it, and it can be harmful. Please contact your midwife or GP if you experience this.

 Dizzy spells

Some pregnant women 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, resting and sleeping on your left side is the recommended position. Don’t change positions suddenly. When you are lying down, ease yourself up to a standing position in stages. This will give your body time to adjust to the new position. 

 The reason why you faint is because if your brain suddenly looses a lot of its blood supply; the fastest way it can equalise the blood supply is by throwing you to the floor so your body is horizontal!  This means less effort for your brain to get the blood back up to it. All quite simple and perhaps less scary, when you understand why but still dangerous if you faint and hit your head.

 Swelling

Not infrequently, later on 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 may be improved by salt restriction during pregnancy and the natural fluid loss that occurs after delivery. A hand splint may also be helpful and your GP or physiotherapist will recommend this if needed.

 Swelling

Again, pressure from the growing uterus and your changing hormones can cause swelling, especially in your legs and hands. Some of this is blockage of drainage pathways in your upper legs caused by the pressure of the baby and some is caused by water retention. Support tights and resting with your legs elevated should help a little. If your feet, ankles or legs are swollen and not relieved by a night in bed (make sure you ask your midwife to check your blood pressure if the swelling is new or has come on suddenly) then ask your partner to place 2 or 3 bricks or books under each foot post to elevate the foot of the bed. Be sure to avoid excessive salt intake, which will only make you retain more water. Notify your midwife, GP or obstetrician if swelling increases dramatically or occurs in your face or around your eyes as this may be an indication of rising blood pressure.

 Stretch marks

Stretch marks show up usually on breasts, the buttocks and lower abdomen, but they might also occur in other places. 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 and rapid 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 change to a pale white within a year or two after pregnancy, and so become less noticeable.

 Nose bleeds

Some women have frequent nose bleeds during pregnancy caused by extra blood supply in the nasal lining. Just treat with finger pressure on the side of the nose which is bleeding. Call if the bleeding is heavy and you are unable to stop with nasal pressure. Nasal congestion is also a common complaint. Avoid nose drops unless prescribed by your GP or obstetrician.

 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 although you can use peppermint oil sticks on your forehead or area when the pain is most concentrated although take care to avoid your eyes. These headaches are caused by blood circulation changes and will usually stop after the first half of your pregnancy. If you notice the headaches are associated with sensitivity to light, excessive nausea or vomiting, fever, or blurred or sparkling vision, call your local maternity hospital.

 Braxton-Hicks contractions

The uterine muscle contracts spontaneously from early pregnancy until the onset of real labour. Usually the contractions are irregular and painless (Braxton-Hicks contractions) and may produce “false” labour if they become painful. If they progressively become closer together, last longer and become more painful, notify your midwife or local maternity hospital so they can make certain you are not in premature or early labour.

 Emotional changes

Many pregnant women may feel downright joyous one minute then break into tears the next. These up and down mood swings are part of the hormonal changes going on in your body.  The impending changes in your life can be quite overwhelming. When any woman gets pregnant, she worries about the health of the baby, the pain of labour, about the future and how she will adjust to being a mother, about a hundred different issues, all surrounded by the addition of a baby into her life. Please talk to your midwife or GP if you find yourself becoming increasingly anxious or distressed as there is help that can be offered. 

What to do about mood swings

Most of these anxieties can be eliminated by asking questions or just talking about your worries. Expect these mood shifts, and don’t think something is drastically wrong when they occur. No matter how much a woman wants a baby, she still may feel inadequate once she becomes pregnant. The key to working through depression and anxiety is to talk about your feelings. You should communicate your feelings, even if you think they are too embarrassing.

 Try not to worry and concentrate on living your life one day at a time. When you feel anxious, pamper yourself with a warm, relaxing bath or whatever else you like to do that relaxes you. Make a point of getting out of the house every day, even if only for a short walk. Reach out to others when you need a comforting word. You will be surprised how many people will tell you they have felt the same at some point in their lives, anxiety and depression is not uncommon. If you still feel depressed, be sure to talk it over with your midwife or GP before it has a chance to affect your overall health.

 Sexual changes

With your mood shifts come other emotional changes, too, including your feelings about sex. Desire for sex may rise or fall significantly during pregnancy. If you lose interest in sex, don’t worry. It happens to a lot of women and doesn’t usually last long. You may find that your partner’s sex drive falls dramatically due to his concerns over possibly hurting the baby or being too intimately close to the baby.  Reassure him that normal sexual intercourse during a healthy pregnancy will cause no harm to the baby. Be sure to discuss your feelings and have your partner read this booklet.   Remember, pregnancy is a natural process and a woman’s body is designed to cope with it and still function as normal in the majority of cases.  

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