Minor ailments in pregnancy

Being pregnant should be one of the happiest times of your life with all the expectations and dreams for the future. However, there are a number of some symptoms of pregnancy that, although not serious, can make some of this time quite uncomfortable.

Here are a few of the more common – morning sickness, constipation, heartburn, backache, pain in pelvic joints, itching, stretch marks, bleeding gums and swelling - with some suggestions for coping which we hope you find useful.

1. Morning sickness

Morning sickness affects up to 70 per cent of pregnant women. Despite its name, it can occur at any time of the day and can vary from mild nausea to vomiting. You might go off certain foods because the smell makes you feel queasy. The exact cause of morning sickness is unknown, but it is thought to be hormonal in nature. The good news is that the symptoms tend to disappear after the first three months.

Some suggestions to ease morning sickness are:
• Rise slowly in the morning
• Try a dry biscuit and a drink of water, before getting up
• Small frequent meals
• Avoid fried, fatty or spicy foods
• Try glucose drinks or boiled sweets

If your symptoms are severe, contact your midwife or GP, as you may need fluid replacement to prevent you becoming dehydrated.

2. Constipation

You may become constipated at any stage of pregnancy, making going to the toilet (opening your bowels and passing stools) more difficult and uncomfortable. To help prevent constipation:
• Include plenty of fibre in your diet (wholemeal breads, wholegrain cereals, fruit and vegetables, and pulses such as beans and lentils)
• Exercise regularly to keep your muscles toned
• Drink plenty of water
• Avoid iron pills if they give you constipation. (Ask a member of the maternity team if you can manage without them or change to a different type. If not, you may have to find ways of living with the constipation.)

3. Heartburn

Pregnancy hormones have a relaxing effect on the muscle at the end of your food pipe (oesophagus). This can allow acid from your stomach to pass back up into your oesophagus, causing heartburn.

• Try eating smaller meals more often
• Avoid particular foods which cause trouble, for example fried or highly spiced ones
• Avoid eating or drinking for a few hours before you go to bed
• Ask your midwife or doctor for advice
• Don’t take antacid remedies before checking that they are safe in pregnancy.

4. Backache

During pregnancy, ligaments become softer and stretch to prepare you for labour. This can put a strain on the joints of your lower back and pelvis, which can cause backache.  To try and prevent backache:
• Avoid heavy lifting
• Bend your knees and keep your back straight when lifting or picking up something from the floor
• If you do have to carry something heavy, hold it close to your body
• Move your feet when turning round to avoid twisting your spine
• Wear flat shoes as these allow your weight to be evenly distributed
• Work at a surface high enough to prevent you stooping
• If you are carrying shopping baskets, try to balance the weight between two
• Sit with your back straight and well supported. 

A firm mattress can help to prevent and relieve backache. If it's too soft, a piece of hardboard underneath the mattress will make it firmer. 

Massage can also help, or you might like to try a support belt, which your midwife can provide. Make sure you get enough rest, particularly later in pregnancy.

If your backache is very painful, ask your midwife to refer you to a physiotherapist.

5. Pain in pelvic joints

If during or after your pregnancy you have pain in your pelvic joints when walking, climbing stairs, turning in bed etc, you should ask a member of the maternity team for a referral to the physiotherapist.
You may have a slight misalignment of your pelvic joints (at either the back or front) that is known as pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD). This affects up to one in four pregnant women and is usually treatable by gentle mobilisation techniques that are safe in pregnancy.

Early diagnosis and appropriate treatment will help minimise the pain and avoid long-term discomfort.

6. Itching

Mild itching is common in pregnancy because of the increased blood supply to the skin. In late pregnancy the skin of the abdomen is stretched and this may also cause itchiness. Wearing loose clothing may help. Itching can, however, be a sign of a more serious problem called obstetric cholestasis.

If itching becomes severe, or you develop jaundice (yellowing of the whites of the eyes and skin), see your doctor. Itching that's associated with a rash may also need treatment if it is severe.

7.  Stretch marks

During pregnancy your skin stretches as your baby grows and for most women this causes stretch marks. To start with, they appear as red lines, usually on your tummy, hips and thighs. After your baby is born they will tend to fade and become silvery in colour. There are many creams and lotions available that claim to prevent and reduce the appearance of stretch marks, but it's not known whether any particular ingredients bring special benefits.

8. Bleeding gums

Pregnancy hormones make your gums much more likely to bleed. It's important that you keep your teeth and gums healthy - make sure you clean your teeth twice a day and use dental floss and mouthwash if you need to. NHS dental care is free during pregnancy and for one year after, so you should make an appointment to see your dentist.

9. Swelling (oedema)

Oedema, or swelling, is a common problem which affects the vast majority of pregnant women. Circulation is slowed down due to the extra blood required to supply the growing fetus (baby). Because of this the blood can pool, causing swelling in the ankles, feet and hands. Oedema is often worse in hot weather, or when standing for long periods of time.  The midwife will ask at your antenatal appointments if you have oedema. Although it is normal, along with other symptoms it can sometimes be associated with pre-eclampsia, which needs special treatment.

To resolve swelling:

• Try to keep your feet elevated. It often helps to put pillows under your feet when you are in bed.
• Likewise, you could try putting your bed on a subtle tilt
• Gentle but firm massage up the leg can help to relieve discomfort
• Support tights can help - and your midwife can provide these
• Drink plenty, as keeping well hydrated helps your body to retain less water
• Take regular light exercise to help increase circulation
• Avoid high-heeled shoes
• Eat a varied diet and avoid salty foods.