Changes in Pregnancy

Physical Changes and Ways to Cope

Pregnancy is an amazing time of change. Your changing hormones cause the physical changes you see and feel throughout your pregnancy.

Some of these hormones include:

Growing a baby is hard work! Almost everyone feels uncomfortable at some point.

Some of the most common discomforts, their causes, and ways to relieve them are listed in the following chart. Most of these changes go away after birth.

Back Pain

Back Pain

• Stress on your back results from the softening of the joints and ligaments of your spine and pelvis and the increased weight of
  your growing uterus
• Muscles work harder as centre of gravity shifts
• Increase in breast size pulls shoulders down
•  

What can help?

• Maintain good posture
• Use a cushion for back support
• Wear low heeled (not flat) shoes with good arch support and a comfortable bra
• Use good body mechanics; bend your knees instead of bending over at the waist. Lift with your legs instead of your back
• Avoid heavy lifting
• Limit standing for long periods of time
• Sleep on your side using a pillow between your legs, under your belly and behind your back
• Stay active; add yoga and/or core and stretching exercises
• Try pelvic rocking to relieve tension
• Promote circulation and relaxation; take a warm
  bath, use a heating pad, get a massage
• Consider a maternity support belt
• See a physiotherapist or massage therapist

Breast Changes

(feel tender and more full, tingling sensations, areola darkens, nipples enlarge and leak colostrum )

• Estrogen, progesterone and prolactin hormones increase the blood supply to the breasts, develop milk ducts and cause the skin to change

What can help?

• Wear a good-quality support bra or a sports bra without wires
• Try wearing a bra at night
• Wear breast pads if leaking colostrum; change pads when they are wet

Constipation

• High levels of progesterone
• Pressure from your growing baby
• Iron supplements

What can help?

• Drink more water
• Eat whole grain foods, fruits, vegetables and legumes to get more fibre
• Try prune juice when taking prenatal vitamins with iron   
• Exercise regularly; try walking 30 minutes daily

Contractions: Braxton Hicks

• Pregnancy hormones trigger the uterus to start practicing for labour
• Dehydration and increased activity of baby or mom, sexual intercourse or a full bladder may be triggers

What can help?

• Change your position; if sitting, stand up (and vice versa)
• Drink a glass of water, have a snack
• Practice relaxation exercises such as slow deep breathing, visualization (imagine the contraction is an ocean wave or count as if going up and down a hill) or try mindfulness exercises
• Enjoy a warm bath 

Dizziness/Feeling Faint

• Progesterone causes blood vessels to relax thereby lowering blood pressure
• Low iron and low blood sugar Stand up slowly

What can help?

• Avoid standing for long periods of time
• Exercise regularly
• Don’t skip meals; enjoy small nutritious snacks and foods rich in iron
• Sit down, place head between knees, add a cool cloth to neck or forehead

Fatigue/Hard Time Sleeping

• Progesterone can make you feel more sleepy
• Metabolism increases so you use more energy
• Lots on your mind

What can help?

• Listen to your body, pace yourself
• Rest during the day, take short naps and go to bed earlier
• Ask for help with household chores, avoid taking on extra responsibilities
• Go to bed and wake up at the same time
• Avoid caffeinated tea, coffee and chocolate and a heavy meal before bedtime
• Put screens/devices away well before bedtime, create a cool environment and wind down with a relaxing activity
• Get comfy in bed, lie on your side and  experiment with lots of pillows
• Sleep until you feel well rested
• Deal with problems and concerns before bedtime or make a list for the next day
• Exercise regularly; avoid within four hours of bedtime
• Eat well, drink plenty of water, but not too close to bedtime

Groin or Lower Belly Pain

• The round ligaments which hold the uterus in place stretch as the uterus  grows causing brief, sharp pain

What can help?

• Avoid sudden movements such as stretching and reaching
• Keep your stomach muscles (core) strong
• Bend at the hips to avoid pulling on the ligament
• Sit down and rest; bring your knees toward your chest or lie on your side using pillows under your belly and between your knees
• Try a maternity belt or an abdominal support garment
• Apply warmth with a heating pad or by taking a warm bath 

Gums that are Red, Swollen and that Bleed

• Progesterone makes it easier for bacteria to grow and for the gums to be more sensitive to plaque.  This increases the risk for gum disease

What can help?

• Brush and floss teeth at least 2x/day using a soft toothbrush and fluoride toothpaste
• Avoid soft, sweet, sticky snacks
• After vomiting, rinse your mouth with water or a fluoride mouthwash
• See your dental professional regularly

Hand Pain and Numbness (morning or night)

• Extra fluid in the tissues puts pressure on nerves and blood vessels

What can help?

• Avoid lying on hands and arms when asleep
• Change or avoid activities that may be causing symptoms; take breaks from repetitive tasks
• Do hand exercises and shoulder circles

Headaches

• Hormone changes, an increase in blood volume, stress/tension, fatigue, hunger, dehydration, an increase in breast size can all cause headaches

What can help?

• Practice good posture
• Try tension-reducing (shoulder circles) and relaxation exercises
• Take a warm bath
• Have your neck and back massaged
• Take naps and rest throughout the day
• Eat small meals often and drink lots of water
• Lie down in a cool, dark room with a cool cloth on your head

Heartburn

• Digestion slows
• Valves that keeps food in the stomach relax due to progesterone
• The amount of space in your abdomen decreases, and pressure on the stomach from the growing uterus pushes its acidic contents up

What can help?

• Eat small frequent meals vs. 3 large ones
• Avoid food that may trigger symptoms e.g., coffee, chocolate, citrus, fatty, fried and spicy foods
• Drink fluids between meals
• Try chewing sugarless gum
• Wear loose clothing
• Avoid lying down right after a meal
• Sleep propped up or elevate head of bed 10-15 cm

Hemorrhoids

• Increased blood volume, pressure from the growing uterus and straining from constipation cause blood vessels in the rectal area to enlarge

What can help?

• Prevent constipation and practice Kegel exercises
• Don’t sit for long periods of time or strain when on the toilet, put feet up on a stool
• Keep the area clean, try unscented wipes
• Alternating cold and heat, apply ice wrapped in a cloth to the area, then soak in warm water 15-20 mins. several times a day
• Lie on your side
• Ask your health care provider about hemorrhoid creams or suppositories

Leg Cramps

• Cause is not known but may be due to less calcium and more phosphorus in the blood

What can help?

• Check that you’re getting enough calcium
• Stretch your legs and exercise regularly
• During a cramp, straighten your leg and point your toes towards your head or heel walk then apply heat (take a bath) or massage the area

Nasal Stuffiness

• Estrogen causes more mucous

What can help?

• Add moisture by using a humidifier or vaporizer, salt water nose drops (1/4 tsp salt in 1 cup water) and applying warm moist towels to your face
• Avoid smoke and antihistamines

Nausea and Vomiting

• Cause is not known but is thought to be due to pregnancy hormones, the size of the placenta and other factors Avoid strong odour triggers

What can help?

• Eat small meals or snacks every one to two hours during the day
• Try a few dry crackers 15 minutes before rising or a few salty potato chips before a meal
• Sniff lemons and ginger or enjoy them in a hot water drink
• Sip fluids frequently to prevent dehydration
• Take a nap and rest more often
• Try acupressure (Sea Bands: acupressure on P6 near wrist), pharmacy-grade ginger (250 mg four times a day) or mindfulness meditation
• Switch iron containing vitamins for folic acid or vitamins low in iron for a short time
•  

Peeing Frequently

• The growing uterus puts pressure on your bladder, kidneys produce more urine Drink less in the evening, but drink lots in the daytime

What can help?

• Go to the bathroom every time you feel the urge to pee; empty your bladder well
• Practice Kegel exercises
• See a pelvic floor physiotherapist if you are leaking urine and not making it to the bathroom in time

Shortness of Breath

• Progesterone early on may cause you to breathe more deeply. Later on, the diaphragm is pushed up by the growing uterus so the lungs have less room to expand when you breathe in Listen to your body; adjust your level of activity and slow down or stop

What can help?

• Breathe slowly and deeply through your mouth
• Maintain good posture; lift your chest and shoulders back
• Wear loose-fitting clothing
• Be physically active
• Prop your head up on pillows when you lay down so you are semi-sitting

Skin Changes

(dry and itchy skin, darkening of the skin on face, line on your abdomen, and stretch marks)

• Hormones cause the blood vessels in the skin to change, increase blood flow and change how elastic and pigmented the skin is

What can help?

• For dry itchy skin use glycerin type soap, take an oatmeal bath and moisturize well
• Avoid hot baths
• Eat a healthy diet and drinks lots of fluids
• Limit sun exposure; be sun safe by covering up and using sunscreen
• Don’t be swayed by products that promise to prevent stretch marks. They don’t work!

Swollen Ankles, Feet and Fingers (mild)

• Caused by hormone changes and increase in body weight
• Amount of blood in body increases by 40% Elevate your legs often above the level of your heart and try not to cross them

What can help?

• Get up and move every half hour
• Avoid standing for long periods of time
• Use a foot stool when sitting
• Wear comfortable shoes and loose fitting clothing
• Exercise to promote circulation. Try support stockings

Varicose Veins or Throbbing Legs

• Pressure and weight of the baby slows the flow of blood from the legs back to the heart
• Blood pools and the veins swell where there are weak areas
• Can be hereditary!

What can help?

• Follow the tips for swollen ankles
• Change your position often; alternate between sitting and standing/walking
• When sitting do ankle and foot exercises
• Sleep on your left side to promote circulation
• Gain weight within the recommended guidelines
• Prevent constipation

!Warning Signs
Be sure to discuss any unusual changes or concerns with your health care provider.

Talk to a health care provider right away if you have:

• Unusual or ongoing headaches.
• Changes in eyesight or “seeing spots”.
• Sudden swelling of the face or hands.
• Pain in the upper right of your abdomen.
• Vaginal bleeding or leaking of fluid.
• Any noticeable decrease in your baby’s normal movement. See info on: kick counts
• Nausea and vomiting that is ongoing.
• Fever (temperature above 38.3° C or 101° F).
• Burning sensation when urinating.
• Unexplained rash.
• Pain in your lower leg (calf).
• Feeling overwhelmed, anxious, or sad.
• Lower pain back, regular contractions, or rectal pressure/a feeling that baby is pushing down.
• If you have been in a motor vehicle accident of any kind, have had a fall, or any injury to your stomach area.