COMMON AILMENTS DURING PREGNANCY

Dr. Jayeshnee Moodly, Gynaecologist & Obstetrician at Melomed Richards Bay
MBChB, FCOG (SA), MMed (O&G), AHMP (YALE)

COMMON AILMENTS DURING PREGNANCY
Although most women have completely normal and healthy pregnancies, various minor ailments may trouble you during these special nine months. Most are actually more irritating than real cause for concern, and many of the aches and pains can be explained away as a combination of carrying that extra weight, hormonal changes and resulting tiredness.

A few of the more common complaints during pregnancy and what to do about them:

BACKACHE

Progesterone – a hormone that is increased 50 to 60 times during pregnancy – causes softening and stretching of the ligaments that support the lower back and pelvic bone. It also relaxes the ligaments that support the spine, putting extra strain on the muscles and joints of the lower spine, pelvis and hips. The increasing load of the uterus, as well as bad posture, can aggravate the problem of backache. What to do • Try to maintain a good posture and do exercises to strengthen the muscles supporting the spine
• Wear sensible shoes and avoid high heels
• Avoid heavy lifting
• Try to rest on a good, firm mattress
• Massage may relieve some of the discomfort

CONSTIPATION The pregnancy hormone progesterone also relaxes the muscles of the intestine, which results in a slowing down of bowel movements. The bowel contents tend to stagnate and dry out, making the stools hard and difficult to pass.
What to do
• Increase your fluid intake to 2 to 3 litres of water per day
• Include plenty of fibre, fresh fruit and vegetables in your diet
• Regular exercise will help alleviate the problem
• Avoid laxatives
• Iron supplements may worsen constipation

CRAMPS
Cramps in the calf muscle, thigh and feet are common during pregnancy. They are usually caused by low levels of calcium and/or magnesium in the blood or, in rare cases, by lack of salt in the diet.
What to do • Firmly massage the affected area, flexing your feet up-wards
• Eat calcium-rich foods, such as dairy products, fish, almonds, lettuce and broccoli, to name a few
• If cramps persist, your doctor may prescribe a calcium/magnesium supplement

HEARTBURN
In early pregnancy, the muscular valve at the entrance to the stomach relaxes, allowing stomach acid to flow up into the oesophagus, causing a burning sensation. In later pregnancy, the baby may press upon the stomach, forcing the acidic contents back into the oesophagus.
What to do
• Avoid spicy foods and carbonated drinks (low pH means they are highly acidic)
• Avoid too much tea, coffee and smoking, as they all cause acidity
• Have smaller and rather more frequent meals and don’t eat a meal just before going to bed
• Prop yourself up in bed so your head and upper body are slightly elevated
• Drink a warm milk drink at night - it may help
• Use antacids to provide symptomatic relief, but avoid excessive use

HAEMORRHOIDS (PILES)
Piles are varicose veins that occur in the rectum. As your baby grows, the pressure it places on the rectum hinders the blood flow to the heart. This causes blood to pool and the veins to dilate to accommodate the extra blood. Although piles could lead to constipation or painful stools, they are mostly harmless and usually disappear after childbirth.
What to do
• Drink plenty of fluid
• Eat high-fibre food and lots of fruit and vegetables to avoid constipation
• Relieve discomfort by using old compresses or, in more severe cases, a local anaesthetic ointment

INSOMNIA
Sleeplessness is a common complaint during all three trimesters in pregnancy. It is usually caused by a general increase in your metabolism and also simply by the fact that you need to urinate more often and consequently wake up during the night. Also, your growing baby does not recognise night from day and is usually on the go, whatever the hour.
What to do
• Try to rest during the day
• Take a warm bath and a hot milky drink before going to bed
• Avoid heavy meals close to bedtime

MICTURITION
(Frequency in passing urine) Early in pregnancy, hormonal changes stimulate the muscular wall of the bladder and the growing foetus presses on the bladder, resulting in an urge to pass urine more often. Later in pregnancy the weight of the uterus on the bladder reduces its capacity.
What to do
• Not much can be done, except to reduce your liquid intake before going to bed
• In case of pain, burning or blood in the urine, consult your doctor

VARICOSE VEINS
In the last month of pregnancy the baby’s head can press down on the pelvic veins, causing blood to pool in the veins of the legs and resulting in ballooning of these veins. Standing for long periods of time can worsen varicose veins.
What to do
• Avoid standing for long periods of time and try to put your feet up as often as possible
• Avoid crossing your legs while sitting
• Avoid wearing high-heeled shoes
• Wear support tights
• Exercise will improve circulation in the legs and feet

A mother's joy begins when new life is stirring inside ... when a tiny heartbeat is heard for the first time, and a playful kick reminds her that she is no longer alone.
MORNING SICKNESS
The main causes of morning sickness are high levels of hormones, particularly the hormone human chorionic gonadotrophin (HCG), and low blood sugar levels. Despite its name, morning sickness can occur at any time of the day and can vary from mild nausea to vomiting. The worst time, however, seems to be first thing in the morning when your stomach is empty, although nausea can also be triggered by strong smells, certain foods and cigarette smoke. Symptoms usually disappear after the first trimester.
What to do
• Eat several small meals throughout the day instead of three larger ones; have some plain or ginger biscuits first thing in the morning
• Avoid high-fat foods, too many spices and all foods that make you feel ill
• Avoid alcohol and tobacco
• Drink plenty of fluids; teas like ginger, peppermint or camomile may also help
• Try to get a lot of rest, as being overtired will make your nausea worse