Common Concerns During Pregnancy

Many women have an increase in vaginal discharge in pregnancy. This discharge is usually white, cloudy, or clear, and thin. If the discharge has a foul or fishy odor, causes itching or vaginal pain, or seems to be water instead of mucus, then please give us a call.

As your uterus grows, the ligaments that help support it also stretch. The ligaments then might spasm briefly. Sometimes, women get sharp pains down low in the abdomen, just above the pubic bone, or on the sides of the uterus, where the ligaments attach. These pains might increase after being more active, especially after activities involving bending and twisting motions. If the pains are short and go away quickly, this is probably normal. Try a warm bath, sleeping with a pillow between your knees, Tylenol, and avoiding twisting motions while you work (turn your entire body versus just twisting your trunk). If your pain is severe, or does not go away, is rhythmic like contractions (regular pains every 10 minutes or less, lasting for a minute, then relaxing) or cause you worry, give us a call.

Pregnant women often begin to get heartburn in the third trimester when your pregnant belly begins to push upwards on your stomach. This pressure causes some of the acids in your stomach to linger and travel up your esophagus. You then feel a burning sensation in your chest, which can be accompanied by nausea. Preventing heartburn is the best way to deal with it! Some ways to avoid heartburn include eating five to six smaller meals throughout the day rather than three large meals, waiting one hour or more after eating to lie down, and avoiding spicy, greasy, and fatty foods.

If you are experiencing heartburn, there are a few natural things you can do to relieve the symptoms including eating yogurt or drinking a glass of milk or trying a tablespoon of honey in a glass of warm milk, papaya enzymes, or apple cider vinegar. Over-the-counter antacids like Tums may prove helpful in relieving you of heartburn problems. (see the medication section in this booklet)

If your heartburn symptoms are severe, your physician or midwife may prescribe medication for you.

Swelling of the feet and ankles is very common in pregnancy. It is caused by fluid retention, and it usually gets worse late in the day. Drinking enough water, eating adequate protein can help reduce swelling, as can elevating your feet periodically during the day. We also recommend comfortable shoes and full-length support hose.

Note: Rapid onset of swelling in the face and hands can be a sign of complications of pregnancy, if accompanied by a severe headache unrelieved by Tylenol. Please give us a call if these symptoms occur.

Hemorrhoids are a common problem in pregnancy, and many women notice pain, bleeding after bowel movements (BM), and tenderness or irritation at the rectum from this condition. Straining while trying to have a BM can also lead to hemorrhoids. To prevent this, eat a diet high in fiber and stay well hydrated. If you suffer from hemorrhoids, you can use a stool softener daily, if needed. One brand is Colace, which is available over the counter at the pharmacy. You can also buy Tucks pads or witch hazel (make your own compress by soaking a disposable cosmetic pad or small cloth with witch hazel). These can soothe and help shrink hemorrhoids or vulvar varicosities. You can apply ice to the area to help decrease swelling. Some women find that wearing a maternity belt, which lifts the pregnant uterus, can help reduce pelvic varicose veins. This type of garment can be purchased online or at specialty maternity stores. 

The physical and hormonal changes of pregnancy contribute to the quality of a pregnant woman’s sleep. In addition, the thoughts that run through our minds during pregnancy can be never ending, especially when we attempt to sleep at the end of a long day. Each trimester of pregnancy brings its own unique sleep issues. Most sleep problems occur in the third trimester. There is growing discomfort from the baby and the due date is quickly approaching. It is more common for pregnant women to be able to fall asleep initially, but then wake after a few hours and then remain awake until the morning. This causes a great deal of fatigue throughout the daytime hours. Here are some suggestions to help you get to sleep in pregnancy:

• Pillows! Pillows! Use as many supportive pillows as you need to support your tummy and back. Also place a pillow or wedge between your knees for low back support. A full-length body pillow is often popular because it can snake around your entire body in several different ways.
• Eat a light snack before bed. Warm skim milk and turkey contain a natural sleep inducer called L-tryptophan.
• Exercise.  Regular exercise promotes physical and mental health. It can help with sleeping more deeply. Avoid exercising 2-4 hours before bedtime.
• Relaxation techniques. Deep breathing, stretching, massage, yoga, soothing music, or a warm bath helps promote relaxation to ease your mind.
• Take short naps (15-30 minutes) during the day, if possible.
• Practice good sleep hygiene:
• Avoid alcohol, caffeine and nicotine (which you should be doing anyway – you are pregnant)
• Establish a regular bed time and waking time. Do not go to bed when you are wide awake.
• Take your television and computer out of your bedroom.
• Avoid staying awake in your bed for long periods. If you have not fallen asleep or become drowsier within 20 minutes of lying in bed, get out of bed and do activities that make you sleepy, such as reading or a warm bath. Once you feel sleepy, try going to bed again.

Sleep medications should be used as a last resort in pregnancy and avoided in the first trimester. Do not use sleep medications on a regular basis. Unisom and Benadryl can be used for sleep in pregnancy but we caution against using these every night. Avoid melatonin, valerian root, and your prescription sleep medications in pregnancy.