Sweet Relief:

Cures for Common Pregnancy Complaints

The list of growing pains associated with pregnancy is endless, starting with exhaustion and morning sickness, and ending with varicose veins and hemorrhoids. The good news is that many women sail through pregnancy without so much as a hint of nausea or even a stretch mark. But others might get it all: swollen ankles, heartburn, and a tummy that looks like a street map of Seattle. In either case, forewarned is forearmed.

Though pregnancy does bring physical challenges, it also affords you the opportunity to step back and evaluate your habits. Health lessons that are learned during pregnancy can have a positive impact throughout your life.

Pregnancy is a time for loving self-care--massage, sleeping in, yoga, new pillows, good food, and long, warm baths. Growing a baby takes a lot of physical and emotional

energy. When you're pregnant, good nutrition, rest, gentle exercise, and time for contemplation are necessities, not luxuries.

The following list of common

pregnancy discomforts includes tried-and-true suggestions for finding relief. Be sure to discuss your discomforts with your health care provider.

Morning sickness. Belying its name, this nauseating feeling can strike anytime, day or night. Eat small, easy-to-digest, high-carbohydrate snacks every two to three hours so that your stomach is never completely empty. Keep crackers beside your bed so you can eat immediately upon waking. Drinking herbal teas-especially peppermint, ginger, or chamomile- can help, and acupressure wristbands might offer relief.

Breast soreness. Increased levels of the hormone estrogen cause breast and nipple tenderness, one of the earliest signs of pregnancy, which generally lasts for three months. Your breasts also increase in size and might start leaking colostrum, the precursor to breast milk. The nipples will darken, stretch marks can appear, and the dark skin around the nipple might develop bumps known as Montgomery's Glands. All of these signs are normal and signal that you should look for a larger bra with good support, which will decrease discomfort. In addition, hot compresses before breastfeeding, and cold compresses after, may help reduce the pain and inflammation associated with engorgement.

Exhaustion. Early in pregnancy, many women feel like sleeping most of the time. Even though you have not started to show, hormones can produce an overwhelming feeling of fatigue or even exhaustion. Fortunately, this feeling disappears around month four, when your normal energy level returns. Though you will slow down in the last two months because of the size and weight of the baby, the need for sleep is most noticeable in those first three months.

Leg cramps. Leg cramps or restless, "twitchy" legs can make it hard to sleep well. Consuming 1,000 mg to 1,500 mg of calcium a day, and a potassium rich snack such as a banana or a glass of orange juice before bed, should help keep cramps at bay. You can also try this gentle stretch before bed: Facing the wall, place both feet about 12 inches away from the wall. Place the palms of your hands against the wall and, keeping your heels flat, move one foot back until you can feel the stretch in your calf. Hold for a count of 10 and then switch legs.

Varicose veins. As your pregnancy progresses, you might have problems with swollen veins in your legs, rectum (hemorrhoids), or vulva (this is rare). Periodic elevation of your legs, especially as the baby gets bigger, can reduce the occurrence of varicose veins. Sitting with crossed legs and spending too much time on your feet can worsen the condition. Wearing full-length compression stockings can decrease discomfort.

Gentle pelvic rocks (getting on your hands and knees and rounding your back) will offer some relief from swelling in the rectum or the vulva. Should you get hemorrhoids, witch-hazel compresses can offer immediate comfort. Swelling in the area of your vulva should be discussed with your healthcare provider.

Constipation. Pregnancy causes digestion to slow, which allows your body to glean every bit of nutritional value from your food. Your digestive tract also has to rearrange itself in order to accommodate a full-size baby. An unpleasant side effect of these natural changes is constipation. Drinking at least eight large glasses of water daily, and eating plenty of fresh or dried fruits, raw vegetables, and whole grains will help prevent the problem. Regular walking is very helpful too. Avoid laxatives and enemas.

Braxton Hicks contractions. In a normal pregnancy, from 16 weeks onward, the uterus begins to contract. These contractions are not a signal of premature labor. Most women do not even feel them until the last two or three months of the pregnancy. At that point, especially for women pregnant for the second or third time, the contractions grow more noticeable each week and may even become regular. Braxton Hicks contractions will either go away or space out if you change your activity. True labor, on the other hand, does not stop so easily.

Heartburn. Your growing baby will eventually leave little room for hearty meals. This causes heartburn for you. Eat smaller meals throughout the day and avoid rich, spicy, and deep-fried foods. Ask your healthcare practitioner which antacid to use, since some have higher levels of sodium than others. Avoiding excess salt is generally a good idea during pregnancy.

Stretch marks. Whether or not you get stretch marks depends primarily on your genetic makeup and how rapidly you gain weight. Creams and lotions cannot change your genes, but they can help the itching and burning.

Carpal tunnel syndrome. Tissues throughout your body retain fluid as your pregnancy progresses. This can put pressure on the nerves in your wrists and hands, causing pain and numbness. Try reaching your arms above your head and rolling your wrists. Gently stretch and rub your hands or ask someone to do it for you. Some women find relief with an acupuncturist or with orthopedic wrist braces.

Swollen feet and ankles (edema). Like carpal tunnel syndrome, a small amount of edema in your ankles and feet is part of the increased fluid retention that comes with pregnancy. You'll notice it more at the end of the day, especially if you've been on your feet. Ask your practitioner to evaluate your salt intake-excess amounts can exacerbate edema. Drink at least eight large glasses of water daily, elevate your feet as much as possible, wear comfortable shoes, and try full-length support hose. If the edema is mild, you can let your practitioner know about it at your next appointment. But if your hands or face begin swelling, if your swelling comes on quickly, or if you also have headaches or blurred vision, call your practitioner immediately. These can be signs of pre-eclampsia.

Round ligament pain. A sharp pain on either side of the lower abdomen can occur with movement such as getting up from a chair, urinating, or turning from side to side in bed. Though sharp, the pain goes away quickly. This is typical of round ligament pain, which is normal in pregnancy. The round ligaments stretch from both sides at the top of the uterus down to the pubic bone, and as the uterus grows during pregnancy, they stretch and occasionally cramp. Support your abdomen when standing or turning in bed to reduce cramping. Notify your caregiver if you have persistent pain in the abdomen that is not easily relieved.

Public bone pain. Late in pregnancy, some women have pubic bone soreness and aching that gets worse when they walk, swim, or do other exercises. Pregnancy hormones loosen up the joints of the pelvis, including the connection between the sides of the pubic bone at the bottom of your abdomen. This lets the pelvis become more flexible during labor as the baby moves forward. (This also explains the "waddle" that women have late in pregnancy).This same flexibility can also create the aches and soreness throughout the pelvis, but especially in the pubic bones. Try warm baths for relief.

Lower back pain (sciatica). A massage can go a long way in helping a tired, aching back feel better. Warm baths can relieve pain too, as can warm compresses. Prenatal yoga classes increase the body's flexibility and strength and can make pregnancy much more comfortable. Again, a pelvic rock might relieve some of the pressure from the weight of the baby on your lower back. Also, if the pain is being caused by your baby's position-especially if the baby is head-down with the back of her head against your tailbone-this exercise may encourage her to turn.

Insomnia. Many mothers report having difficulty falling asleep or staying asleep during the last trimester. A daily walk outside helps promote a better night's rest, and an extra pillow tucked under and supporting your belly or between your knees can help you find a more comfortable sleeping position. Try taking a warm bath with a few drops of lavender oil added to the running water. Although it's tempting to eliminate fluids in an effort to limit the trips to the bathroom in the middle of the night, this isn't healthy for you or your baby. Instead, continue to drink at least eight large glasses of water each day before 4 P.M. That should help decrease the frequency of nighttime visits to the bathroom.

Anxiety. The physical discomforts that come with pregnancy are more difficult to bear when accompanied by anxiety. Fears about the baby's health and labor, and disturbing dreams about pregnancy, childbirth, and motherhood are commonly experienced by expectant women. Remember, your healthcare practitioner is your partner in care. Talk to her about your concerns. Your partner, childbirth educator or doula are also good resources for support. Use deep breathing and visualization as a means of relaxation, and ask for a massage when you need it. These could be the most valuable lessons you learn in prenatal education or yoga classes.

Dehydration. When you're pregnant, your need for fluids increases dramatically. As you begin your third trimester, your blood volume will increase by about 50 percent, and approximately every three hours your body will be busy replacing the amniotic fluid cradling your baby. So don't limit your water intake. Get into the habit of drinking lots of fluids (about two quarts a day) early in your pregnancy, and keeping a filled water bottle by your side will make getting the right amount of water much easier. Milk, fruit, or vegetable juice, and herbal teas are fine, too. But stay away from caffeine-it's not only bad for your baby, but it also acts as a diuretic, further depleting your water stores.

Headaches. Yet another side effect of the hormonal circus going on in your body is the headache. Hormone fluctuations, sinus troubles, tension, and dehydration can all contribute to more, and more severe, headaches. Remember to watch your water intake, try to find room to relax daily, and don't be afraid to ask for a neck rub. If your head is already pounding, have something to eat, try drinking a large glass of water or lying in a dark room with a cool washcloth over your eyes. Sinus headaches can be helped by placing a warm compress across your eyes or by rubbing your forehead and cheekbones. If your headaches increase in number or severity, or if they are accompanied by any disturbance in your vision, see your midwife or doctor immediately-these can be signs of pre-eclampsia.

Urinary tract infections (UTIs). UTIs are caused by bacteria that infect the bladder, kidneys, or urethra. Pregnancy changes the shape of the urinary tract, making you more vulnerable to UTIs. Women with diabetes, the sickle-cell trait, or women who have had many children are at higher risk for developing UTIs, but all pregnant women should be screened for them. UTIs are uncomfortable, annoying, and can cause preterm labor. Fortunately, UTIs are easily diagnosed and treated. You can focus on preventing UTIs by drinking lots of water and going to the bathroom often.

Gestational diabetes. Gestational diabetes occurs in 2 percent to 5 percent of pregnant women. It is caused by a glitch in the messages that go between mom and baby. Around week 25, the placenta steps up its hormone production. Sometimes these hormones can interfere with the action of insulin in your body. This causes insulin resistance, which causes an abnormal rise in blood sugar. Babies born to mothers with gestational diabetes are usually larger than they should be. This can cause problems during delivery. Sometimes after the birth, they can develop low blood sugar or jaundice. Gestational diabetes can also make you more prone to toxemia and UTIs. Your midwife or doctor will screen you for gestational diabetes between your fifth and sixth month. For the screening you will be asked to skip breakfast, then come in for a sweet glucose drink. About an hour later, your doctor will take your blood and measure your glucose. Some women have difficulty with the drink. Taking the drinkon ice and eating a healthy, high protein snack right after the test will make it easier. Gestational diabetes generally disappears once the baby is delivered.

Dental problems. During pregnancy, you might notice that your gums bleed more easily. Your hormones and increased blood flow may well have you seeing red after you floss. But it is important that you don't use sore gums as an excuse to take a break from extensive dental care. In fact, studies indicate that women with serious gum disease are seven times more likely to deliver early and have a baby with a low birth weight. Get a checkup early in your pregnancy, and continue good hygiene; mouth or dental infections can be more serious when you're pregnant. However, try to avoid routine X-rays.

Nasal problems. During pregnancy, you might also incur some annoying, persistent nasal conditions. Unfortunately, congestion and frequent colds are common, as indeed are nose bleeds. These are caused by the swelling of the lining of your nose and air passages, as well as increased production of mucus-this is due primarily to an increase in blood flow throughout your entire body. As over-the-counter medications such as antihistamine are not recommended while you are pregnant, mild curatives such as Tylenol or even breathing strips are your best bet for relieving the symptoms.

*taken from "Changing Times" by Dawn Friedman and Marion McCartney, CNM, FACNM, Every Baby magazine, Issue Four.

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