Common Pregnancy Pains and Their Causes

Most pregnancies are medically uneventful and end happily in the birth of a healthy baby. Your first -- and most important -- step is to sign up for a comprehensive prenatal program with an obstetrician (a doctor who specializes in pregnancy and childbirth) or a midwife. You and your developing baby will get routine monitoring to make sure everything is going well, and if it isn't, you will be referred for appropriate care. You and your partner will get confidence- building information about each stage of your pregnancy, including labor, childbirth, and the care and feeding of a newborn.

Yet you still have 40 weeks to wonder whether certain physical discomforts are serious enough for medical intervention or are minor problems you can deal with on your own.

You'll have various kinds of discomforts during pregnancy -- some fleeting, some more permanent. Some may happen in the early weeks, while others emerge closer to the time of delivery. Still others may start early and then go away, only to return later.

Every person's pregnancy is unique, so you may not have all of the changes described below.

When to Call Your Doctor

Talk to your doctor if:

• You have severe nausea and vomiting, dehydration, a persistent rapid heartbeat, or pale, dry skin; you may have hyperemesis gravidarum, a severe form of morning sickness.
• You have vaginal spotting or bleeding; you may be having a miscarriage or serious placental complication.
• You have sudden weight gain over a few days, severe headache, or blurred vision; you may have preeclampsia, a form of high blood pressure that can endanger your health and the health of your baby.
• You have a fever over 100 F and chills, backache, or blood in your urine; you may have a kidney infection or other infection.
• After the baby begins to move, you feel less or no movement for more than 2 hours; your baby may be in fetal distress.
• You feel wetness or a leaking of fluid, unlike normal vaginal secretions or urinary leakage; you may have ruptured membranes or leaking of amniotic fluid.

Pregnancy Breast Changes

Most pregnant women will feel some changes in their breasts. Your breasts will get bigger as your milk glands enlarge and the fat tissue enlarges, causing breast firmness and tenderness, typically during pregnancy's first and last few months. Bluish veins may also appear as your blood supply increases. Your breasts might leak a yellowish fluid called colostrum, usually during the third trimester. Colostrum is the “pre-milk” that will nourish your baby in the first days of life until your milk comes in. As you get closer to delivery, it changes to a thin, colorless liquid.

Your nipples can also darken. They may stick out more, and the areolas may get bigger. Small glands around the nipples become raised. They make oil to keep your nipples soft. These changes make it easier for your baby to find and latch onto your nipples for breastfeeding.

The freckles and moles on your body may be darker, too. Talk to your doctor if you have a mole or freckle that is growing, changing color and shape, itching or bleeding, or larger than a pencil eraser. These may be signs of skin cancer.

Recommendations:

• Wear a bra that provides firm support.
• Choose cotton bras or those made from natural fibers.
• Get a bigger bra as your breasts become larger and fuller. Your bra should fit well without irritating your nipples. Try maternity or nursing bras, which provide more support and can be used after pregnancy if you choose to breastfeed.
• Try wearing a bra during the night.
• Tuck a cotton handkerchief or gauze pad into each bra cup to absorb leaking fluid. You can also buy nursing pads in the drugstore or maternity/baby store that fit into your bra. Make sure to change these pads as needed so your skin doesn't get irritated.
• Wash your breasts with warm water and mild soap that will not cause dryness.

Pregnancy Fatigue

Feeling tired? That might be because your growing baby requires extra energy. Sometimes, it's a sign of anemia (low iron in the blood), which is common during pregnancy.

Recommendations:

• Get plenty of rest; go to bed earlier and take naps.
• Keep a regular schedule when possible.
• Pace yourself. Balance activity with rest.
• Moderate exercise daily boosts your energy level.
• Ask your health care provider to test your blood routinely for anemia.

Pregnancy Nausea or Vomiting

It's very common -- and normal -- to have an upset stomach when you're pregnant.

Chalk it up to pregnancy's hormonal changes. It usually happens early in pregnancy, while your body is adjusting to the higher hormone levels.

Good news: Nausea usually disappears by the fourth month of pregnancy (although in some cases it can persist throughout the pregnancy). It can happen at any time of the day but may be worse in the morning, when your stomach is empty (that's why it's called "morning sickness") or if you aren't eating enough.

Recommendations:

• If nausea is a problem in the morning, eat dry foods like cereal, toast or crackers before getting out of bed. Try eating a high-protein snack such as lean meat or cheese before going to bed (protein takes longer to digest).
• If you are hungry but extremely nauseated, try the BRAT (bananas, rice and tea) diet as well as bland foods.
• Acupressure wristbands offer some pregnant women comfort.
• Ginger may combat nausea.
• Eat small meals or snacks every two to three hours rather than three large meals. Eat slowly and chew your food completely.
• Sip on fluids throughout the day. Avoid large amounts of fluids at one time. Try cool, clear fruit juices, such as apple or grape juice.
• Avoid spicy, fried, or greasy foods.
• If you are bothered by strong smells, eat foods cold or at room temperature to minimize or avoid odors that bother you.
• Talk to your doctor about taking vitamin B6. Other natural treatments and prescription medications can provide relief.
• Contact your health care provider if your vomiting is constant or so severe that you can't keep fluids or foods down. This can cause dehydration and should be treated right away.

Pregnancy Diarrhea

Diarrhea usually doesn't mean anything is wrong. But it can be distressing. It may be related to your prenatal vitamin or your attempts to eat better, or it could just be a bug you caught. In any case, when diarrhea strikes during pregnancy, it's even more important to take good care of yourself.

Pregnancy Bloating

Your pants may feel tight even if you're not that far along. Blame hormone changes. Early in pregnancy, rising progesterone can cause your digestive system to slow and your smooth muscle tissue to relax. This can cause bloating. It's similar to what happens to many women right before their period starts.

Recommendations:

• Do gentle exercise, such as walking or swimming, which helps keep the digestive system moving.
• Drink water throughout the day to help digestion.
• Eat smaller meals more often. It's easier on the digestive system.
• Eat foods high in fiber, such as fruits, vegetables, and whole grains.

Pregnancy Frequent Urination

It's normal to have to pee a lot when you're pregnant. Early in your pregnancy, your body makes a hormone that may increase urination. Your growing uterus and baby also press against your bladder. The pressure can wake you up several times a night to go to the bathroom. You may also have the urge to go even when your bladder is almost empty. This problem usually goes away a few days after your baby is born.

Call your doctor if you have a fever or blood in your urine, or if you have the urge to go again just after you've emptied your bladder. If it hurts, burns, or stings when you pee, you could have a urinary tract infection. This needs treatment right away.

Recommendations:

• Don't wear tight-fitting underwear, pants, or pantyhose.
• Drink plenty of fluids to avoid dehydration. Try to get them mostly during the day. Drink less in the evening and at night. This should help you cut back on nighttime bathroom visits.
• Avoid coffee, tea, colas, and other caffeinated drinks. These can make you urinate more often.

Pregnancy Headaches

Headaches can happen anytime during pregnancy. They can be caused by tension, congestion, constipation, or in some cases, preeclampsia (detected after 20 weeks).

Recommendations:

• Put an ice pack on your forehead or the back of your neck.
• Rest, sit, or lie quietly in a low-lit room. Close your eyes and try to relax your back, neck, and shoulders.
• Over-the-counter acetaminophen like Tylenol may help. But if your headaches don't go away, are severe, make you nauseous, or affect your vision, tell your doctor.

Pregnancy Bleeding and Swollen Gums

You may not have expected pregnancy to affect your mouth. But your blood circulation and hormone levels can make your gums tender and swollen, and you may notice they bleed more easily. You may also develop nose bleeds.

Recommendations:

• Get a dental checkup early in your pregnancy to make sure your teeth and mouth are healthy. See your dentist if you notice a particular problem.
• Brush your teeth, floss regularly and rinse daily with an antiseptic mouthwash.

Pregnancy Constipation

Your hormones, as well as vitamins and iron supplements, may cause constipation (trouble pooping or incomplete or infrequent passage of hard stools). Pressure on your rectum from your uterus may also cause constipation.

Call your doctor if you also have abdominal pain or rectal bleeding. If iron supplements are causing constipation, they may recommend a different one.

Recommendations:

• Add more fiber (such as whole grain foods, fresh fruits, and vegetables) to your diet.
• Drink plenty of fluids daily (at least 6-8 glasses of water and 1-2 glasses of fruit or prune juice).
• Drink warm liquids, especially in the morning.
• Exercise daily. Walking and swimming are activities that are gentle on your pregnant body.
• Avoid straining when you have a bowel movement.
• Talk with your doctor about a laxative or stool softener.

Pregnancy Wrist Pain (Carpal Tunnel)

You might be surprised that carrying a baby could cause pain in your wrist. But up to 35% of women get pain or weakness in their wrist during pregnancy, usually in the third trimester. Fluid retention puts more pressure on the carpal tunnel, which runs from your wrist to the bottom of your palm. Most likely, the pain will get better within a few months of your baby's birth.

Pregnancy Dizziness (Feeling Faint)

Dizziness can occur anytime during middle to late pregnancy. Here's why it happens:

• The hormone progesterone dilates blood vessels so blood tends to pool in the legs.
• More blood is also going to your growing uterus. This can cause a drop in blood pressure, especially when changing positions -- and that can make you dizzy. If your blood sugar levels get too low, you may feel faint.

Recommendations:

• Move around often when standing for long periods of time.
• Lie on your left side to rest. This helps circulation throughout your body.
• Avoid sudden movements. Move slowly when standing from a sitting position.
• Eat regular, small meals throughout the day to prevent low blood sugar.
• Drink plenty of water.

Trouble Sleeping During Pregnancy

Finding a comfortable resting position can become difficult later in pregnancy. And your ballooning belly and bathroom breaks aren't the only things keeping you up. From backaches to heartburn to anxiety, a wide range of concerns can affect slumber. Hormones can also disrupt your sleep patterns, leaving you exhausted by day and wide awake by night.

Even though you may not be sleeping well, now is when you need sleep the most. Your body needs to rest so it can feed and house your growing baby.

Recommendations:

• Don't take sleep medication.
• Try drinking warm milk at bedtime.
• Take a warm shower or bath before bedtime.
• Use extra pillows for support while sleeping. Lying on your side, place a pillow under your abdomen, behind your back, and between your knees to prevent muscle strain and help you get the rest you need.
• Use blocks to prop up the head of the bed a few inches. This can ease breathing and help prevent any backflow of stomach acid from reflux.
• You will probably feel better lying on your left side; this improves circulation of blood throughout your body. Sleep with bent knees to take pressure off your back.
• Exercise. Every day, try to take a 30-minute walk or a pregnancy exercise class. Staying active can help you sleep better. Just do it early in the day. Exercising within 4 hours of bedtime can be stimulating enough to keep you up.
• Relax before bed. Try a pregnancy yoga video or some deep-breathing exercises.
• Stretch. Do a few leg stretches to keep your legs from cramping during the night.
• Limit drinks. Stop drinking within 2 or 3 hours of bedtime so you won't have to get up and go to the bathroom in the middle of the night.
• Avoid late meals as well as spicy, greasy, or acidic foods close to bedtime.
• Pee before sleeping. Make one last trip to the bathroom before you turn out the light.
• Turn down the thermostat. You're going to feel warmer now because extra blood is rushing to your skin. Keeping your bedroom cool will make you more comfortable and prevent you from having to kick off the covers in the middle of the night.

Pregnancy Heartburn or Indigestion

Heartburn is a burning feeling that starts in the stomach and seems to rise up to the throat. During pregnancy, changing hormone levels slow down your digestive system, weaken the stomach sphincter, and your uterus can crowd your stomach, pushing stomach acids upward.

Recommendations:

• Eat several small meals each day instead of three large meals.
• Eat slowly.
• Drink warm liquids.
• Avoid fried, spicy, or rich foods, or any foods that seem to give you indigestion.
• Don't lie down right after eating.
• Keep the head of your bed higher than the foot of your bed. Or place pillows under your shoulders to prevent stomach acids from rising into your throat.
• Don't mix fatty foods with sweets in one meal, and try to separate liquids and solids at meals.
• Try heartburn relievers such as Gaviscon, Maalox, Mylanta, Riopan, Titralac, or Tums.

Pregnancy Hemorrhoids

Hemorrhoids are swollen veins that appear as painful lumps on the anus. During pregnancy, they may form as a result of increased circulation and pressure on the rectum and vagina from your growing baby.

Recommendations:

• Try to avoid constipation. Constipation can cause hemorrhoids and will make them more painful.
• Avoid sitting or standing for long periods of time; change your position frequently.
• Don't strain during a bowel movement.
• Apply ice packs or cold compresses to the area or take a warm bath a few times a day to provide relief.
• Avoid tight-fitting underwear, pants, or pantyhose.
• If you still need more help, consult your health care provider.

Pregnancy Varicose Veins

Pregnancy hormones may cause the walls of your veins to weaken and swell. Pressure on the veins behind your uterus also slows the circulation of blood to your heart, making the smaller veins in your pelvis and legs swell. You're most likely to get these bluish, swollen veins in your legs. But in late pregnancy, they may appear in your vulva, the area outside your vagina. Varicose veins will probably get better after your baby is born, when pressure on your veins goes away.

Call your doctor if the veins feel hard, warm, or painful, or if the skin over them looks red.

Pregnancy Leg Cramps

Pressure from your growing uterus can cause leg cramps or sharp pains down your legs.

Recommendations:

• Be sure to eat and drink foods that are rich in calcium (such as milk, broccoli or cheese).
• Wear comfortable, low-heeled shoes.
• Try wearing support hose, but avoid any leg wear that is too tight.
• Elevate your legs when possible; avoid crossing your legs.
• Exercise daily.
• Stretch your legs before going to bed.
• Avoid lying on your back, since the weight of your body and the pressure of your enlarged uterus can slow the circulation in your legs, causing cramps.
• Gently stretch any muscle that becomes cramped by straightening your leg, flexing your foot, and pulling your toes toward you.
• Massage the cramp or apply heat or a hot water bottle to the sore area.

Pregnancy Nasal Congestion

You may have a stuffy nose or feel like you have a cold. Pregnancy hormones sometimes dry out the nose's lining, making it inflamed and swollen.

Recommendations:

• Apply a warm, wet washcloth to your cheeks, eyes, and nose to reduce congestion.
• Avoid using nasal sprays unless prescribed by your doctor because they can aggravate your symptoms.
• Drink plenty of fluids (at least 6-8 glasses of fluids a day) to thin mucus.
• Elevate your head with an extra pillow while sleeping to prevent mucus from blocking your throat.
• Use a humidifier or vaporizer to add moisture to the air.
• Take a warm shower or bath.

Shortness of Breath During Pregnancy

Shortness of breath can happen due to increased upward pressure from the uterus and changes in physiologic lung function.

Recommendations:

• When walking, slow down and rest a few moments.
• Raise your arms over your head (this lifts your rib cage and allows you to breathe in more air).
• Avoid lying flat on your back, and try sleeping with your head elevated.
• If prolonged shortness of breathing continues or you experience sharp pain when inhaling, contact your health care provider. You could have a pulmonary embolism (blood clot in the lungs).

Pregnancy Stretch Marks

Stretch marks are a type of scar tissue that forms when the skin's normal elasticity is not enough for the stretching that occurs during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks or thighs.

Though they won't disappear completely, stretch marks will fade after delivery. Stretch marks affect the surface under the skin and are not preventable.

Recommendations:

• Be sure that your diet contains enough sources of the nutrients needed for healthy skin (especially vitamins C and E).
• Apply lotion to your skin to keep it soft and reduce dryness.
• Exercise daily.

Swelling in the Feet and Legs During Pregnancy

Pressure from your growing uterus on the blood vessels carrying blood from the lower body causes fluid buildup. The result is swelling (edema) in the legs and feet.

Additional weight during pregnancy can also make your feet bigger. Plus, pregnancy hormones loosen your ligaments and muscles so your pelvic joints open up to get ready for childbirth. This affects your whole body, even your feet. Call your doctor if any swelling is more than mild or if it suddenly gets worse.

Recommendations:

• Try not to stay on your feet for long periods of time. Avoid standing in one place.
• Drink plenty of fluids (at least 6-8 glasses of fluids a day).
• Avoid foods high in salt (sodium).
• Elevate your legs and feet while sitting. Avoid crossing your legs.
• Wear loose, comfortable clothing; tight clothing can slow circulation and increase fluid retention.
• Soak your feet in cool water.
• Keep moving. Exercise your legs to keep fluid from building up.
• Don't wear tight shoes; choose supportive shoes with low, wide heels.
• Keep your diet rich in protein; too little protein can cause fluid retention.
• Notify your health care provider if your hands or face swell. This may be a warning sign of preeclampsia.
• Rest on your side during the day to help increase blood flow to your kidneys.

Vaginal Discharge During Pregnancy

Normal vaginal secretions increase during pregnancy due to greater blood supply and hormones. Normal vaginal discharge is white or clear, isn't irritating, is odorless, and may look yellow when dry on your underwear or panty liners.

Recommendations:

• Choose cotton underwear or brands made from natural fibers.
• Avoid tight-fitting jeans or pants.
• Do not douche. Douching can introduce air into your circulatory system or break your bag of waters in later pregnancy.
• Clean the vaginal area often with soap and water.
• Wipe yourself from front to back.
• Contact your health care provider if you have burning, itching, irritation or swelling, bad odor, bloody discharge, or bright yellow or green discharge (these symptoms could be a sign of infection).

Pregnancy Backaches

Backaches are usually caused by the strain put on the back muscles, changing hormone levels, and changes in your posture.

Recommendations:

• Wear low-heeled (but not flat) shoes.
• Avoid lifting heavy objects.
• Squat down with your knees bent when picking things up instead of bending down at the waist.
• Don't stand on your feet for long periods. If you need to stand for long periods, place one foot on a stool or box for support.
• Sit in a chair with good back support, or place a small pillow behind your lower back. Also, place your feet on a footrest or stool.
• Check that your bed is firm. If needed, put a board between the mattress and box spring.
• Sleep on your left side with a pillow between your legs for support.
• Apply a hot water bottle or heating pad on low setting to your back, take a warm bath or shower, or try massage.
• Perform exercises, as advised by your health care provider, to make your back muscles stronger and help relieve the soreness.
• Maintain good posture. Standing up straight will ease the strain on your back.
• Contact your health care provider if you have a low backache that goes around your stomach and does not go away within one hour after you change position or rest. This might be a sign of premature labor.

Abdominal Pain or Discomfort

Sharp, shooting pains on either side of your stomach may result from the stretching tissue supporting your growing uterus. These pains may also travel down your thigh and into your leg.

Recommendations:

• Change your position or activity until you are comfortable; avoid sharp turns or movements.
• If you have a sudden pain in your abdomen, bend forward to the point of pain to relieve tension and relax the tissue.
• Apply a hot water bottle or heating pad to your back, or take a warm bath or shower.
• Try a massage.
• Make sure you are getting enough fluids.
• Take Tylenol (acetaminophen) occasionally.
• Contact your health care provider if the pain is severe or constant or if you are less than 36 weeks pregnant and you have signs of labor. (Signs of labor include repetitive cramping like contractions.)

Braxton-Hicks Contractions

The uterine muscles will contract (tighten) starting as early as the second trimester of pregnancy. Irregular, infrequent contractions are called Braxton- Hicks contractions (also known as "false labor pains"). These are normal during pregnancy.

Recommendations:

• Try to relax
• Change positions. Sometimes this can ease the contractions.
• Call your doctor if they do not go away.

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