Menstrual-like cramping is common in early pregnancy, as is a bloated sensation. Persistent or worsening cramping can be an indication of a urinary tract infection, so you should contact the nurse at the office to discuss your concerns with her. Later on in your pregnancy, the muscles that support the growing uterus are being stretched and pulled and you may feel this as a dull ache or sharp pain on one side of your abdomen. This is commonly referred to as “round ligament pain.” Tylenol, a heating pad, changing positions, and rest can provide relief.
Late in pregnancy, the weight of the growing baby distorting your normal balance and pulling on your back muscles can cause back pain. Good posture, low-heeled shoes, rest, back massage and a heating pad will help. Exercises to stretch and strengthen your back may help, or you may try a maternity support belt. Sitting in a chair with good back support is important and sleeping on your side with pillows between your knees and below your abdomen for support is also helpful. Avoid lifting heavy objects and when doing any lifting, be sure to bend at the knees, not your back. If you’re experiencing unrelieved lower back pain along with lower abdominal pain or consistent mid back pain (kidney pain), please contact our nurse.
“False labor” contractions are intermittent, irregular uterine contractions which occur periodically toward the end of pregnancy. They may or may not be painful but will fade with rest or a warm bath. If the contractions become regular, every 3-5 minutes, lasting 60 seconds each, or if they persist, please call us (if after hours, please call our office to page the on call doctor). If past 34 weeks, please head over to Labor and Delivery for evaluation.
Breast tenderness is common and may last the entire pregnancy. A bra with good support helps. Some women will have a clear, milky discharge from their nipples and may need to use nursing pads to protect their clothing.
Pregnancy alone can slow digestion and cause constipation. Prenatal vitamins also contain iron which may be constipating. To help, you should drink plenty of water, and eat high fiber foods such as whole grains, fruits, and fresh vegetables. Adding a fiber supplement to your diet may help as well. Regular exercise also aids your digestion. You may also consider using a stool softener such as Colace, which is available over the counter.
Hormonal changes, the adjustment to pregnancy, and anticipation of caring for a new baby can cause normal emotional ups and downs. Communicate your feelings with supportive friends and family, and please be sure to discuss this with your OB provider and/or nurse if you are concerned about how you are feeling.
It is not unusual to feel lightheaded in pregnancy. This may be caused by changing positions suddenly, being dehydrated, having low blood pressure or low blood sugar, being anemic, or being in a room that is too warm. If you feel dizzy, you should rest or lay down right away. To prevent feeling this way, be sure to drink fluids throughout the day, eat small frequent meals with higher protein, and change positions slowly. Do not hesitate to call us if the dizziness persists, or if you have chest pain or shortness of breath that occur at the same time.
Fatigue is a common complaint during early and late pregnancy. Increased rest and fluids are advised. Paradoxically, mild exercise often helps to combat the fatigue by releasing endorphins. Remember to take your prenatal vitamins and iron, if needed. If you find that you are experiencing constant fatigue, please contact our nurse to come in for a blood pressure and iron check.
More frequent urination usually occurs early in pregnancy when the uterus is expanding and may push against the bladder. It should improve in mid-pregnancy, but recurs in late pregnancy, as the growing uterus and baby leave little room for a full bladder. Limiting fluids in the evening may decrease the number of times you need to get up during the night. Burning or pain with urination, consistent lower abdominal, or lower back pain may indicate a bladder infection. Please call if you have any of these symptoms.
Headaches are quite common in all stages of pregnancy (particularly if you have a history of headaches). Rest, stress reduction, and Tylenol with a caffeinated drink may help. If headaches are prolonged or accompanied by blurred vision, swelling, upper abdominal pain, please call us. DO NOT take aspirin, anti-inflammatories (ibuprofen, Advil, Nuprin) or naproxen (Naprosyn). If your headache persists, please contact our nurse for further recommendations.
Burning, acidic feeling in the mid to lower chest is oftentimes experienced during pregnancy due to slower digestion and regurgitation. Sitting upright, elevating the head of the bed and “over the head” stretching exercises may provide relief. Do not lie down for 2 hours after eating. Mild antacids used in small quantities may also provide relief (Tums, Rolaids, and liquid antacids such as Mylanta and Maalox are fine). If these mild antacids don’t provide relief, you may try over-the-counter Pepcid AC, Tagamet, or Zantac.
Hemorrhoids are dilated veins that protrude from the rectum and can therefore be quite irritable. You may experience itching or burning around the anus or have a spot of bright, red blood on the toilet tissue after a bowel movement. Avoiding constipation (see above) and straining with bowel movements is important in the prevention of hemorrhoids. Sitz baths are helpful to treat hemorrhoids, and TUCKS pads, and Anusol or Preparation H may decrease itching/burning. Ask about prescription medications available if symptoms are not improving.
Hip Pain/Pubic Bone Pain
Pelvic bone pain can occur late in pregnancy. The hormones of pregnancy loosen the ligaments supporting these areas in expectation of delivery. This loosening allows the pelvis to accommodate the passage of the baby’s head/body in labor. The downside is that it creates pain in the hip and/or pelvic bone region. Prolonged standing or walking tends to worsen ligament pain. Be gentle to yourself—rest, warm baths, and applying heat can be of great help.
Leg cramps tend to occur in mid-pregnancy due to poor circulation. These often occur at night. To relieve the cramp, flex your toes vigorously towards your knees. To lessen the cramps, you may try the following: Maternity support hose can help achy legs. Be sure that your ted hose aren’t too tight, therefore creating further decreased circulation. Balance rest and mild exercise during the day. You may try gentle massage, stretching your legs, or taking a calcium supplement. Bananas and oranges may also help provide electrolytes such as potassium that can decrease the cramps. If a specific area of tenderness or any redness develops behind the knee or in the calf, please contact our office immediately.
Lightening or “Dropping”
Lightening is a change in the baby’s position. Your abdomen appears lower and may experience more pelvic pressure and frequent urination instead of heartburn, shortness of breath, or rib discomfort as before. It usually means that the baby has “engaged” into the pelvis which is normal as a preparation for delivery.
The most common ailment of pregnancy is morning sickness-- which is nausea, and sometimes vomiting. It usually occurs within 2-5 weeks of conception and in most cases, clears up by 12-16 weeks (fourth month of pregnancy). Even though it’s referred to as morning sickness, it can happen any time of the day. Morning sickness cannot be cured and probably to some degree, you will be nauseated-- but this nausea should be manageable. The following link has suggestions for dealing with the morning sickness. https://intermountainhealthcare.org/ext/Dcmnt?ncid=51061848
In addition to these remedies, we suggest
- Try over-the-counter vitamins/medications: Taking vitamin B6 25 mg 2-3x/day with Unisom 25 mg once a day may help lessen the nausea and vomiting.
- Ask for help! Please remember to ask for help from your partner, family, friends, or neighbors. Morning sickness is very real and different for every woman, so you shouldn’t wait until you are desperate to seek help.
- If remedies do not help: Please contact our nurses if these remedies are not helping. If you’re unable to keep fluids down for 24 hours and/or exhibiting signs of dehydration (severe nausea and/or vomiting, fatigue, dry mouth, decreased urine output), please contact our nurses for further recommendations/treatments (prescriptions, IV hydration, etc.)
The mucus plug is an accumulation of secretions that form within the cervical canal (opening to the uterus). This mucus accumulates early in pregnancy and serves as a protective barrier against infection. As you near the late part of your pregnancy, your cervix will begin to thin out and dilate. As it changes, you may lose your mucus plug and have a gooey, mucous-like discharge. It is not uncommon for this mucus to be mixed with brown, pink, or red streaks of blood. Some women may lose the plug at around 36 weeks but many women are not even aware when they pass it. Loss of the mucus plug indicates that labor is approaching within the next few weeks, but has no other real significance. You may continue normal activity after losing your mucous plug (exercise, intercourse, bathing, etc.). If you happen to notice any consistent, watery discharge (like wetting your underpants), please go to labor and delivery for evaluation of possible rupture of membranes.
Nasal Congestion/NoseBleeds/Bleeding Gums
Nasal congestion can be bothersome to some and may make you think of an on-coming cold. Usually it is due to increased blood supply in the nasal membranes and does not make one feel ill. Due to the mucus membranes having more blood supply, nosebleeds may also occur. Saline nasal spray or Vaseline applied at bedtime to the nasal passages can keep the nasal passages moist and decrease nosebleeds. If they persist despite ice compression for 5-10 minutes and head tilting back, please call us. For bleeding gums, good dental care should continue including flossing, but you may want to change to a softer toothbrush.
Numbness or Tingling
As a result of tissue swelling and fluid retention, you may develop a carpal tunnel syndrome-like effect in your fingers, with numbness or tingling in one or both hands that usually resolves after delivery. Wrist splints may lessen the symptoms. Nerves may also be compressed by the uterus that can cause pain in the hips or lower legs called sciatic nerve pain. Rest or a maternity support belt may be helpful, and again, symptoms usually resolve after delivery.
Pressure under the Rib Cage
This is another discomfort which can occur as the baby presses against the organs of the upper abdomen. This pressure often feels like a sore spot or bruised area, especially under one rib. Sitting in a straight-backed chair with a pillow behind the lower back helps relieve the pressure and facilitates breathing. A warm bath or heating pad may also help.
Shortness of Breath
Shortness of breath often occurs in the last few months. Several factors contribute to this: Your blood is more dilute, less oxygen-rich, and your additional bulk/weight contribute to the exhaustion and the pressure of the uterus against the diaphragm makes it harder to take a deep breath. You may find you need more time to do your usual activities. You should rest more frequently and may need to stop some overly strenuous activities. It is very helpful to control your rate of weight gain. Sleeping with your head elevated or on your side may help at night. If shortness of breath is extreme or comes on suddenly and persists, please let us know.
Dry itchy skin, pigment changes, and stretch marks can occur during your pregnancy. An emollient cream may help relieve the dryness and itchiness. Some women develop brownish discolorations on their face, skin, or a brown line appears in the middle of their abdomen. These are related to hormone changes and will fade after delivery in most cases. Whether you will develop stretch marks on your breasts and abdomen will be determined by your skin type/elasticity, hereditary factors, and total weight gain during pregnancy. No creams will prevent or eliminate them.
Some swelling is normal in the hands, face, legs, and feet during your pregnancy, especially towards the end. Continue to drink plenty of water, avoid high sodium foods (pretzels, potato chips, salted popcorn, etc.) Exercising and elevating your legs when able will also help. Notify our nurse if you have a sudden increase in swelling.
This increases for most women during pregnancy. It is usually a white or pale yellowish discharge. Maintain good hygiene. Douching is not recommended during pregnancy. If you have persistent itching or irritation, please call us to check for possible yeast infection/vaginitis.
The weight of the uterus and growing baby may compress and slow blood flow from the lower body. This may result in bulging veins in the legs or perineum. To relieve leg soreness and swelling, you may try wearing support hose, elevating your legs, exercising regularly, and avoiding crossing your legs. Notify our nurse if a vein becomes suddenly tender or more swollen.
A healthy weight gain for most women is between 25‐35 pounds for the entire pregnancy. If you are overweight, you should gain between 15‐25 pounds. If you are underweight or pregnant with twins, you may need to gain more. Most of this comes during the last three months when the baby is growing very rapidly. Pregnancy is not the time to attempt weight loss.
Daily flossing, brushing, and routine dental visits should be continued. If your dentist feels X-rays are necessary, have them properly shield your abdomen. Local anesthetics such as Xylocaine or Novacaine are safe.
Daily exercise is highly recommended for all women during an uncomplicated pregnancy. Exercise is helpful to maintain your health, combat fatigue of early and late pregnancy, and benefit your labor and post-partum period. Exercise can improve muscle tone and strengthen and lessen some of the aches and pains during the pregnancy, including back pain. It may improve your mood and help you to sleep better. Keep in mind that now is NOT the best time to take up a vigorous new sport or exercise program. If you already exercise regularly, you can continue in moderation. Be sure to drink plenty of fluids while you exercise. Very high levels of exercise for long periods of time may be problematic for blood flow through the uterus and are not recommended. Women who enjoy aerobics usually should switch to low impact in mid‐pregnancy. In late pregnancy when many exercises are awkward, lap swimming is especially good. Brisk walking, jogging, swimming, dancing, or racket sports are all fine, as long as you do them for fun and do not push yourself to exhaustion (heart rate should not exceed above 140 bpm). Avoid sports and entertainment which might be bumpy or jerky, or have potential for falls.
Sitting in a hot tub or sauna is discouraged due to the extreme temperature, but you’re fine to dangle your feet/legs in a hot tub. Swimming is fine as long as you’re not having any watery vaginal discharge and/or bleeding (if that’s the case, contact our clinic immediately).
Things to be aware of during pregnancy:
- Healthy Eating: Eating a well balanced diet is an important part of staying healthy throughout your life, but it’s especially important during pregnancy for you and your baby. A healthy balance of meats, vegetables, fruits, grains, and dairy are recommended. Good sources of protein may be obtained from lean meats, poultry, fish, and milk products. The remainder of the diet should be well balanced with vegetables, fruits, whole grain breads, and whole grain cereal products. Be cautious of fats and concentrated sugars (candy, soft drinks), which have many empty calories. If you have some fluid retention, watch out for very salty foods (canned meats, canned soups, chips, pretzels, etc.). Read labels! There is hidden salt in so many prepared foods. Do not eliminate salt from your diet, however.
- Vitamins: A daily prenatal vitamin supplement is recommended for every woman in pregnancy. If you are a vegetarian, please discuss this with your doctor. You will need to be sure you are getting adequate protein, iron, vitamins B12 and vitamin D.
- Folic acid/Iron: Be sure that 0.4 to 0.8 mg (400 – 800 mcg) of folic acid is included in your prenatal vitamin. This is especially important during and before becoming pregnant to decrease certain types of birth defects. Prenatal vitamins also have a sufficient amount of iron needed for most women to prevent iron‐deficiency anemia during the pregnancy. Very large doses of vitamins may be harmful and should be avoided.
- Caffeine: Caffeine is contained in coffee, tea, chocolate, colas, and some other soft drinks. It is a drug and should be limited to 1-2 servings a day.
- Alcohol: Alcoholic Beverages are NOT recommended! Drinking alcohol during pregnancy can put the baby at risk for growth restriction, birth defects, problems with joints and limbs, and mental and behavioral problems. There is no known safe level of alcohol in pregnancy.
- Mercury: Fish is a good source of protein and other nutrients, however, some types may contain high levels of mercury which may affect the baby’s development. Fish such as shark, king mackerel, and swordfish should be limited. No fish should be eaten raw (sushi).
- Smoking: Smoking is strongly discouraged, as it is known to decrease the amount of oxygen received by the fetus, therefore impairing growth and development. Passive exposure to tobacco use by other household members has the same effect on the fetus. A baby born to a smoking mother is more susceptible to respiratory infections and other physical ailments. Please ask us about information/programs which can help you to stop smoking and have a healthier lifestyle for you, your baby, and others around you.
More information about Nutrition During Pregnancy can be found at
Paint fumes are not toxic unless metallic based. Remember to wear a mask and keep the area well ventilated by opening windows/doors. Do not climb on steep ladders or paint awkward angled areas that could potentially lead to a fall.
Sexual activity/intercourse can continue throughout the pregnancy unless you are at risk (bleeding, spotting, history of a low lying placenta “previa,” ruptured membranes, or premature deliveries). Please keep in mind that it is not uncommon to have a little bit of spotting after intercourse, but should resolve within a day or two. If you are high risk, your physician will advise if and when you should resume intercourse.
Tanning, hair color
Tanning is not harmful to your baby, although it is discouraged due to the increased risks of skin cancer. Hair permanents, hair coloring, and fingernail sculpting are safe. You may want to have a hair spot color test done if you’ve never had your hair dyed, for possible skin reaction.
In general, attending a theme park while pregnant is not a problem, but you should avoid all rides where you might be “thumped or bumped.” Also be sure to rest frequently, and drink plenty of fluids.
Toxoplasmosis is a common infection in people, birds, and animals that often is not noticed or may cause mild flu-like symptoms. The infection can cause problems for a fetus (when the mother becomes infected). Human infection usually happens when a person eats food that contains the toxoplasmosis parasite, such as undercooked meat. You also can get infected by touching an infected cat or its feces. You should avoid these behaviors while pregnant.
Travel poses no specific risks during pregnancy, but there are minor precautions to observe. Consider access to obstetric care. Travel will not cause premature labor, but there is a possibility that you may deliver in different surroundings with an unfamiliar obstetrician. If traveling, we recommend you stop frequently and walk around to aid circulation. Also, be sure to drink plenty of fluids. Extended travel after 34 weeks is discouraged and should be discussed with your doctor. If you’re planning to fly while pregnant, check with the airlines to find out what their guidelines are.
Additional information: http://www.acog.org/~/media/For%20Patients/faq055.pdf