Varicose veins
Because your blood volume increases during pregnancy, the pressure in the blood vessels of the lower half of your body rises too. Later in pregnancy the heavy weight of the womb is added to that. Varicose veins can be the result. Support stockings can bring relief, and raising your legs a little at night can ease the symptoms. But do not put a pillow behind your knees — always at the foot of the bed, and preferably under the mattress. Our advice: do not sit or stand for too long at a stretch, as that can hinder the circulation. Rinsing with cold water after a shower helps the circulation along.
Piles
Piles are varicose veins of the anus. The hormone progesterone has a slackening effect on the walls of the blood vessels in and around the anus, so during pregnancy piles can easily appear or grow larger. Constipation should be avoided as far as possible, because it makes piles worse. It is therefore a good idea to eat food rich in fibre and to drink enough — at least two litres a day. Piles often shrink after the birth, or even disappear altogether. There is a special ointment for treating them.
Ligament pain
The womb hangs from ligaments attached to the pelvis. As the womb grows, those ligaments are stretched. This causes a stabbing feeling low in the abdomen that can radiate to the groin and the vagina. The symptoms usually pass of their own accord.
Pelvic pain
Pelvic pain can be the result of the softening of the ligaments and tissues of the pubic bone and the joints near the tailbone. A degree of softening is normal and helps your baby pass through the pelvis more easily during the birth. If the pelvic pain is severe, contact the midwife. If necessary you will be referred to a pelvic physiotherapist.
Bladder infection
Pregnant women usually need to pass water often. If it hurts when you do, or if you have abdominal pain or your abdomen regularly goes hard, contact your family doctor. They can test your urine and prescribe a course of antibiotics if you have a bladder infection.
Vaginal bleeding
Bleeding during pregnancy is sometimes harmless, but it can also be a warning sign of a miscarriage.
Early in pregnancy, bleeding can occur because the cervix bleeds more easily now that the blood supply has increased. That can happen after sex or after a hard bowel movement.
An implantation bleed is the most common form of bleeding in the first trimester. It happens when the embryo settles into the wall of the womb.
Later in pregnancy, bleeding can be caused by a low-lying placenta or one covering the cervix. In the latter case it may come with abdominal pain. If you bleed after 16 weeks it is always wise to contact the midwife.
Carpal tunnel syndrome
During pregnancy there is extra fluid circulating in the body. This can put pressure on the nerves running from the inside of the wrist into the hand, which often gives a tingling feeling in the fingers. Pain can develop too. There is no reliable treatment for this condition. Sometimes, though far from always, fixing the wrist with a plaster splint gives some relief. Wearing the wrist guards used for skating can also help. If the symptoms are very severe, with loss of strength, surgery may be needed. Most symptoms do go away by themselves after the birth.
A hard abdomen (Braxton Hicks)
A hard abdomen, also called practice contractions, can occur in the second half of pregnancy. These are tightenings of the womb that often happen spontaneously, but are just as often brought on by the baby's movements or by suddenly bending, standing up or lifting. Stress can cause them too.
They do no harm — not to your baby either — as long as they are not painful, come at no fixed rhythm, and there are no other symptoms such as bleeding, loss of amniotic fluid or pain when passing water. If there is a definite rhythm to them and they are very painful, it is wise to contact the midwife.
Itching
Many pregnant women suffer from itchy skin. Usually it is a harmless form of pregnancy rash. The cause is not known. The itching is felt to be very unpleasant and is hard to treat. If blisters, sores or broken skin appear with it, or if you itch on the palms of your hands or the soles of your feet, it is wise to contact the midwife. Rubbing in petroleum jelly, menthol powder or aftersun cream can help reduce the itching. Drinking goldenrod tea sometimes brings relief too. Using ointments containing hormones during pregnancy is not advised.
Calf cramp
Calf cramp happens mainly at night. The cause is that the extra pressure on the blood vessels suddenly falls away when you lie down. Pulling your toes towards your nose with the leg stretched, or having someone do it for you, sometimes makes the cramp go. Massage can help as well.
Feeling no movement, or less
There is great variation among pregnant women in how they notice and experience their baby's movements. Someone pregnant for the first time feels the baby for the first time at around 18 to 22 weeks. Someone who has been pregnant before feels the baby at around 16 to 18 weeks, sometimes earlier. When you first feel the baby also depends on where the placenta lies: if it sits against the abdominal wall it can take a little longer. In these weeks the feeling of movement can still be very changeable, and there may be days when you feel nothing at all. Partners often feel the baby move later than the mother does. From 28 weeks the baby's movements grow stronger and should be felt every day. Towards the end of pregnancy the movements often change and can feel less forceful, because there is less room. If you do not feel the baby move, or noticeably less often, it is important to rest by lying on your side on the bed or the sofa. If you still cannot feel the baby clearly, it is wise to contact the midwife.
Heartburn
Progesterone is a sex hormone produced in fairly large amounts by the placenta during pregnancy. It slackens the muscle between the gullet and the stomach, which lets stomach acid rise into the gullet more easily. An extra pillow at night and lots of small meals during the day can help ease this. Avoid fatty and highly spiced meals, and coffee, tea, orange juice and fizzy drinks. Sometimes a spoonful of custard or a sip of milk helps. If none of that works, antacids may bring relief — ask the midwife about them.
Nausea
Nausea is often one of the first signs of pregnancy and comes on mainly in the morning after waking. It can lead to being sick. For most women the nausea passes by itself after about 16 weeks; for some it lasts the whole pregnancy. A few tips: eat a rusk or a cracker before getting up, and have small, light meals regularly.
If pregnancy sickness turns into excessive vomiting, it is wise to contact the midwife. Excessive vomiting means being unable to keep down any fluid and/or food at all. Admission to hospital may then be needed, where a drip is given to prevent further dehydration.
Nosebleeds and bleeding gums
During pregnancy you can easily get a nosebleed. That is because the walls of the small blood vessels in the nose are thinner and better supplied with blood. The vessels in the lining of the mouth are more sensitive too, which is why bleeding gums are fairly common in pregnancy. Use a soft toothbrush.
Constipation
Hard stools are common in pregnancy. Under the influence of pregnancy hormones the bowels work more slowly, so the stools become thicker and harder. It is therefore important to drink plenty (at least two litres a day), to eat food rich in fibre — wholemeal bread, fruit, vegetables — and to get enough exercise.
Back pain
Back pain is common in pregnancy. It comes partly from the changes in posture caused by the growing womb. Hormonal changes make the pelvic joints more mobile and soften the ligaments. Swimming and back exercises help keep the muscles supple. Wearing high heels is not advised. If the back pain persists, physiotherapy and/or exercise therapy (Mensendieck or Cesar) can bring relief.
Tiredness
Nine out of ten pregnant women feel tired. Being pregnant simply takes a lot of energy. Listen to your body and take the rest you need. Try to have a nap during the day and go to bed in good time. Sometimes anaemia is behind the tiredness, but by no means always.
Fluid retention
Every pregnant woman retains some fluid. Swollen ankles and fingers do no harm, as long as your blood pressure is normal and you have no symptoms such as vomiting, stomach pain and/or pain high in the abdomen. Nettle tea helps the body shed fluid. Do keep drinking enough water.
Stretch marks
Stretch marks appear when the skin can no longer keep up with the growth of the womb. Great tension is put on the skin and the outer layer begins to tear a little. During pregnancy the marks are purple-red. After the birth they fade and grow smaller, but they never disappear completely. There are no creams on the market, and no methods, that can prevent them.