An A to Z Guide to Common Problems During Pregnancy

Even the healthiest pregnancy has some uncomfortable symptoms. They may be from changes in hormone levels—progesterone and estrogen. But also the weight of the uterus, extra fluid needed to support the developing baby, stretching muscles and skin, and weight gain can all cause symptoms.

Many pregnant women experience aches and pains. Some symptoms may come and go. Others may be with you throughout your pregnancy. Still, there are things you can try to minimize discomfort.

While most symptoms do not require treatment, always talk to your doctor about any concerns or questions.

Bleeding gums

Your changing hormones can trigger inflammation in your gums, leading to bleeding, sore, or swollen gums during pregnancy. Gums will be back to normal after delivery.

What do to

• Brush and floss twice daily.
• See your dentist if your gums are especially painful or bleed easily.
• Have a professional cleaning and dental checkup before you get pregnant.
• Use a soft toothbrush.
• Don’t skip seeing the dentist. It is OK to have your teeth cleaned and get routine dental care during pregnancy.

Breathlessness

Breathlessness is common in the first trimester of pregnancy because the hormone progesterone causes pregnant women to breathe more deeply.

Breathlessness can also occur in the third trimester, when the growing uterus causes your diaphragm to press on your lungs. During the final weeks of pregnancy, breathing may be easier as the fetus drops in the uterus.

What do to

If your breathlessness is severe or you also have rapid breathing or chest pain, call your doctor right away.

Otherwise, try to sleep and sit in a comfortable position. Some women feel more comfortable sleeping with two pillows behind their head while other women may sleep in a recliner chair.

Constipation

Constipation affects more than half of pregnant women. The hormone progesterone slows the contractions of the intestinal muscles that move stool through your digestive tract. The iron found in prenatal vitamins may also contribute to constipation.

What do to

Constipation can be helped by:

• Increasing the fiber content of your diet.
• Drinking at least 8 glasses of water daily.
• Exercising regularly.
• If these do not offer relief, call your doctor, who may recommend a stool softener that is safe to use during pregnancy.

Dizziness

Feeling light-headed or dizzy is common during pregnancy. Pregnant women often have lower overall blood pressure, which can make you feel lightheaded. Also, the enlarged uterus can compress the large vein carrying blood to your heart. Either can cause a reduced supply of blood to the brain.

Brief light-headedness is common, especially when rising from a seated position or when lying on your back. If you repeatedly feel dizzy or have fainted, call your doctor.

What do to

To prevent dizziness:

• Rise slowly from seated and lying positions.
• Avoid becoming overheated.
• Avoid lying flat on your back in the second trimester.
• Wear compression socks.
• Stay hydrated.
• If you feel dizzy, eat some salty foods such as pretzels or crackers.
• When you feel dizzy, sit down and bend over while breathing deeply. Or lie down on your side. Both positions increase blood flow to the brain.

Fatigue

Fatigue is something almost all women experience during pregnancy. It’s because the body’s energy is directed toward physically supporting the growing fetus.

During the first trimester, your body is undergoing many changes. By the third trimester, you are bearing much more weight. Also, restlessness and interrupted sleep are common during pregnancy.

There are many reasons sleep can be difficult during pregnancy, including the need to shift your sleeping position due to your changing body shape and size. Hormonal changes and other discomforts of pregnancy also interrupt sleep.

What do to

Here’s what you can do to improve your sleep and reduce fatigue:

• Sleep on your side with your top knee bent and resting on a pillow. This position may be comfortable. It also reduces strain on your back.
• Exercise moderately every day.
• Let your doctor know if you are having bad sleep problems.
• Adjust your sleep habits, such as limiting caffeine intake and avoiding screens at least two hours before bedtime.

Tell your doctor if you experience extreme, ongoing fatigue. Otherwise, don’t overdo your activities, sleep and nap as much as you can, and exercise regularly.

Food cravings

Up to 90% of pregnant women have food cravings. Hormonal fluctuations during the first trimester are a suspected, though not proven, cause. There is no evidence that cravings signal an underlying nutritional deficiency.

What do to

Talk to your doctor if you have cravings for unhealthy food, cravings are causing excessive weight gain, or you are avoiding healthier foods. Otherwise, giving in to the occasional craving is OK. Cravings usually become less powerful in the later stages of pregnancy.

Frequent urination

The need to urinate more frequently, especially at night, affects many women during the first trimester. This is due to hormonal changes and the added pressure of the growing uterus on your bladder. You may feel the urge to urinate but pass only a small amount of urine.

You may also start urinating more often during the third trimester as the fetus drops in preparation for delivery.

What do to

Frequent urination may also be a sign of urinary tract infection. Let your doctor know if you have pain when urinating. If there is no infection, don’t drink a lot after dinner to prevent getting up in the middle of the night to go to the bathroom.

Heartburn

Indigestion and heartburn affect almost every pregnant woman. The hormone pro­gesterone relaxes the ringlike sphincter at the base of your esophagus. The sphincter normally closes so food cannot come back up from your stomach. When it’s relaxed, food mixed with digestive enzymes can back up into the esophagus, causing irritation and a burning chest.

You may also feel full due to the pressure of your expanding uterus on your stomach.

What do to

Prevent heartburn and indigestion by:

• Staying upright for at least 2 hours after eating.
• Eating frequent small meals throughout the day.
• Many antacids will relieve heartburn and are safe to take during pregnancy. Talk to your doctor before taking anything.
• Call your doctor if heartburn is persistent or prevents you from eating and gaining weight.

Hemorrhoids

Hemorrhoids are swollen veins in the rectum. Up to 50% of pregnant women get them. They develop when your enlarged uterus presses on the veins. They also can worsen if you are constipated or strain during bowel movements.

Symptoms include enlarged veins, pain while passing stool, and, sometimes, bleeding during a bowel movement.

What do to

If you have hemorrhoids, try these approaches:

• To prevent constipation, eat a fiber-rich diet, drink at least 8 glasses of water daily, and exercise regularly.
• Reduce pressure on anal veins by lying on your side.
• Topical (applied externally) medications (like Preparation H) can relieve discomfort and pain, and help shrink hemorrhoids.
• Take stool softeners to stop straining.
• Soak daily in a warm bath or a sitz bath (a warm, shallow bath that fits over your toilet).

Incontinence

Some women notice incontinence, or uncontrolled urination, during the last trimester. Symptoms include leakage of urine, especially while laughing, coughing, sneezing, or lifting. It can be from pressure on the bladder from the growing uterus and relaxation of the pelvic muscles.

The muscles of the pelvic floor are responsible for the strength, tone, and elasticity of the vagina and urethra (the opening to your bladder). During pregnancy and childbirth, these muscles expand and stretch to deliver the baby.

What do to

Doing daily muscle-strengthening Kegel exercises. Here’s how to do it:

1. To locate pelvic floor muscles, stop the flow of urine midstream or squeeze your vagina around your finger.
2. Contract and relax the muscle, in quick succession, 10 times.
3. Rest for 10 seconds.
4. Contract and hold for 10 seconds, or as long as you can.
5. Rest for 10 seconds.
6. Repeat, working gradually to about 150 contractions a day. Hold the contractions for increasingly longer periods of time.

Leg cramps

Cramps in the thighs or calves are common during pregnancy. They usually occur during the last trimester, often at night. Doctors are not certain of the cause.

What do to

Try the following home remedies:

• Wear support hose.
• Rest with your feet up.
• During cramping, extend your leg and flex your foot.
• Apply heat or gently massage the cramped area.
• Increase your calcium and magnesium intake; you can also eat a banana daily.

Morning sickness

Morning sickness—nausea or vomiting—can occur at any time during pregnancy, but usually during the first trimester. It can also happen any time of day, not just in the morning.

It is caused in part by increasing amounts of the hormone estrogen during the first 3 months of pregnancy.

What do to

Most often, morning sickness can be treated by:

• Eating frequent, small meals.
• Eating something, such as a soda cracker, when you wake up in the morning.
• Eating something light (such as crackers or soup) to minimize hunger and the stimulation of digestive enzymes that can cause nausea.
• Avoid odors, such as greasy foods, household cleaners, and perfumes, which can trigger nausea during pregnancy.

Talk to your doctor if your morning sickness is very bad, prevents weight gain, or continues after your first trimester. Severe cases may require anti-nausea medication.

Skin changes

Hormonal fluctuations can cause darkening of the areola (area surrounding the nipples). You may develop a dark line running from the navel to the pubic area.

Hormonal changes can also cause skin to darken. Some women develop a mask-like change in skin color on the cheeks, forehead, and above the lips called melasma. Sunlight can make it worse.

Estrogen can cause the palms of the hands to look red. Some women also have a blue-tinged, dappled discoloration of their feet. Fluid leaking out of blood vessels can cause the dappled appearance.

Changing hormone levels may also cause temporary acne and heat rash.

All of these skin changes usually fade after delivery.

Stretch marks can also develop from weight gain and the stretching of the skin over your enlarging breasts and abdomen. This stretching can also cause skin to feel itchy.

Small growths known as skin tags may form in areas where you have increased friction. Stretch marks and skin tags may not go away after delivery.

What do to

If you are concerned about any skin changes, see your doctor. Otherwise, keep your skin clean and dry. Moisturizers can help with itchy skin. If you start to have an intense itch, contact your doctor right away.

Stuffy nose

You may notice a stuffy nose (called nasal congestion). An increase in estrogen levels can inflame the mucous membranes of your nose. Many women think it’s allergies.

Although stuffiness may worsen during your pregnancy, it usually gets better on its own after delivery. Hot air and dry conditions can make you feel more stuffed up.

What do to

• If your symptoms are severe, see your doctor, who may recommend medications that are safe to take during pregnancy.
• Keep your home moist by using a humidifier to help with symptoms.
• Avoid blowing your nose a lot and intensely. Pregnancy can cause the tiny blood vessels in your nose to swell and sometimes burst with repeated hard nose blowing, causing a nosebleed.

Vaginal discharge

Vaginal discharge is common during pregnancy. You just want to make sure you can tell the difference between harmless discharge and discharge that could be a sign of an infection.

Vaginal discharge during pregnancy is thin and white with a non-offensive odor. You may notice more during later stages of your pregnancy.

If you have a discharge with itching, burning, or other discomfort, an unpleasant odor, or is green or yellow, see your doctor. You will probably be tested for an infection.

What do to

• Reduce the risk of infection by keeping your genital area clean, bathing regularly, and drying thoroughly.
• Avoid tight clothing.
• Wear cotton underwear—and consider not wearing underwear to bed.
• Do not use any scented products in your vaginal area.
• Do not use any feminine hygiene products.
• Your doctor may give you medication if an infection is detected.

Varicose veins

Varicose veins are veins that are swollen and can be seen through the skin. They may cause your legs to feel heavy and ache.

During pregnancy, they can be caused by pressure from the uterus on the veins in your pelvis and legs, which causes blood to pool there. An increased amount of blood in pregnancy also places pressure on the valves in the veins that normally keep the blood from building up.

What do to

To help keep blood circulating and ease the discomfort:

• Take a daily walk.
• Keep your legs elevated whenever you sit down.
• Avoid standing in one place for long periods of time.
• Wear support hose.

Water retention

Swelling of the ankles and feet due to water retention (edema) is from an increase in fluid during pregnancy. Your hands may also swell. And rings on your fingers may become tight.

Usually, some water retention is not a problem. However, if you have swelling of the face, blurred vision, or headache, call your physician. You could have preeclampsia, a potentially dangerous spike in blood pressure.

What do to

You can relieve the discomfort of water retention by elevating your feet whenever sitting or lying down, wearing support hose, and not standing for long periods.