Early signs of pregnancy has its share of
discomforts. Some, such as mild nausea and
fatigue, are almost universal. Others, including
nosebleeds and bladder infections, are less
common.
Soon after you conceive, your body begins a
series of major changes that enable it to
sustain your baby through 37 weeks of growth and
development. The glands of your endocrine system
and placenta step up hormone production. Your
blood volume increases and your uterus expands.
By the fourth month of pregnancy, you'll begin
to feel much more like your old self, presumably
because your body has adjusted somewhat to these
dramatic changes. Until then, you can rest
assured that first-trimester symptoms are almost
always associated with normal pregnancies that
have good outcomes. Morning sickness and the
other ailments that occur around this time are
almost always mild enough to manage on your own.
Here's a rundown of the most common
first-trimester symptoms.
Morning sickness
How common is it?
Up to 70 percent of expectant mothers have
nausea, sometimes with vomiting, early in
pregnancy. Queasiness may be most noticeable in
the morning, but it can occur at any time. Even
if you aren't nauseated, you may develop
aversions to certain foods, such as coffee and
meat, partly because of their odors. As long as
you continue to eat a healthy diet and get all
the nutrients you need, food aversions aren't a
cause for concern.
What causes it?
The exact cause is unclear, but pregnancy
hormones that relax the stomach may play a role.
How long does it last?
It generally improves by the 13th or 14th week
of
pregnancy, but some women continue to feel
queasy from time to time well into the second
trimester.
How can you manage it?
Munch a few crackers before getting up in the
morning.
Eat several small meals a day so that your
stomach is never empty.
Avoid anything that causes nausea.
Drink plenty of liquids, especially if you've
been vomiting. Try crushed ice, fruit juice or
frozen ice pops if water upsets your stomach.
Try wearing a motion sickness band, which may
relieve nausea by pressing on an acupressure
point inside the wrist.
Suck on hard candy.
Try ginger, which has proved effective in
combating morning sickness. Some ways to consume
the spice include ginger soda or tea,
gingersnaps or ginger in capsule form.
Constipation
How common is it?
Constipation affects at least half of all
pregnant women.
What causes it?
An increase in the hormone progesterone, which
slows the digestive process, is partly to blame.
In addition, your colon absorbs more water,
which tends to make stools harder and bowel
movements more difficult.
How long does it last?
Infrequent, difficult-to-pass stool can be a
problem any time during pregnancy, but it may be
worst in the first 13 to 14 weeks.
How can you manage it?
Try to eat on a regular schedule.
Drink plenty of liquids — at least eight to 10
glasses a day.
Get some exercise every day.
Eat high-fiber fruits, vegetables and grains
such as whole wheat and oatmeal.
Try fiber supplements, such as psyllium powder,
Metamucil, Konsyl, Fiberall or Citrucel. A mild
laxative such as milk of magnesia is safe, but
don't take any other laxative without discussing
it with your doctor.
Dizziness or fainting
How common are they?
Although exact numbers aren't available, perhaps
as many as one in 20 women experiences some
degree of lightheadedness during pregnancy.
Contrary to what's often depicted in movies,
pregnant women rarely faint.
What causes them?
Pregnancy results in a dramatic dilation of the
blood vessels of your body. In the first half of
pregnancy, however, your blood volume may not
have expanded enough to fill all of this space.
The result is lower blood pressure. Two
conditions that are common during pregnancy —
low blood sugar (hypoglycemia) and a low red
blood cell count (anemia) — also can cause
lightheadedness. The latter two causes may need
medical attention.
How long do they last?
Dizziness or fainting can occur at any time
during pregnancy, but may be especially
noticeable early in the second trimester, when
your blood vessels have dilated in response to
pregnancy hormones but your blood volume hasn't
yet expanded to fill them.
How can you manage them?
Arise slowly as you get up from lying or sitting
down.
Walk at a slower pace and take frequent rest
breaks.
Avoid prolonged standing.
Instead of lying flat on your back, lie on your
side. A pillow tucked under your abdomen may
make this position more comfortable.
Guard against overheating. Saunas and hot tubs
may increase the chance of fainting. Take cooler
baths and showers, use air conditioning when
needed, and avoid warm, crowded areas.
Stay physically active to improve blood
circulation. Good activities include walking,
water aerobics and prenatal yoga.
Drink plenty of fluids, particularly early in
the day.
Eat iron-rich foods such as beans, red meat,
green leafy vegetables and dried fruits to help
your body get the iron needed to build red blood
cells.
Fatigue
How common is it?
Almost all women report increased fatigue and
need for sleep in the first trimester.
What causes it?
To carry oxygen and nutrients to the fetus, your
body produces extra blood and your heart works
harder and faster. These
early pregnancy changes make enormous
demands on your circulatory system. During this
time, you're also producing higher levels of
progesterone, which tends to make you sleepy.
These may be factors producing the fatigue of
early pregnancy.
How long does it last?
Fatigue usually subsides by the second
trimester, but may return in the third trimester
when carrying the extra weight of the baby may
be tiring.
How can you manage it?
Rest. Take naps during the day or after work. If
you need to go to bed at 7 p.m. to feel rested,
do so. This is a symptom that has no solution
other than sleep.
Avoid taking on extra responsibilities. Cut down
on volunteer commitments and social events if
they're wearing you out.
Ask for the support you need. Get your partner
or children to help out as much as possible.
Exercise regularly. Moderate exercise, such as
walking for 30 minutes a day, can help you feel
more alert and energetic.
Eat foods rich in iron and protein. Skimping on
these nutrients can aggravate your fatigue.
Foods rich in both iron and protein include red
meat, seafood, poultry and eggs. Other good
sources of iron include whole-grain or
iron-fortified cereals, breads and pastas.
Avoid stimulants. Avoid caffeine, which may be
harmful in high doses. Any product marketed for
relieving fatigue and enhancing wakefulness is
unsafe in pregnancy.
Heartburn
How common is it?
More than half of all pregnant women get
heartburn, an uncomfortable sensation caused by
the backward flow of stomach acids into the
esophagus, the tube that carries food from your
mouth to your stomach.
What causes it?
Constipation, gas and heartburn are all effects
of sluggish digestion, induced by pregnancy
hormones. As pregnancy progresses, a second
factor — the expansion of the uterus, which can
push your stomach out of its normal position —
also may contribute to heartburn.
How long does it last?
Heartburn can be a problem at any time during
pregnancy, but may be most noticeable during the
third trimester.
How can you manage it?
Eat several small meals instead of two or three
large ones. No matter how small the meal, eat
slowly.
Avoid common heartburn triggers, such as fried
foods, alcohol, chocolate, peppermint, garlic
and onion.
Drink plenty of fluids, especially water.
Avoid coffee. Both regular and decaffeinated
coffee may worsen heartburn.
Stay up for two to three hours after your
evening meal. If your heartburn comes on when
you recline, raise the head of your bed four to
six inches.
Talk to your physician about using antacids or
other medications that relieve heartburn. These
products can be used safely in pregnancy, but
your physician should know which ones you take
and how often you take them.
Mood swings
How common are they?
Although the incidence of mood swings is
unknown, some women in the first trimester and
again in the weeks before delivery may
experience emotional fluctuations ranging from
exhilaration and joy to irritation and
depression.
What causes them?
Nagging discomforts, hormonal changes and
understandable anxiety about the future may all
contribute to sudden shifts in your mood. You
may feel better if you remind yourself that
powerful emotions are normal and healthy. Simply
recognizing that you're unusually moody can help
you and those around you weather the storms.
How long do they last?
Mood swings may occur at any time during
pregnancy. If you've typically experienced
premenstrual syndrome, you may have more extreme
mood swings when you're pregnant.
How can you manage them?
Eat regular meals and snacks that include a
variety of fresh fruits and vegetables and whole
grains.
Get plenty of sleep.
Rely on your network of family and friends for
support, but if you feel overwhelmed, contact
your physician.
Try relaxation techniques such as meditation,
guided mental imagery and progressive muscle
relaxation.
Nasal problems: Snoring, congestion and
nosebleeds
How common are they?
Up to a quarter of pregnant women snore,
compared with about 4 percent of women the same
age who aren't pregnant. Nasal congestion and
nosebleeds also are relatively common.
What causes them?
As more blood flows to your body's mucous
membranes, the lining of your nose and airway
swells, which can restrict airflow and cause
snoring, congestion and nosebleeds. Although
snoring is usually just a nuisance, it can be
associated with serious conditions such as high
blood pressure (hypertension) or a sleep
disorder in which you stop breathing for short
periods (sleep apnea). Women who snore during
pregnancy are at higher risk of
pregnancy-induced high blood pressure (preeclampsia).
How long do they last?
Nasal problems can develop at any time during
pregnancy.
How can you prevent snoring?
Sleep on your side rather than your back.
Sleeping on your back can cause your tongue and
soft palate to rest against the back of your
throat and block your airway.
Wear a nasal strip to open your nasal passages.
Avoid gaining more than the amount of weight
your doctor recommends.
Vaginal discharge and vaginal infections
How common are they?
An increase in vaginal discharge is essentially
universal in pregnancy as a result of marked
increase in the turnover of vaginal lining
cells.
What causes them?
The hormonally induced thickening of the vaginal
wall can cause a thin, white and odorless
discharge called leukorrhea. It's harmless and
needs no treatment. Other types of discharge can
be caused by bacterial or yeast infections.
Bacterial vaginosis, for example, causes a
foul-smelling, gray to greenish discharge. Signs
and symptoms of a yeast infection include a
thick, white and curd-like vaginal discharge,
itching, burning and redness around the vagina
and vulva, and painful urination. Neither a
bacterial nor a yeast infection presents a
direct hazard to your baby, and both can be
treated during pregnancy. Yeast infections are
more common due to the effect of pregnancy
hormones on the vaginal environment. Bacterial
vaginosis is no more frequent in pregnant women
than in other sexually active women.
How long do they last?
A whitish vaginal discharge will likely be
present throughout pregnancy. If you have
symptoms of itching, odor, burning or other
vaginal discomfort, it may be an infection and
should be evaluated and treated by your doctor.
Douching will not help the normal increase in
vaginal discharge and could cause an infection
in your uterus that could actually provoke the
premature delivery of your baby. Never douche
during pregnancy.
Other problems
Headaches are quite frequent in early pregnancy
but are rarely serious. If you get an occasional
headache, ask your physician about taking
acetaminophen when the pain begins. Back pain is
usually a problem of later pregnancy but may
arise in the first trimester, especially if you
have been pregnant before.
Urinary tract infections are somewhat more
common in pregnancy and must be treated when
they happen. Frequency of urination is very
common in pregnancy as the expanding uterus
exerts pressure on your bladder. Pain with
urination may be a symptom of a urinary
infection and should be promptly evaluated by
your care provider.
Also call your doctor immediately if you
experience any of the following:
Moderate to heavy vaginal bleeding
Any amount of vaginal bleeding accompanied by
pain, cramping fever or chills
Passing of tissue
A severe or persistent headache, especially with
dizziness, faintness, nausea or vomiting, or
visual disturbance
Moderate or severe pelvic pain
Any degree of pelvic pain that doesn't subside
within four hours
Pain with fever or bleeding
Vomiting with pain or fever
Chills or fever (102 degrees Fahrenheit or
higher)
Your morning sickness, day and evening
sleepiness, heartburn and other early symptoms
are strong reminders that your body is
supporting your baby's growth and development.
If you get enough rest and do what you can to
stay comfortable, you and your baby will thrive
throughout your pregnancy.
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