Hesperian Health Guides
Body changes and discomforts
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A woman’s breasts get bigger during pregnancy because they are getting ready to make milk for the baby. Sometimes the breasts are also itchy or sore.
During the last months of pregnancy, a watery, yellowish fluid may leak out of the nipples. This is normal. The fluid is colostrum — the first milk for the baby.
Swelling of the feet is very common, especially in the afternoon or in hot weather. Swelling of the feet is usually not dangerous, but severe swelling when the mother wakes up in the morning, or swelling of the hands and face anytime, can be signs of pre-eclampsia.
Swelling in the feet may improve if the woman puts her feet up for a few minutes at least 2 or 3 times a day, eats fewer packaged foods that are very salty, and drinks more water or fruit juices.
Swollen veins (varicose veins)
Swollen blue veins that appear in the legs or on the woman’s genitals are called varicose veins. Sometimes these veins hurt. If the swollen veins are in the legs, they may feel better if the mother puts her feet up often. Strong stockings or elastic bandages may also help.
If the swollen veins are around the genitals, they can cause bleeding problems if they tear during birth. Putting a cool cabbage leaf on the genitals may help.
Constipation (difficulty passing stool)
Some pregnant women have difficulty passing stool. This is called constipation. To prevent or treat constipation, a woman should:
- eat more vegetables and fruits.
- eat whole grains (brown rice and whole wheat instead of white rice or white flour).
- drink at least 8 cups of clean water a day.
- walk, move, and exercise every day.
Home or plant remedies that soften the stool or make it slippery (like remedies made from psillium seed or certain fruits or fiber plants) may also help.
WARNING! Pregnant women should not take medicines called laxatives or purgatives for constipation. These work by making the bowels tighten or contract — and they may cause labor to start too soon. Some can harm the baby.
Also, pregnant women should not wash out the bowels with water (enema). This could also start labor too soon.
Hemorrhoids are swollen veins around the anus. They may burn, hurt, or itch. Sometimes they bleed when the woman passes stool, especially if she is constipated. The woman should try to avoid getting constipated by eating a lot of fruit and vegetables and drinking plenty of fluids.
Sitting or standing a lot can make hemorrhoids worse. But sitting in a cool bath or lying down can help. Some women say it helps to soak a clove of garlic in vegetable oil and then insert it into the anus.
If you have heard of other remedies, ask an experienced health worker whether they are safe. Some remedies are dangerous for pregnant women and may hurt the baby.
Needing to urinate often
Needing to urinate (pee) often is normal, especially in the first and last months of pregnancy. This happens because the growing womb presses against the bladder (the place where the body stores urine). It is so common that some midwives joke: “A man who cannot find his pregnant wife should wait near the place where she urinates. If she is not there, she will be soon!”
Discharge (wetness from the vagina)
Discharge is the wetness all women have from the vagina. A woman’s body uses this discharge to clean itself from the inside. For most women the discharge changes during their monthly cycle. Pregnant women often have a lot of discharge, especially near the end of pregnancy. It may be clear or yellowish. This is normal.
Changes in the discharge can be a sign of an infection if the discharge is gray, green, lumpy, or has a bad smell, or if the vagina itches or burns.
Difficulty getting up and down
It is better if a pregnant woman does not lie flat on her back. When a woman is on her back, the weight of the womb presses on the big blood vessels that bring food and oxygen to the baby. If the mother wants to be on her back, she should put something behind her so she is not lying completely flat.
A pregnant woman should also be careful how she gets up. She should not sit up like this:
|Getting up like this can harm
the muscles of the belly.
Instead, she should roll to the side and push herself up with her hands, like this:
|Turn to the side...||then push up with the hands||then stand up|
Shortness of breath
Many women get short of breath (cannot breathe as deeply as usual) when they are pregnant. This is because the growing baby crowds the mother’s lungs and she has less room to breathe. Reassure her that this is normal.
But if a woman is also weak and tired, or if she is short of breath all of the time, she should be checked for signs of sickness, heart problems, anemia, or poor diet. Get medical advice if you think she may have any of these problems.
Feeling hot or sweating a lot
Feeling hot is very common, and as long as there are no other warning signs (such as signs of bladder infection), the woman should not worry. She can dress in cool clothes, bathe frequently, and drink plenty of water and other fluids.
The mask of pregnancy
The mask of pregnancy is a name for dark-colored areas that may appear on the face, breasts, and belly of some pregnant women. This mask is not harmful. Usually most of the color goes away after the birth. A woman may be able to avoid dark areas on her face by wearing a hat when she goes out in the sun.
Purple spots on the skin
Purple spots come from small groups of veins under the skin. They sometimes happen when blood vessels swell. They are not harmful and usually go away after the birth.
Aches and pains in the joints
A pregnant woman’s body gets soft and loose so the baby can get bigger, and so she can give birth. Sometimes her joints also get loose and uncomfortable, especially the hips. This is not dangerous, but she can more easily sprain her ankles or other joints. So she should move more carefully. Her joints will feel better after the birth.
Sudden pain in the side of the lower belly
The womb is held in place by ligaments on each side. Ligaments are like ropes that attach the womb to the mother's bones.
A sudden movement will sometimes cause a sharp pain in these ligaments. This is not dangerous. The pain will stop in a few minutes. It may help to stroke the belly gently, or to put a warm cloth on it.
Cramps in early pregnancy
It is normal to have mild cramps (like mild monthly bleeding cramps) at times during the first 3 months of pregnancy. These cramps happen because the womb is growing.
Cramps that are regular (come and go in a pattern) or constant (always there), are very strong or painful, or come with spotting or bleeding are warning signs. The woman may have a tubal pregnancy or may be having a miscarriage. She should get medical help immediately.
Baby's kicks hurt the mother
Most of the baby’s movements feel good. But sometimes babies kick very hard or always in the same place. And sometimes the baby’s head bounces against the mother’s back or bladder during the last weeks of pregnancy. These movements may make the mother sore or uncomfortable, but they are not harmful.
WARNING! The mother usually feels regular kicks every day by the 6th or 7th month. If the baby stops kicking for a few hours, it is OK. But if the mother feels no movement for more than a day and a night, there may be a problem. The mother should meet with her midwife or get medical help.
Many women get back pain. The weight of the baby, the womb, and the waters puts a strain on the woman’s bones and muscles. Too much standing in one place or leaning forward can cause back pain. Hard work can also cause back pain. Most kinds of back pain are normal. But it can be caused by a
Encourage husbands, children, other family members, or friends to massage the woman’s back. A warm cloth or hot water bottle on her back may also feel good. Her family can also help by doing some of the heavy work (carrying small children, washing clothes, farming, and milling grain) for her.
A woman can also do an exercise — called the angry cat exercise — to reduce lower back pain. She should do this exercise several times in a row, 2 times a day, and whenever her back hurts her
|Start on hands and knees
with the back flat.
|Push the lower back up.||Return to flat back. |
|Point the toe up,||then stroke the leg.||Do not point the toe down.|
Many women get foot or leg cramps — sharp sudden pain and tightening of a muscle. These cramps especially come at night, or when women stretch and point their toes. To stop the cramp: flex the foot (point it upward) and then gently stroke the leg to help it relax (do not stroke hard). See when leg pain can be dangerous.
Foods rich in calcium and potassium can help prevent leg cramps.
To prevent more cramps, a woman should not point her toes (even when stretching), and she should eat more foods high in calcium and potassium. The woman can also try taking calcium, magnesium, and potassium pills.
Headaches are common in pregnancy but are usually harmless. Headaches may stop if the mother rests and relaxes more, drinks more juice or water, or gently massages her temples. It is OK for a pregnant woman to take 2 paracetamol tablets with water once in a while.
Some women have migraine headaches. These are strong headaches, often on the side of the head. The woman may see spots and feel nauseated. Bright light or sunshine can make them worse. Migraines may get worse in pregnancy.
Unfortunately, migraine medicine is very dangerous in pregnancy. It can cause labor to start too soon, and it may also harm the baby. It is better for a pregnant woman with migraines to take 500 to 1000 milligrams paracetamol, and rest in a dark room. Although coffee and black tea are usually not healthy in pregnancy, they are OK occasionally and they may help cure a migraine.
Headaches late in pregnancy are a warning sign of pre-eclampsia, especially if there is also high blood pressure or swelling of the face or hands.
It is common to have other small aches and pains during pregnancy. Get medical advice for pain that is not normal in pregnancy, such as:
- red, swollen joints.
- severe pain.
- signs of anemia with joint pain.
WARNING! If there is pain in one leg that will not go away, it may be a blood clot. Get medical help.