Conditions and problems in pregnancy 7 7 Your body goes through a lot of changes during pregnancy. Sometimes these C changes can cause you discomfort or in pregnancy onditions and problems irritation, and you may be worried about what is happening to you. There is usually nothing to worry about, but you should mention anything that concerns you to your midwife or doctor. If you have concerns or questions in between appointments write them down in the “what matters to me” section of your maternity hand-held record (MHHR) and discuss with your midwife or doctor at your next appointment. If you think that something may be seriously wrong, trust your own judgement and get in touch with your midwife or doctor straight away. This chapter describes some of the minor and more serious health problems and gives advice on how to deal with them and when you should get help. Problems in early need a second scan to check How to avoid backache pregnancy that all is well. • Avoid lifting heavy objects. Most women feel well in Common minor • Bend your knees and keep early pregnancy but can problems feel uncomfortable. Some your back straight when women describe a pain low Backache lifting or picking something down in the abdomen similar As your baby grows, the up from the floor. to a period pain. This does hollow in your lower back may not necessarily mean that become more pronounced, something is wrong, but if the and this can also cause pain is more than discomfort backache. During pregnancy, or if there is any bleeding, your your ligaments become softer midwife or GP should refer and stretch to prepare you for you for a scan in the early labour. This can put a strain on pregnancy assessment unit. the joints of your lower back This scan will show whether and pelvis, which can cause the pregnancy is growing in backache. the uterus. Sometimes you 75 Feeling faint You may often feel faint when you are pregnant. This is because of hormonal changes taking place in your body and happens if your brain is not getting enough blood and therefore enough oxygen. If your oxygen level gets too low, you may actually faint. You are most • Move your feet when turning How to avoid constipation likely to feel faint if you stand round to avoid twisting your still for too long or get up too spine. • Eat foods that are high in fibre, like wholemeal breads, quickly from a chair or out of • Wear flat shoes that allow wholegrain cereals, fruit and a hot bath. It can also happen your weight to be evenly vegetables, and pulses such when you are lying on your back. distributed. as beans and lentils. How to avoid feeling faint • Work at a surface that is • Exercise regularly to keep high enough so that you your muscles toned. • Try to get up slowly after don’t stoop. sitting or lying down. • Drink plenty of water. • Try to balance the weight • If you feel faint when between two bags when • Avoid iron supplements. Ask standing still, find a seat carrying shopping. your doctor whether you can quickly and the feeling manage without them or should pass. If it doesn’t, lie • Sit with your back straight change to a different type. down on your side. and well supported. Cramp • If you feel faint while lying on • Make sure you get enough your back, turn on your side. Cramp is a sudden, sharp pain, rest - particularly later in It is advisable not to lie flat on usually in your calf muscles or pregnancy. your back at any time in later feet. It is most common at night, pregnancy or during labour. When to get help but nobody really knows what If your backache is very painful, causes it. • Ask your doctor or midwife ask your doctor to refer you to a to check your haemoglobin maternity physiotherapist at your How to avoid cramp (Hb) level as you may need hospital. They will be able to Regular, gentle exercise in iron supplements. give you some advice and may pregnancy, particularly ankle suggest some helpful exercises. and leg movements, will improve Feeling hot your circulation and may help to During pregnancy you are likely prevent cramp occurring. Constipation to feel warmer than normal. This You may become constipated is due to hormonal changes very early in pregnancy because and to an increase in the blood of the hormonal changes taking supply to your skin. You are also place in your body. likely to sweat more. 76 How to avoid feeling hot • Wear loose clothing made of natural fibres, as these are more absorbent and ‘breathe’ more than synthetic fibres. • Keep your room cool. You could use an electric fan to 7 cool it down. and after pregnancy. stomach. Heartburn is more than C onditions and problems in pregnancy onditions and problems Sometimes pregnant women just indigestion. It is a strong, • Wash frequently to help you are unable to prevent a sudden burning pain in the chest caused to feel fresh. spurt of urine or a small leak by stomach acid passing from when they cough, sneeze or your stomach into the tube Headaches laugh, or when moving suddenly leading to your stomach. This is Some pregnant women find they or just getting up from a sitting because the valve between your get a lot of headaches. position. This may be temporary, stomach and this tube relaxes because the pelvic floor muscles during pregnancy. How to ease headaches relax slightly to prepare for the baby’s delivery. How to avoid indigestion • Try and get more regular rest and relaxation. Some women have more severe • Try eating smaller meals more often. • Paracetamol in the incontinence and find that they recommended dose is cannot help wetting themselves. • Sit up straight when you generally considered safe for are eating, as this takes the pregnant women but there When to get help pressure off your stomach. are some painkillers that you In many cases incontinence is should avoid. Speak to your curable, so if you have a problem • Avoid the foods which affect pharmacist, nurse, midwife, talk to your midwife, doctor or you, like fried or highly health visitor or GP about health visitor. spiced food, but make sure how much paracetamol you you are still eating well (see can take and for how long. You can also get help and support pages 31 for information on from the confidential Bladder healthy eating). When to get help and Bowel Foundation helpline If the headache is severe or is on 0845 345 0165 (9.30am to associated with swelling, blurred 1.00pm Mon to Fri) or visit vision or heartburn type pain www.bladderandbowelfoundation.org contact your doctor or midwife immediately. Indigestion and heartburn Indigestion is partly caused Incontinence by hormonal changes and Incontinence is a common in later pregnancy by your problem. It can affect you during growing uterus pressing on your 77 How to avoid heartburn • Heartburn is often brought on by lying flat. Sleep well propped up with plenty of pillows. • Avoid eating and drinking for a few hours before you go to bed. • Your GP may prescribe an many as 1 in 4 women being have enough iron reserves for antacid if the problem is anaemic before pregnancy a health pregnancy. There is no persistent. and 1 in 3 after delivering their benefit in taking more than one baby. You might not be aware iron tablet a day as your body How to ease heartburn that you are anaemic but if you can only absorb a certain amount experience tiredness, paleness, each day and it will make side • Drink a glass of milk. Have shortness of breath or dizziness effects more likely. The best one by your bed in case you these could all be warning improvement in your blood count wake with heartburn in the signs. Women with anaemia in is seen if you take one tablet night. pregnancy have been shown to daily consistently. Taking your have a higher risk of low birth tablets on an empty stomach with • Note that you should not weight babies and of needing a vitamin C rich foods (such as take antacid tablets before blood transfusion. There will be fruit and vegetables) will ensure checking with your midwife, huge demands on you after birth your body can absorb as much doctor or pharmacist that and being anaemic will make iron as possible. Tea, coffee, dairy they are safe for you to take the caring for you and your baby products and antacids can all during pregnancy. much more difficult. reduce the amount of iron you absorb so avoid these for about Leaking nipples You will be offered a blood two hours before taking your Leaking nipples are normal and test to check for anaemia at iron tablets. Some people find usually nothing to worry about. your booking appointment. For that iron tablets can make them The leaking milk is colostrum, most women the cause is a constipated but this is a common which is the first milk your lack of iron. Good sources of problem in pregnancy and can breasts make to feed your baby. easily absorbed iron include be avoided by drinking plenty of red meat, chicken and fish. If When to get help you are vegetarian ensure you See your midwife or doctor if the are getting enough iron from milk becomes bloodstained, or other foods such as tofu, beans, if you notice unusual lumps on lentils, peas and dried fruits. your breasts.