Seven Pregnancy Problems

Backache

A pregnant woman's pelvis has to expand at the time of birth to allow the baby through. To facilitate this expansion, the ligaments that normally hold the joints of the pelvis (and other parts of the body) together become slightly more elastic. This makes them more susceptible to strain. The joints of the spine are particularly susceptible to strains because the expanding womb shifts your centre of balance and changes your posture. Standing for any length of time is likely to impose unusual stresses on the back, and this strains the supporting ligaments and results in backache.

Slight movements of the vertebrae, one on the other, can cause nerves to be pinched and result in pain such as sciatica. This nerve pinching is further aggravated by the retention of fluid in the whole body, which causes the nerves to be slightly swollen and therefore more easily pinched.

The best way to reduce the likelihood of backache is not to gain weight excessively and to avoid all heavy lifting. If you attend antenatal classes, you will be shown the correct way of lifting, and you will also be taught exercises to help relieve the backache.

Constipation

Constipation is common in pregnancy and is thought to be due to a loosening of the muscles of the digestive tract caused by hormonal changes. In late pregnancy the enlarging womb presses on the intestines and aggravates the condition. It is not dangerous, but if it is worrying you, your doctor can recommend a faecal softener. No medication, including laxatives, should be used during pregnancy without discussing it with a doctor.

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Pain relief in labour

Labour is usually painful, but the degree of pain and discomfort and the way it is perceived varies dramatically from one woman to another. A few decades ago, anaesthetics were routine for labour, but today the trend has swung towards natural childbirth and relaxation techniques.

Unquestionably, having a child is an experience that most women wish to experience while conscious. It is after all one of the most significant happenings in their life. However, there are many pain- relieving options, and a woman who wants to take advantage of these should never feel hesitant about doing so. A woman is not any less of a woman because she makes use of modern medical science to have a more comfortable childbirth.

One of the simplest forms of pain relief is nitrous oxide (laughing gas), usually administered through a face mask which the woman holds herself and breathes through during a contraction. The effect will last virtually only while it is being breathed and is very safe for both mother and baby. Pain-relieving injections of pethidine or similar drugs can also be given regularly, and sometimes analgesic tablets are given, but these are not particularly effective.

For women experiencing severe pain or requiring some intervention (e.g. forceps), an epidural or spinal anaesthetic is appropriate. This involves an injection into the spine, which numbs the body from the waist down. The woman feels nothing but remains quite conscious and alert, and is able to assist in the birth process. Even a caesarean section can be performed using this type of anaesthetic.

Sleep problems

Sleep disturbances during pregnancy are common. You may find it difficult to get to sleep, or to stay asleep. This may be because of the changes in hormone levels, but it may also be because you have to get up more often to urinate. In late pregnancy it can be difficult to find a comfortable position in which to lie.

Discuss the problem with your doctor, but it is unlikely the doctor will want to prescribe any sleeping medication, as it may harm the developing baby. Relaxation techniques and exercise are the most appropriate remedies. Women who are constantly tired from lack of night-time sleep should allow time for a regular afternoon nap.

Morning sickness

The nausea and vomiting that affects some pregnant women between the sixth and fourteenth weeks of pregnancy is called morning sickness, but it can occur at any time of the day. Its severity varies markedly, with about one third of pregnant women having no morning sickness, one half having it badly enough to vomit at least once, and in 5% the condition is serious enough result in prolonged bed rest or even hospitalisation.

Morning sickness is caused by the unusually high levels of oestrogen present in the mother's bloodstream during the first three months of pregnancy. Although it usually ceases after about three months, it may persist for far longer in some unlucky women. Severe cases may be associated with twins, and it is usually worse in the first pregnancy.

Because morning sickness is a self-limiting condition, treatment is usually given only when absolutely necessary. A light diet, with small, frequent meals of dry fat-free foods, is often helpful. A concentrated carbohydrate solution (Emetrol) may be taken to help relieve the nausea. Only in severe cases, and with some reluctance, will doctors prescribe more potent medications. In rare cases, fluids given by a drip into a vein are necessary for a woman hospitalised because of continued vomiting.

Morning sickness has no effect upon the development of the baby.

Heartburn

Indigestion or heartburn affects about half of all pregnant women. This is because during pregnancy the muscle that closes off the upper part of the stomach from the oesophagus (gullet) loosens and allows digestive juices from the stomach to flow back up the gullet and irritate it. In late pregnancy the enlarging uterus presses on the stomach and aggravates the condition.

Heartburn can be dreadfully uncomfortable but is not harmful. You may be able to lessen the symptoms by eating small, frequent meals so that there is never too much food present but always enough to absorb the stomach acid. Antacids can usually be taken safely at most stages of pregnancy, and may be used to relieve more severe symptoms. The problem disappears when the baby is born.

Varicose veins

Many women develop varicose veins during pregnancy, especially during the later months. This is because their blood vessels have to cope with an increased supply of blood to meet the needs of the developing baby, and because of the pressure of the enlarging womb on the veins in the pelvis and abdomen. This combination of factors causes an increase in the back pressure on the superficial veins in the legs to cause them to become swollen and painful.

If you suffer from aching legs and are developing varicose veins, you should rest with your feet up as much as possible, wear loose clothing, and avoid anything tight around the top of the legs. Support stockings can both prevent the problem and relieve the symptoms. The varicose veins will become less swollen after the birth, but they will usually not disappear completely.

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