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Pregnancy is the time between conception and childbirth in which a fetus grows and matures for forty weeks (approximately 9 months) inside the womb until it is ready to be born. There are many problems and concerns than can occur during a pregnancy. Many, like stretch marks and gas, are merely annoying. Others, such as miscarriage, are quite serious.
Most of the problems that occur during pregnancy are the result of hormonal changes within the body, nutritional deficiencies, or the shift in weight distribution caused by sudden weight gain. This page addresses some of the most common pregnancy-related problems and offers natural remedies as well as helpful hints and suggestions for maintaining maximum health during pregnancy. For a healthy pregnancy and birth, it is necessary to consult and work with your midwife or health care practitioner.
BASIC INFORMATION ABOUT PREGNANCY-RELATED PROBLEMS
Ankle Pains & Strains
Alcohol
Backache
Balance Changes During Pregnancy & Postpartum
Bathing
Bleeding Gums
Balance Disturbances
Breasts & Skin Discoloration
Caffeine
Clothing & Shoes
Constipation
Dizziness
Douching
Edema - Swelling of Hands & Feet
Emotions & Moods
Employment & Working During Pregnancy
Exercise
Feet Care During Pregnancy
Gas (Flatulence)
Groin Spasm, Stitch or Pressure
Heartburn
Hemorrhoids
Insecticides
Insomnia
Knee Pain & Discomforts
Leg Cramps
Medications
Miscarriage (Spontaneous Abortion)
Mood Changes (Mood Swings)
Morning Sickness
Neck Pain & Forward Head Syndrome
Nose Bleeds & Nasal Congestion
Paints & Painting Supplies
Pelvis, Pubic Bone, Tailbone (Coccyx) Pain & Instability
Personal Care Products, Cosmetics & Hair Care
Rest Periods
Sciatica
Seat Belt Use
Sexual Intercourse
Shoulder Pain
Skin Problems
Smoking & Tobacco Use
Soreness of the Rib Area
Stretch Marks
Sweating
Tests - Prenatal Diagnostics
Travel
Urination, Frequent
Varicose Veins
Video Display Terminals (Computers)
Wrist Pain & Carpal Tunnel
Additional Notes
Nutritional Health In Pregnancy
ANKLE PAINS & STRAINS
A history of ankle sprain, muscle and tendon strain, or tendonitis of the Achilles tendon put you at higher risk for re-injury during your pregnancy and postpartum period. Ankle sprains most often occur when walking down stairs, stepping off sidewalks, or during abrupt changes of direction. For women with a history of sprains and strains, hiking or jogging on hard or uneven surfaces during the last half of pregnancy is not advisable.
Pregnancy Safety Tips for Preventing Trips, Falls, Sprains and Strains
- When using stairs, avoid carrying loads that obstruct your view, such as large loads of laundry or stacks of packages.
- Step down from stairs and curbs with greater caution than you did before your pregnancy.
- Use handrails to compensate for the shift in your center of gravity.
- Practice simple balance exercises throughout your pregnancy to maintain ankle motor-control and adjust to center of gravity shifts.
- Enlist your family and household members in a campaign to keep the floor and stairs clear of obstacles or spills that might trip you or cause slip and fall accidents, explaining that pregnant women are more likely to get injured if they should slip and fall.
- Using night lights in hallways and bathrooms can also help prevent trip and fall accidents.
ALCOHOL
Don't drink alcoholic beverages. It is a known fact that alcohol in excess can cause damage to your unborn child. As time goes by, more and more drugs are found to exert harmful effects on the fetus during pregnancy. Remember that alcohol is a drug and that any product that contains alcohol is a drug.
MoonDragon's Obgyn Information: Pregnancy & Alcohol
BACKACHE
Backache is common in pregnancy is often rooted in poor posture. The increase in body weight, the muscle-relaxing effects of the hormone progesterone, and the shift in the center of gravity contribute to the problem.
Lower Back Support Garments: Habitual Use May Cause More Harm than Good - Avoid over-relying on lower back and belly-support garments during pregnancy. Wearing a support garment on a daily basis inhibits the deep abdominal muscles and deep spinal muscles from doing the work intended for them, i.e., supporting your spine. When not worked, muscles will in fact weaken and atrophy-exactly what you don not want to happen.
Maintaining Strength Remains Superior to Support Garment Use - In order to support your spine and the growing weight of your baby, build and keep your internal girdle strong and supportive, rather than wearing a support garment. If by the end of the day, you find that you no longer have the stamina to support your lower back, then by all means, use a support garment to ease symptoms for short periods of time. If you do decide to use a back-support device, put it on while you are lying on the floor, with your pelvis and spine in the neutral position. Putting on any type of support garment on while standing with your pelvis and spine misaligned will not help your back.
Exercises for Relieving Back Pain
- The "Cat Stretch" can be done either on all fours, or standing with your hands on your knees. It is a great way to lengthen lower-back muscles.
- Lying down with your lower legs resting on an ottoman or soft chair seat, or with both knees pulled up to the chest is also effective in relieving pain. During pregnancy, watch for signs of dizziness in this position.
BALANCE CHANGES DURING PREGNANCY & POSTPARTUM
Several physiological responses to pregnancy diminish your body's ability to maintain adequate balance, and place you at higher risk for injury and falls. During the latter part of pregnancy and the postpartum period, ligament laxity creates dynamic instability in joints. The body's center of gravity is in a state of flux during pregnancy, slowly shifting up and forward as the uterus and baby grows. Because the body has no prior neuromuscular experience of it's new and evolving center point, it is inherently less coordinated and less adept at remaining in balance and/or righting itself as necessary. And lastly, because the area surrounding your center of gravity is larger and heavier, you will need to exert more effort to move efficiently.
EXTRA CAUTION: Because balance is compromised during pregnancy and through about six months postpartum (until the ligaments have returned to their former length), you should avoid all activities that increase the risk of falling, such as using a ladder, or hiking on steep or uneven terrain. Most trip-and-fall injuries occur when walking down stairs and stepping off curbs.
INJURY RISK CONDITIONS: You should be particularly careful and attentive if you have a history of ankle sprain or patella (knee) dislocation. These injuries put you at a significantly higher risk for falling in the last half of pregnancy and postpartum period. To maintain good neuromuscular control and help prevent injury, regularly include simple balance exercises in your workout routine during and after pregnancy.
Simple Balance Exercise for Pregnancy:1. Stand adjacent to a wall (wearing fitness shoes) with your left fingertips gently touching the surface of the wall.
2. Step forward onto your right foot, bringing your left foot to your right ankle.
3. Keep your fingertips lightly touching the wall until you have established good balance, then release contact.
4. Stay balanced on your right foot for several seconds. If your ankle begins to wobble, bring your fingertips back onto the wall.
5. Step backward onto your left foot, bringing your right foot to left ankle. Release contact with the wall.
6. Stay balanced on the left foot for several seconds. Bring your fingertips back to the wall if needed.
7. Turn around, place your right fingertips on the wall and repeat the entire sequence on the other side. (Step forward onto your left foot first.)
8. After this balance sequence becomes easy, perform the exercise with bare feet.
9. To increase the challenge, close your eyes while balancing.
BATHING
Take tub baths or showers, whichever you prefer. Water generally does not enter the vagina during these activities, so chance of infection is minimal. Your balance may be more difficult to maintain toward the end of your pregnancy, so be careful while getting in and out of the bathtub and make sure it has a non-slip surface on the bottom.
Do not take extremely hot baths or showers since the heat can cause problems with the fetus, especially as the pregnancy progresses. Instead have the water comfortably warm (about 99°F to 101°F).
BLEEDING GUMS
During pregnancy, increasing estrogen levels cause the gums to swell and become somewhat softer than normal, and the circulation of blood to them increases. This make the gums more prone to bleeding and infection, especially if good oral hygiene is not maintained.
Suggestions for bleeding gums:
- Be sure your diet contains enough calcium and high quality, complete proteins.
- Increase your intake of foods rich in vitamin C, as a deficiency in this vitamin can contribute to bleeding gums.
- If you smoke - Quit! Preferably before you get pregnant. Cigarette smoking reduces the oxygen supply to the developing fetus, and also drains the vitamin C from the body.
- Brush your teeth three to four times daily (remembering to rinse your mouth well), and massage your gums with clean fingers when necessary. Floss your teeth daily.
- See your dentist either right before getting pregnant or once during pregnancy. DO NOT have x-rays taken.
BOWELS DISTURBANCES
Your regular bowel habits may become disturbed during your pregnancy due to hormonal changes. The increasing level of progesterone in your system makes the bowels less efficient. The normal rhythmic contractions of the intestines slow down, and can result in constipation. These changes probably result from relaxation of the muscle cells in the bowel and pressure on the surface of the bowel wall from the expanding uterus containing the growing baby. Hemorrhoids appear more frequently.
Do not use any commercial hemorrhoid medications. These contain local anesthetics and mercury which are absorbed through the skin and can be harmful to the fetus. Consider using pads soaked in Witch Hazel and place them against the hemorrhoid(s). Witch Hazel helps to ease the irritation and soothingly shrink the swelling.
Some suggestions for hemorrhoids & constipation:
BREASTS & SKIN DISCOLORATION
Breasts enlarge during pregnancy because of hormonal changes. The nipple area becomes darker. This is natural. Other parts of the skin may become discolored - the neck, the face, and a line down the middle or lower part of the abdomen. These changes are temporary and normally disappear after delivery.
According to the American Academy of Dermatology, up to 70 percent of pregnant women develop blotchy areas of darkened skin, commonly called the mask of pregnancy (but officially known as chloasma or melasma). Women with darker complexions are more prone to this condition than women with lighter skin. The effects of chloasma may become more pronounced with each pregnancy. The splotches can show up around your upper lip, nose, cheekbones, and forehead, sometimes in the shape of a mask (think Lone Ranger). They may also appear on your cheeks or along your jawline. You may develop dark patches on your forearms and other parts of your body that are exposed to the sun. What's more, you may find that skin that is already more pigmented - such as your nipples, freckles, scars, and the skin around your genitals - becomes even darker during pregnancy. This also tends to happen in areas prone to friction, such as your underarms and inner thighs. These changes are caused by hormonal changes during pregnancy, which stimulate a temporary increase in your body's production of melanin, the natural substance that gives color to hair, skin, and eyes. The areas of increased pigmentation will probably fade within a few months after delivery and your skin should return to its normal shade, although in some women the changes never completely disappear.
The dark line running down your belly is called the linea nigra. Before pregnancy, there was a line called the linea alba running from your belly button to your pubic bone. You probably didn't notice it, though, because it was the same color as the rest of your skin. The same increased production of melanin that causes facial splotches is responsible for darkening this line on your belly. It will probably fade back to its pre-pregnant color several months after you deliver your baby.
Skin pigmentation changes usually disappear on their own after delivery, but you can do a few things to safely minimize them in the meantime:
- Eat foods that contain folic acid (you'll also get plenty in your prenatal supplement), since studies have shown that a folate deficiency can be related to hyperpigmentation. Good choices include green leafy vegetables, oranges, whole-wheat bread, and whole-grain cereal.
- Protect yourself from the sun: This is crucial because exposure to the sun's ultraviolet (UV) rays intensifies pigment changes. Use a broad-spectrum sunblock (a formula that protects against both UVA and UVB rays) with SPF 30 or higher every day, whether it's sunny or not, and reapply often during the course of the day if you're outside.
In fact, even if you don't plan to leave the house or spend much time outside, make applying sun protection part of your morning routine. The American Academy of Dermatology cautions that your skin is exposed to a significant amount of UV light when you do things like walk down the street, ride in a car, or even sit inside near a window. When you're outside, cover up and wear a hat with a brim, as well as a shirt with long sleeves if you have pigmentation changes on your arms. Limit the time you spend in the sun, especially between 10 a.m. and 2 p.m. And definitely avoid tanning salons.
- Use gentle cleansers and facial creams. Preparations that irritate your skin may make the problem worse.
- Apply a concealing makeup. (Don't use skin-bleaching products now. Wait to see if the pigmentation changes go away after you give birth.)
After you have your baby, continue to protect your skin from the sun! Use sunscreen, cover up, and stay out of the sun at midday. In most cases, the discolorations will slowly fade without any treatment. For a small number of women, however, contraceptives that contain estrogen (such as the Pill, the patch, and the vaginal ring) can contribute to chloasma. If the skin changes are bothersome, consider another birth control option. If your skin is still blotchy after a few months and it's bothering you, talk to your practitioner or a dermatologist about treatment options. She may suggest using a bleaching cream that contains hydroquinone (some of which also contain sunscreen), a topical medication that contains tretinoin (Retin-A), or a chemical peel such as glycolic acid. Of course, if you're breastfeeding or plan on becoming pregnant again soon, be sure to let your practitioners know and also check in before using any over-the-counter treatments. Don't expect instant results - it may take many months to see improvement. In rare cases, dermatologists can use laser treatments to remove the darkened skin, but that's not the first option. Whatever approach you take, it's crucial to continue protecting yourself from the sun during treatment and afterward.
Certain types of skin discoloration can be a symptom of skin cancer or other medical problems, so let your practitioner know if changes in skin pigmentation are accompanied by pain, tenderness, redness, or bleeding, or if you notice any changes in the color, shape, or size of a mole. You may be referred to a dermatologist who can determine the cause of the changes and the appropriate treatment, if any.
CAFFEINE
Consumption of caffeine in low to moderate amounts is not associated with significant risks during pregnancy. Heavy caffeine use can result in potential problems, such as low-birth-weight, caffeine withdrawal symptoms in the newborn and fetal loss. Heavy caffeine drinkers need to reduce or eliminate caffeine completely during pregnancy. Other sources of caffeine besides coffee to be alert to are teas, colas, chocolate and some non-prescription drugs. No caffeine is best, if at all possible.
CLOTHING & SHOES
Maternity clothes are available in a wide range of prices and styles. In addition, some regular clothing with loose fit can be worn during and after a pregnancy. Outer clothing should be practical and non-constrictive. Because a pregnant woman may feel the cold less and perspire more, cotton and natural fibers may be more comfortable than synthetic fabrics. Borrow maternity clothing from a family member or a friend. Keeping up your appearance can help boost your spirits. Many second hand shops are located in most areas that may have used, but nice and inexpensive maternity wear. Check them out. If you know how to sew, obtain sewing patterns and create your own designs and adapt them to your own style.
Some suggestions for clothing and shoes:
- Wear maternity pantyhose or special support hose. Regular pantyhose may constrict blood flow. Wear well-fitting maternity bras that give good support to the breasts and the spine.
- Shoes should be low or medium heeled and as comfortable as possible with nonskid soles. As a pregnant woman's belly grows, it will throw her center of balance off. This will make her more prone to falls and loss of balance as well as backaches. High heeled shoes will only make this problem worse. Swollen feet are common during pregnancy due to normal fluid retention. There may be extra fat in the feet if weight gain is excessive. The shoe size may increase, and sometimes becomes a permanent change.
CONSTIPATION
Hormonal changes during pregnancy have a relaxing effect on the muscles, including those of the digestive tract. The increasing level of progesterone in your system makes the bowels less efficient. The normal rhythmic contractions of the intestines slow down, and the result can be constipation.
Some suggestions for constipation:
- Eat fresh and dried fruit such as prunes, raisins, and figs.
- Eat fresh vegetables and salads containing a variety of raw green and colored vegetables daily.
- Increase the amount of fiber in your diet. Whole grain breads, cereals, and bran are helpful. Begin by taking 2 teaspoons of bran in a glass of apple juice twice daily. The bran may cause some gas until your system is used to it, but after that you should not have any difficulty.
- Drink six to eight 8-ounce glasses of liquid, including water, each day.
- Walk at least a mile a day, and set a regular time each day for bowel movement. This is very helpful for digestion and elimination. Elevate your feet and legs during elimination to relax the anal muscles.
- If all else fails, an enema, using body temperature water, may be used occasionally.
- Do NOT take over-the-counter laxatives unless specifically recommended by your midwife or health care provider.
DIZZINESS
During pregnancy, especially during the second trimester, blood pressure often drops as the expanding uterus presses on major blood vessels. this can cause dizziness.
Do not change positions quickly. Always go from lying down to sitting to standing slowly. Take your time and focus on what you are doing.
DOUCHING
Do not douche during pregnancy unless your midwife suggests it for medical reasons. It will require special care and instructions, which she will give to you. Do not attempt it on your own.
EDEMA (SWELLING OF THE HANDS & FEET)
The rise in estrogen in the body during your pregnancy increases the tendency to retain fluids. This can cause some swelling of the hands and feet and is considered normal.
- Remove any rings or tight fitting jewelry that you wear on a regular basis. Do not wait, or the rings may need to be cut off.
- As soon as you notice your hands, feet, ankles or legs getting puffy or larger than usual, tell your midwife. While some swelling is acceptable, the condition should be evaluated for a symptom of Toxemia (also known as preeclampsia/eclampsia), a potentially serious complication of pregnancy.
- Avoid excess salt. Some is needed for expanding blood volume, but don't go overboard. Salt to taste. Don't eat highly processed foods which tend to contain high levels of "hidden salt" in them to give them "flavor" and used as a food preservative. Maintaining a healthy, nutritional diet high in protein is necessary. Protein can be obtained from either animal or plant sources. Do NOT take diuretics (water pills).
- Wear loose, comfortable clothing and properly fitting shoes. You may require a larger shoe size during pregnancy. Once the baby is born, your shoe size should return to normal. Don't wear tight fitting girdles or elastic in underwear or stockings.
- Do not sit with a weight on your lap (like a small child) as this impedes circulation.
- Walk one mile each day. This helps to keep this condition under control.
- Do not sit on a chair that cuts across the back of the legs for a long period of time. Put a small lift under your feet to prevent circulation disruption. Rest with your feet up periodically during the day. Raise them on a stool, pillows or ottoman to bring them up to about waist to chest height.
EMOTIONS & MOODS
You may experience more emotional ups and downs than usual. This is quite normal during pregnancy. This emotional roller coaster ride is due to hormonal influences. Urge those close to you to understand and to be supportive. Use exercise, relaxation, meditation, diet, and herbal therapies to improve your energy and moods, but don't neglect emotional and spiritual work.
Some suggestions for feeling energetic and at peace:
EMPLOYMENT & WORKING DURING PREGNANCY
You may safely continue working throughout your pregnancy for as long as you remain comfortable at your job and avoid severe physical strain.
Some types of jobs that involve physical exertion may need evaluation by your midwife or health care provider. There are no set of guidelines regarding work during pregnancy as expectant mothers have differences in levels of capability, pre-pregnancy conditioning, exercise tolerance and physique.
If you work around hazardous materials and/or chemicals. Carefully consider your situation and discuss it with your midwife or health care provider. If you choose to continue working, make sure you take extra precautions to prevent exposure to any hazardous substances.
If you work a potentially dangerous job exposing you to serious fall, accident or other type of danger. Again, discuss it with your midwife or health care provider and make choices from there.
EXERCISE
Continue to enjoy fitness and recreational activities as you did before pregnancy if your midwife has given the go ahead. Some activities may need to be moderated if they are physically strenuous. Pregnancy is not the time to try a new sport or physical activity. Exercise classes designed for pregnant women are helpful.
Avoid activities that may endanger the abdomen, or that involve jarring, bouncing, or twisting movements. Also avoid activities involving rapid starts and stops, because during pregnancy, the body's center of gravity changes, and it is easy to lose your balance. After the fourth month, do not exercise on your back, as this can interrupt the blood flow to the uterus and slow the fetal heart rate. Avoid activities such as horseback riding, skydiving, motorcycle-racing, fast or long distance running, water-skiing and others that carry undue risk.
FEET CARE DURING PREGNANCY
Put Your Feet before Your Sense of Style - The idea of "sensible shoes" may seem like an anathema for women who follow fashion trends, but pregnancy and postpartum-related foot pain can make even the most dedicated fashion conscious woman appreciate the value of supportive, good-fitting shoes. For the duration of your pregnancy, shoes with high heels and pointy toes are better left in your closet than on your feet.
Shoe Doesn't Fit The Foot - At Least for Now Shoe-fitting problems stem from added body weight in conjunction with ligament laxity and fluid retention. This combination of physical changes can stress and flatten the longitudinal and metatarsal arches of the feet, and ultimately affect they way your shoes fit. With stretched ligaments and swelling from water retention and weight gain, your feet may spread and swell enough to require longer and/or wider shoes. Some women will need to buy larger shoes during pregnancy to accommodate these changes. You'll notice foot swelling especially at the end of the day.
Taking Care of Your Feet during Pregnancy
- Take frequent breaks to keep from standing for long periods of time.
- If your feet tend to swell, elevate your lower legs and feet while sitting.
- During the last half of pregnancy, get your feet re-measured before buying shoes.
- Avoid walking in your bare feet.
- To increase blood flow and reduce swelling, practice simple ankle exercises, such as flex and point, and ankle circles.
- Select shoes with a contoured foot bed and a large, naturally shaped toe, which support the arches and prevent compression of the forefoot and toes.
Evaluating the Condition of Your Shoes - Evaluate the condition of your shoes to see if they're safe to wear during your pregnancy. Check the heels and soles of your shoes for wear. If, when placed on a table or similar flat surface, your shoes slump in any direction, or the heels show marked signs of wear on one side, they're too worn to wear. Even if they are your favorite pair, wearing them can risk injury. And of course, any shoe that causes pain should not be worn for the duration of your pregnancy.
GAS (FLATULENCE)
Gas, like other digestive upsets, is a common complaint during pregnancy. Even foods that cause no difficulties at other times may begin to cause trouble.
Some suggestions for gas:
- Keep a food diary to determine which foods or combination of foods may be causing the gas. Avoid these foods. Eat 4 or 5 small meals a day, instead of 3 big meals. Chew your food well and slowly.
- Eat four or more servings of fresh fruits an vegetables every day. If you cook vegetables, do it quickly using a perforated steamer instead of boiling water. Do not over cook them.
- To reduce gas-causing sulfur compounds in beans (garbanzo, pinto, navy, etc.), place 1 cup of beans in 5 cups of water and bring to a boil. Boil the beans for one minute. Drain them and add 5 cups of fresh water. Bring the water to a boil and continue cooking according to directions.
GROIN SPASM, STITCH OR PRESSURE
When the round ligaments connecting the corners of the uterus to the pubic area kink and go into spasm, it feels like a "stitch" on the right side. In later months of pregnancy, lower groin pressure may develop.
Some suggestions for groin spasms or pressure:
- Exercise and slowly stretch daily, using exercises recommended by your midwife. This will help alleviate the condition. Consult with a yoga instructor specializing in pregnant women. She may have some stretching, breathing, and movement exercises that would help to relief. Be careful how you move and be conscious of your movements.
- During spasms, breathe deeply and bend toward the point of pain in order to allow the ligament to relax. Rest on the bed on one side until the spasm is over. To relieve round ligament pain, perform a "hip-hiker" on the painful side to shorten the ligament, reduce tensile forces, and relieve pain.
HIP-HIKER EXERCISE FOR ROUND LIGAMENT PAIN
- Stand adjacent to a wall, back of a chair, or countertop with your painful side facing away from your support object.
- Place your near hand on the wall, chair, or countertop for balance.
- Lift the foot on your painful side and bring it to your opposite ankle.
- Lift the hip bone (called a hip-hike) on your painful side straight upward, so that it moves closer to your armpit. Try to stay as upright as possible on your supporting side to prevent twisting or bending.
- Hold for ten seconds, or until pain has subsided.
- Bring your hip and foot back down and stand evenly on both legs for a moment or two.
HEARTBURN
Heartburn occurs more often than normal during pregnancy. This is because the expanded size of the uterus promotes the reentry of stomach fluids into the esophagus.
Some suggestions for heartburn:
- To prevent heartburn, do not consume spicy or greasy foods, alcohol, coffee, baking soda, or antacids containing sodium bicarbonate (such as Alka Seltzer).
- Remain active. Refrain from bending or lying flat for several hours after eating.
- To relieve discomfort, try using Acid-Ease" from Prevail Corporation. This product contains natural plant enzymes, and can be taken with meals and/or between meals, as needed. It is safe and effective for reducing heartburn.
HEMORRHOIDS
Hemorrhoids are common during pregnancy. A number of factors contribute to the development of hemorrhoids, including constipation and the pressure exerted by the uterus as the fetus gains in size and weight.
Some suggestions for hemorrhoids:
- Increase your intake of fiber. Eat plenty of raw vegetables, fruits, dried fruits, bran, and whole grain breads. This helps to soften stools and make elimination easier. Hard stools can be very painful to pass and can cause bleeding. Also, drink six to eight 8-ounce glasses of fluid each day, including water, juices, and herbal teas.
- Keep your feet and legs elevated on a high footstool while eliminating. This helps to move the bowels by relaxing the anal muscles. Do not strain and do not sit on the toilet for too long.
- Use cold witch hazel compresses to help shrink hemorrhoids.
- Walk one mile a day to help digestion and elimination.
INSECTICIDES
Avoid the use of, or contact with, pesticides for the yard, pets or the home (including pesticide strips and flea collars). Little information is available about the risks of exposure during pregnancy to these products, so it is best to keep them out of your household.
INSOMNIA
Insomnia is very common during the last weeks of pregnancy when finding a comfortable sleeping position is difficult. Deficiencies of the B vitamins also can contribute to insomnia. The emotional changes that accompany pregnancy often contribute to sleep difficulties as well.
Some suggestions for insomnia:
- Increase your intake of foods rich in the B vitamins. See Nutrition Basics for more information about vitamins, minerals and supplements.
- Do not force yourself to sleep if you are not really tired. Read or do non-strenuous chores until you feel sleepy. Arrange pillows behind or under your abdomen to relieve breathlessness.
- Try drinking a cup of chamomile, marjoram, lemon balm or passion flower herbal tea with honey or lemon before bed. These herbs are well known for sleep-inducing qualities. Caution: Do not use chamomile tea on an ongoing basis or drink it too often or a sensitivity toward ragweed may develop. If you have allergies to ragweed, avoid chamomile tea completely.
KNEES - PAIN & DISCOMFORTS
Obviously, any exercise that causes pain or discomfort in any joint, and especially the knee, should be avoided. Women commonly feel knee-pain during pregnancy and the postpartum period. Fortunately, it's relatively easy to manage or prevent knee pain. Usually, simply building up strength in the thigh, particularly in the muscles that straighten the knee, can help relieve symptoms.
All prenatal and postpartum exercise programs need to compensate for ligament laxity and dynamic instability. To protect your knees, eliminate exercises that may strain the knee ligament and cartilage from your routine. These may include jogging or running down hill, squats, lunges, leg presses, and weighted leg extensions. Yoga style squats where the knees extend beyond the toes are also not recommended.
How to Prevent or Cope with Knee Pain:
- If you experience pain, discomfort, or reduced range of motion in your knee the day after exercise, discontinue the exercise.
- If you have knee pain, don't kneel, squat, crawl on your knees, or get down on your hands and knees for housework, gardening or exercise.
- Avoid hyperextension of the knee and positions that may stress knee ligaments.
- Perform knee-protective exercises, such as leg extension exercise described below.
Pre-and-Post Natal Leg Extension Exercise:1. Stand adjacent to a chair, one hand resting on the back of the chair for balance.
2. Lift one foot up to the inside of your opposite knee.
3. Try to hold your knee in place as you straighten the lifted leg out in front of you, positioning it at a 45 to 90 degree angle.
4. Hold the extension for a moment.
5. Slowly bend your leg, returning your foot to the opposite knee.
6. Perform eight repetitions on each leg.
LEG CRAMPS
Leg cramps are often a result of nutritional deficiencies and/or electrolyte imbalances, in addition to the strain placed on the legs by the extra weight.
Some suggestions for leg cramps:
- Increase your calcium and potassium intake by eating foods such as almonds, bananas, grapefruit, low-fat cottage cheese, oranges, salmon, sardines, sesame seeds, soy products (such as tofu), and low-fat yogurt to help avert leg cramps. Adequate calcium is also needed to help prevent high blood pressure, often seen in late pregnancy, as well as for fetal development.
- While sleeping or sitting, elevate your legs so that they are higher than your heart.
- Do not stand in one place for too long. Shift your weight from one leg to the other every few minutes.
- Do not point your toes.
- Walk at least a mile every day to stimulate the circulation of blood through the legs.
- To relieve cramps, flex your feet, with your toes pointing upward.
- When experiencing a cramp, apply a hot water bottle or heating pad to the cramping area and apply pressure with your hands.
MEDICATIONS
Don't use any drug without checking with your midwife first. This includes all prescription drugs, non-prescription drugs, vitamins, laxatives, cold remedies, simple pain relievers, and others. For the sake of your unborn child as well as for your own welfare avoid completely marijuana, cocaine, tobacco, alcohol, narcotics, tranquilizers, sleeping pills, or any other mind-altering drugs. The safest course to follow during pregnancy is to take nothing except nutritious food and beverages.
Avoid the following medications, which can stunt fetal growth: Acetaminophen (Tylenol, Datril, and others), antacids (Alka-seltzer, Di-Gel, Gelusil, Maalox, Pepto-Bismol, Rolaids, Tums), antihistamines, aspirin, cold pills, cough remedies, decongestants, and estrogens. Do not take mineral oil, which blocks the absorption of the fat-soluble vitamins. Consult with your midwife or health care provider about the use of any supplements or over-the-counter medications.
Aspirin has been linked with fetal deformities, bleeding, and complications during delivery.
Isotretinoin (Accutane), a drug prescribed for acne, can cause birth defects, as can etretinate (Tegison), which is used for psoriasis.
Taking the drug phenytoin (Dilantin) or phenobarbitol, used to control epileptic seizures, creates four times the usual risk of producing a baby with heart defects. In addition, the antibiotics ampicillin (Omnipen, Polycillin) or tetracycline may cause heart malformation.
Large quantities of caffeine can cause birth defects.
MISCARRIAGE (SPONTANEOUS ABORTION)
Some pregnancies are not carried to full term, resulting in a miscarriage, or spontaneous abortion or if it occurs later in pregnancy, a still birth. There are many reasons for this, including abruptio placenta (separation of the placenta from the wall of the uterus), cervical incompetence, ectopic pregnancy (implantation of the fertilized egg outside the uterine cavity, most commonly in one of the fallopian tubes), emotional stress, general malaise, infection, glandular disorders, malnutrition, placenta previa (implantation of the placenta over the cervical opening), and pregnancy-induced hypertension. In many cases, the miscarriage may be the result of some abnormality in the fetus.
Some suggestions regarding miscarriage:
- If you experience bleeding or cramping during pregnancy, contact your midwife or health care provider immediately and follow his or her advice.
- Some women who have had repeated miscarriages may be able to boost their chances of a full-term pregnancy with a new immunization procedure. Researchers at the University of Michigan have discovered that injecting two vaccines containing white blood cells from the father into the mother can prevent an abnormal reaction in the woman's immune system that results in rejection of the growing fetus as a "foreign transplant."
- Premature labor is the onset of rhythmic uterine contractions before fetal maturity. It usually occurs between the 20th and the 37th weeks of gestation. Around 5 to 10 percent of pregnancies end prematurely; 75 to 85 percent of infant deaths and many birth defects are associated with prematurity.
- Ectopic pregnancy is a potentially dangerous condition that may produce cramping and light bleeding, but in some cases may result in not symptoms other than mild abdominal pain, making diagnosis difficult. If a fallopian tube ruptures as a result of ectopic pregnancy, life- threatening hemorrhage and infection may result. This condition requires immediate surgical treatment.
MOOD CHANGES (MOOD SWINGS)
Mood changes are quite common during pregnancy. They are thought to be caused by hormonal changes and deficiencies of the B vitamins, as well as the stress of physical discomforts and psychological issues that arise as a result of bodily changes and the awareness of impending motherhood.
Some suggestions regarding mood changes are:
- Increase your intake of foods rich in the B vitamins and iron, such as alfalfa, blackstrap molasses, brown rice, eggs, enriched whole-grain cereals, fish, green leafy vegetables, kidney beans, oats, poultry, soy products, and wheat germ. Inadequate iron intake causes anemia, which can make you feel tired, irritable, and unhappy.
- If mood changes are severe and/or are interfering with your life, consider counseling. Making an effort to explore and understand underlying emotions can help you to cope with your feelings as well.
- Keep in mind that mood changes during pregnancy are normal, and most likely temporary.
MORNING SICKNESS
Approximately 50 percent of all pregnant women experience some degree of nausea and vomiting between the 6th and the 12th weeks of pregnancy. This is considered normal. Although it is commonly called morning sickness, it can occur at any time of day.
Abnormal vomiting (hyperemesis gravidarum) is a severe, continual nausea and vomiting that occurs after the 12th week of pregnancy and it occurs in approximately 1 in 200 pregnancies. It can result in dehydration, acidosis, malnutrition, and substantial weight loss. Possible causes of abnormal vomiting include bile duct disease, drug toxicity, pancreatitis, inflammatory bowel disorders, vitamin deficiencies (mainly a lack of vitamin B6), and the production of high levels of a hormone called human chorionic gonadotropin. This may occur due to the presence of cysts in the uterus or multiple pregnancy.
Some suggestions for morning sickness are:
- Keep crackers or whole wheat toast near your bed and eat some before arising.
- Eat small, frequent meals and snack on whole-grain crackers with nut butters (but not peanut butter) or cheese. It helps to keep some food in the stomach at all times.
- Do not go without food or drink because of the nausea.
- Keep in mind that morning sickness usually does not last beyond the first 13 weeks of pregnancy. If you suffer from persistent nausea or vomiting later in pregnancy, consult with your midwife or health care provider. With appropriate treatment, the prognosis is good.
HERBS:
- Ginger, taken in capsule or tea form, is helpful for relieving nausea. Other beneficial herbs include catnip, dandelion, peppermint, and red raspberry leaf. For a healthy "pregnancy drink", mix 2 parts red raspberry leaf, 1 part peppermint, 1 part alfalfa, and 1 part nettle and make into a pregnancy tea. This is very nutritious and helps to alleviate nausea. This tea can be taken throughout the entire pregnancy and is the one MoonDragon recommends for homebirth clients.
NUTRIENTS:
- L-Methionine: 1,000 mg daily. Effective in preventing nausea. Used to prevent toxemia in pregnancy.
- Vitamin B-6 (pyridoxine): 50 mg every 4 hours. Plus Magnesium: 400 mg daily, upon arising. A combination of nutrients that helps to prevent and alleviate nausea. Caution: Take this combination only as long as needed. Do not take it for longer than 6 weeks.
NECK PAIN & FORWARD HEAD SYNDROME
Upper body misalignment and neck-pain go hand-in-hand. When the upper spine over-flexes, the head compensates and slides forward. The muscles that lift the shoulders tighten and shorten in response.
Neck-Related Symptoms that Require Medical Consultation: If you have severe muscle spasms, persistent headaches, weakness in one arm, or marked asymmetrical mobility of the head, then see a medical professional, such as a chiropractor, for an evaluation.
For common neck stiffness, try gentle stretches and head-rolls.
- Try to sleep in positions where the back of the neck is elongated, rather than with the head thrust forward or rolled backward.
- Pay particular attention to your head alignment while driving and other seated postures.
- Relaxation and meditation techniques are also valuable for relieving chronic neck-tension.
Exercise to Re-align Forward Head:1. Maintaining a neutral spine, stand with your back and head against a wall, your legs slightly bent, and your feet about a foot away from the wall, about hip distance apart.
2. Roll your chin toward your chest without moving your head away from the wall.
3. Press the back of your head into the wall as strongly as you can for five slow counts.
4. Gradually relax your muscular effort and allow your head to glide back in to the neutral position.
5. Perform four repetitions.
NOSEBLEEDS AND NASAL CONGESTION
During pregnancy, increased blood volume often causes some of the tiny capillaries in the nasal passages to rupture, causing a nosebleed. Inner nasal passages normally swell as well. A lack of vitamin C and the bioflavonoids may be a contributing factor. These conditions disappear with the birth of the baby.
Some suggestions for these concerns are:
- Increase your intake of foods rich in vitamin C, including broccoli, cabbage, grapefruits, lemons, oranges, peppers, and strawberries.
- If congestion is a problem, eat fewer dairy products and supplement your diet with calcium and magnesium. Dairy products tend to stimulate the secretion of mucus.
- Use a humidifier to help keep nasal tissues moisturized.
- Do not use nasal sprays or nose drops. Instead use an empty nasal spray container filled with warm water to spray into the nostrils. This helps to moisten the nose and shrink the membranes.
PAINTS
Avoid painting and inhaling toxic fumes in confined areas. Medical studies on paint exposure and fetal harm are inconclusive. Oil-based paints and paint thinners contain different solvents that should be avoided, especially in the first trimester of pregnancy.
PELVIS, PUBIC BONE, TAILBONE (COCCYX) PAIN & INSTABILITY
PELVIS - PUBIC BONE
Usually, the right and left pubic bones are fused together at the midline: the pubic symphysis. The hormones of pregnancy, however, soften the dense ligaments of this joint, which allows the pelvic outlet to expand during childbirth. Occasionally, this joint becomes unstable at the end of pregnancy, during labor, or in the early postpartum period. The chief symptom of pubic instability is pain directly at the pubic symphysis. Groin pain, or an inner thigh strain, is more commonly felt slightly off center of the joint, and can often be mistaken for pubic bone instability.
Pelvic Instability of Any Kind Needs Professional Treatment: If your pubic bone is painful after childbirth, make an appointment with your health care provider, chiropractor, and/or a physical therapist who specializes in pre-and-postnatal exercise therapy.
Precautions to Take if You Have Pubic Pain
- See your health care provider as soon as possible to rule out pubic instability.
- Avoid straddle stretches, side leg-lifts and other groin stretches.
- Always directly face any object before you lift or carry it.
- Refrain from twisting and bending movements when carrying heavy loads.
PELVIS - SACROILIAC JOINT
The sacroiliac joint is where the back of the pelvis connects with the sacral vertebrae of the lower spine. Most body types display a small dimple on each side of the low back at the sacroiliac joint. Generally, this joint moves very little, however; instability from increased ligament laxity at this joint can occur during the last half of pregnancy and, more commonly, the postpartum period.
Sacroiliac instability is painful and may cause functional weakness in one or both legs, and low back muscle spasms. Bending, lifting and carrying, sitting with the legs crossed or to one side, prolonged standing/slouching, or walking up a steep hill may aggravate the condition.
Take Care of Sacroiliac Problems Right Away: Directly after pregnancy, the abdominal wall is lax and does not have enough strength to adequately support the lower back and sacrum. Untreated sacroiliac instability may worsen or become chronic. If you think you might have a sacroiliac problem, make an appointment with your health care provider, physical therapist or chiropractor who specializes in pre-and-postnatal problems.
Preventing or Managing Sacroiliac Problems
- If you have pain in this joint, do not sit with you legs crossed, or with both legs to one side.
- Never sit without lower back support, particularly while nursing.
- Refrain from all exercises that use straddle positions, sitting with the legs folded in front of the body, or sitting with the soles of the feet together.
- Avoid all yoga poses that stretch the sacroiliac joint, including all standing and seated twisting poses, all "lotus" variations, and "pigeon pose."
- Stay away from most Pilates exercises, including mat and reformer; they are contraindicated for sacroiliac instability.
- Do not lift heavy loads.
TAILBONE (COCCYX)
Many of us habitually sit slouched, or rolled back off the pelvis, with our spines curved in a "C" shape. This misplaces our body weight onto lower spine and sacroiliac, rather than on the bottom bone of the pelvis, the ischium or "sit bones." Slouching stresses the tailbone and sacroiliac joint which are particularly vulnerable during and after pregnancy. During labor and delivery, the natural curve of the tailbone flattens and is pushed outward as your baby's head passes through the pelvic outlet. Not surprisingly, the stress of delivery commonly results in postpartum tailbone pain. If you experience persistent discomfort in your tailbone, consult with your health care provider.
Preventing or Managing a Pain in the Tailbone
- Sit up tall, with your weight on the bottom bones of your pelvis (the ischium or "sit bones") rather than rolled back onto your coccyx or sacrum.
- If seat cushions are too deep for your frame, use pillows behind the lower spine to help avoid slouching.
- Place a small rolled towel behind the waistline to support a neutral pelvis and lower spine.
- When seated, keep your thighs on a slightly downward diagonal position, rather then parallel to the floor; you may need to elevate your seat height, or use a solid wedge pillow under the pelvis to attain this position. This position is especially helpful for women with tight hips and/or lower back.
- Do not use donut-shaped pillows during pregnancy and the postpartum period; they weaken pelvic floor muscles.
- Avoid any roll-back exercises, either sitting or on an exercise ball, or Pilates style rolls, as these types of exercises are not recommended for pregnancy and the postpartum period.
PERSONAL CARE PRODUCTS (COSMETICS & HAIR CARE)
Although there is not specific evidence that cosmetics and other personal care products (soaps, lotions, deodorants) affect pregnancy outcomes, there should be some reasonable caution in the use of some of these items. Overall, there should be no limit to their use unless advised differently by your midwife or health care provider. Become a label reader and look for teratogenic ingredients in the items. Many of these substances are absorbed into the skin and into your system. Use reasonable caution.
Some suggestions about personal care items:
- Hair care products such as dyes, straighteners (relaxers) and permanent wave solutions have been studied in pregnant women and have not shown any specific risks. Exposure to these products should not pose a risk to the fetus. Again, use reasonable caution. Know what you are using. During pregnancy hair reacts differently to a tint or permanent so it might be best to wait until after delivery. Hair care products such as sprays and shampoos carry no evidence that they do or don't cause any adverse outcomes for a pregnancy. Most women continue to use their pre-pregnancy hair products and experience no problems. If you have doubts about any cosmetic or personal care product, switch over to more naturally based items. Again, read labels and know what you are using.
REST PERIODS
Include rest periods in your routine, several times a day for short periods. Fatigue is common during pregnancy. Lie on one side or the other during these rest periods, rather than flat on your back, because blood flow through the placenta may be decreased if you lie on your back. It is common to have more fatigue during pregnancy and your sleeping patterns may change. You may do well to take a daily afternoon nap, if this is possible.
SCIATICA
The sciatic nerve is the longest nerve in the body. It arises from the sacral plexus, in the lower back, threads downward through the pelvis through an opening called the greater sciatic foramen, and runs through the hip joint and down the back of the thigh. Irritation of this nerve is common during pregnancy and usually disappears with the birth of the baby.
Some suggestions regarding sciatica are:
- Ask your midwife or health care provider to recommend a registered physical therapist or a chiropractor who has been specially trained to deal with pregnancy problems. A competent practitioner is best able to deal with this problem.
SEAT BELT USE
The use of seat belts is recommended to decrease maternal and fetal trauma in the event of a motor vehicle accident. Use a diagonal shoulder strap and a lab belt. The diagonal strap should pass over the shoulder and across the chest between the breasts. The lap strap should be across the upper thighs. The straps should be above and below the "bump" of pregnancy, not over it.
SEXUAL INTERCOURSE
Enjoy sexual intercourse as usual, as long as it is not uncomfortable. Some women have more or less libido during pregnancy, often caused by hormonal changes. Many experience a sense of "freedom" from birth control issues once they become pregnant and enjoy their sexual freedom. Each woman is different and each phase of pregnancy may alter your desire for sexual intercourse or intimacy. You may have to try new sexual positions or techniques during late pregnancy as your belly becomes larger and old ways have become uncomfortable. Have fun and experiment a little. There may be some restrictions on sexual intercourse during the last few weeks of pregnancy or if you have previously had a miscarriage. Discuss your concerns with your midwife. She may have some answers and helpful hints.
SHOULDER PAIN
Shoulder pain is almost universal during and after pregnancy. Alignment changes, heavier breasts, and a weakened core all conspire to impair upper body alignment. When bones are out of ideal alignment, nearby muscle functioning is reduced. Because new moms do so much lifting and carrying throughout their days, shoulder and upper-back muscles strain easily.
Pregnancy Impacts the Shoulder
- The shoulder girdle muscles become imbalanced and inhibit good body mechanics.
- The internal rotators over-tighten and external rotators weaken.
- Muscles that elevate the shoulders tighten while muscles that depress the shoulders weaken.
Managing and Preventing Shoulder Pain
- Use gentle daily stretches for the chest, neck, and shoulders to improve upper-spine alignment.
- Strengthen muscles groups that tend to weaken.
- Avoid sleeping with your head tilted back or thrust forward.
- Use massage or self-acupressure to relieve muscle spasms.
- Remind yourself to stand and sit up straight to avoid slouching.
- Use ergonomic breastfeeding positions. Contact your lactation consultant or midwife for helpful suggestions.
SKIN PROBLEMS
Common skin problems during pregnancy include pimples, acne, red marks, and mask of pregnancy (dark blotches on the skin of the face). These skin changes usually disappear with the birth of the baby.
Some suggestions for skin problems are:
- Take folic acid daily. A recommended dosage is 5 mg before each meal. This may help to prevent or make the mask of pregnancy disappear.
- Keep your skin clean. Do not use makeup if your skin is broken out.
SMOKING
There can now be not doubt that smoking is injurious not only to you but also (even more so) to your unborn child. So don't smoke! If you are a smoker and need help in stopping, speak to your midwife about methods, support groups and so on.
SORENESS IN THE RIB AREA
The ribcage expands enormously during pregnancy to help make room for the expanding uterus and to maintain adequate lung capacity. Many pregnant women experience rib discomfort from this expansion and pressure from the uterus, as well as the occasional little foot or knee that might habitually press against the ribs.
Some recommendations for this problem are:
- Change positions frequently.
- To help ease discomfort, try gentle stretches and spine-mobility exercises, such as twists and upper-spine extensions.
- Centered breathing techniques, in either a sitting or a side-lying position will help to ease discomfort.
- Keep in mind that this problem is temporary. It often disappears in the last 6 weeks of pregnancy, once the baby drops into position in the pelvis in preparation to be born.
- After pregnancy, perform rib-closure exercises to re-bevel the ribcage and re-narrow the waistline.
STRETCH MARKS
Stretch marks are wavy stripes appearing on the abdomen, buttocks, breasts, and thighs. They start out reddish in color and gradually turn white. They are caused by rapid weight gain such as that typically associated with pregnancy, and appear when the skin becomes over stretched and the fibers in the deep layers tear. Once they appear, they are permanent, but they do become much less noticeable with time.
Some recommendations for stretch marks are:
- Try the following recipe for preventing stretch marks:
1/2 cup virgin olive oil
1/4 cup aloe vera gel
6 capsules vitamin E, cut open
4 capsules vitamin A, cut open
1. Mix all the ingredients together in a blender.
2. Pour the mixture into a jar and store it in the refrigerator.
Once a day, apply the oil externally all over the abdomen, hips, and thighs - the places where stretch marks commonly appear. If you do this diligently, every day, you may be able to prevent stretch marks.
- Apply cocoa butter and/or elastin cream topically as directed on the product label. These substances are very good for stretch marks.
SWEATING
While you are pregnant, your body makes sure that its temperature is perfect for your baby's development. In addition, as your size increases, the amount of effort it takes to walk, climb stairs, and do many everyday things also increases. As a result, you may find yourself sweating more than you did before.
Some suggestions for sweating are:
- Wear loose, light, comfortable clothing. Choose clothing made of "breathable" natural fibers, such as cotton.
- Do not use a hot tub during pregnancy. This increase in body temperature can cause fetal distress. For the same reason, be careful about strenuous exercise, especially in hot weather.
TEETH
Pregnancy puts an extra strain on dental health. Be particularly careful about brushing and flossing during your pregnancy. Routine dental examinations, preventive and restorative procedures should be provided when necessary. Local anesthetics used for dental procedures are considered relatively safe. If dental x-rays (or other kinds of x-rays) become necessary, make sure that your abdomen is shielded by a standard lead apron. Ideally, you should have all your dental work done and up to date prior to becoming pregnant. This eliminates the potential hazards of anesthesia, x-rays and other procedures from becoming an issue.
TESTS PERFORMED DURING PREGNANCY
There are many tests that can be performed during pregnancy to assess the health and development of the fetus. However, many of these tests involve an element of risk for both mother and child. Therefore, they should be done only when medically indicated, and not used routinely or for the mother's or the health care provider's convenience. If a test is suggested, be sure that you are fully aware of why it is needed and of any dangers that may be involved before deciding to have it done.
AMNIOCENTESIS
This medical procedure is performed during pregnancy to determine the health of the fetus. A local anesthetic is administered and then a long, hollow needle is inserted through the mother's abdomen into the uterus to remove amniotic fluid for cellular analysis. Although it has become fairly common, this procedure entails risks for both the pregnant woman and the fetus. Specifically, there is some chance of blood exchange between the mother and the fetus (important in Rh-negative mothers expecting Rh-positive babies), infection of the amniotic fluid, peritonitis, the development of blood clots, placental hemorrhage, needle injury to the fetus, and premature labor and possibly miscarriage. Therefore, great care must be taken in recommending, and then in performing, amniocentesis. Make sure your health care provider is well trained and experienced in performing this test (or any other of the interventive tests mentioned) to reduce the risk and possibility of complications.
This test can determine the sex of the fetus. However, it definitely should not be performed only to find this out. This test should be performed only if you plan to terminate the pregnancy if an abnormality is found, or if knowledge of any problem is necessary for proper prenatal care.
CHORIONIC VILLUS SAMPLING (CVS)
The chorionic villi are finger-like projections of the embryonic sac that contain cells with the same genetic composition as the embryo. In this test, a small sample of this chorionic tissue is taken and analyzed to determine genetic abnormalities in the fetus. It can be performed earlier than amniocentesis, usually between the eighth and tenth weeks of pregnancy, and takes about a half hour to complete.
Possible dangers from CVS include infection, maternal or fetal bleeding, spontaneous abortion, Rh immunization, birth defects, and perforation of the membrane surrounding the embryo. CVS is generally considered to be slightly riskier than amniocentesis. The chief advantage is that it can be performed earlier in pregnancy, when termination, if deemed necessary, is a simpler and less dangerous procedure. As with all tests, you should outweigh all the pluses and minuses carefully before making a decision.
ULTRASOUND (SONOGRAPHY)
Ultrasound is a procedure in which high-frequency sound waves are bounced off objects to create images of these objects. This technology was originally developed for the space program and is often used in oceanography (mapping out the ocean floor) and for use as a military device (such as locating submarines). However scientists later found uses for ultrasound in medical diagnosis including prenatal care.
One form of ultrasound, the sonogram or B-scan, directs intermittent sound waves toward the pregnant woman's abdomen. An outline of the fetus, placenta, and other structures involved in pregnancy is transmitted to a video screen. In this way, the health care provider can determine fetal size and position, estimate the maturity of the fetus, confirm a multiple pregnancy, find the location of the placenta, check the fetal heart rate, and estimate the baby's due date.
Ultrasound is effective and is far safer for the fetus than x-ray. Like all medical tests, it should only be used when medically indicated and not used as general test for all pregnant women and their babies. Some concern has been raised about long term effects ultrasound may have on the developing fetus.
ESTRIOL EXCRETION STUDIES, NON-STRESS TEST, OXYTOCIN CHALLENGE TEST
These tests are also used to determine the health of the fetus. The estriol excretion study determines the best time for delivery of the baby in cases of diabetes or other difficulties in pregnancy. The non-stress test determines the well-being, and the oxytocin challenge test helps to predict how well the baby will fare during the stress of labor.
If it is determined that any of these tests are necessary, your health care provider or midwife should discuss it with you in depth. When considering any type of prenatal testing, always remember that it is your body and your baby. You should be fully informed of all the advantages and all the risks of any procedure before agreeing to it.
OTHER TESTS & LINKS
TRAVEL
If possible, plan your trip for the second trimester of pregnancy. The risk of miscarriage is greatest during the first trimester and in the third trimester, early labor could begin.
Some suggestions about travel include:
- Travel does not adversely affect pregnancy. Avoid sitting for many hours without getting up and moving around. Empty your bladder frequently so as to avoid an increased risk of bladder infections caused by retained urine. Don't take any anti-nausea travel medications without your midwife's approval. Carry a record of your medical history with you.
- Avoid travel if you have a threatened miscarriage or a history of miscarriage. Avoid travel to areas at high altitudes or areas where certain vaccinations (that may be hazardous during pregnancy) would be necessary.
- Airlines will not allow you to fly late in pregnancy (usually, the last month) without a letter stating your midwife's or health care provider's approval.
URINATION, FREQUENT
Frequent urination is a natural byproduct of the early and last months of pregnancy. It is primarily a result of changes in kidney function and pressure from the expanding uterus. Many women find it most common during the night.
Some suggestions regarding frequent urination include:
- Although it may seem that drinking liquids aggravates this problem, do not cut down on fluid intake in an attempt to minimize it. Drink 6 to 8 full glasses of liquid each day. This is important to keep your kidneys in good working order, flushing toxins and wastes from your blood stream from both you and your baby and to provide fluid for your expanding blood volume and to maintain a healthy amount of amniotic fluid (which is changed frequently) for the baby.
VARICOSE VEINS
Varicose veins are enlarged veins close to the surface of the skin. In many cases they disappear after the birth of the baby. They may be found in the legs or in the vulva area. When varicose veins are located around the anus, they are referred to as hemorrhoids.
Some suggestions for varicose veins are:
- As often as possible, sit with your feet elevated, higher than your heart.
- Change positions frequently. Do not stand or sit for long periods of time or sit in cross-legged positions.
- Walk one mile each day to promote circulation.
- Wear support hose if your midwife or health care provider recommends them. Keep them near your bed and put them on before you get out of bed.
- Do not wear elastic-topped knee socks, garters, belts, or high-heeled shoes.
VIDEO DISPLAY TERMINALS (COMPUTERS)
Medical studies to date have not demonstrated a convincing association between use of these devices and an increased rate of miscarriage, low-birth-weight or birth defects.
Some suggestions regarding computer use:
- Sitting for long periods in front of a computer does cause other symptoms which can compound the normal discomforts of pregnancy. These include back, neck, wrist, arm and eye strain, dizziness and headaches. Be sure to take frequent breaks from the sitting position and do stretching or relaxation exercises. use an adjustable height chair with good back support and have the keyboard and monitor at a comfortable height.
Wrist Pain
REPETITIVE STRESS & CARPAL TUNNEL SYNDROMES
Pregnancy and the postpartum period place women at an increased risk for Carpal Tunnel Syndrome. Swelling, fluid retention, and increased blood-volume can restrict and compress the medial nerve as it passes through the wrist, the carpal tunnel, and into the hand, causing pain in the hand, wrist and arm. Repetitive stress injuries and Carpal Tunnel Syndrome are increasingly common, and because they have the potential to cause long-term disability, must not be ignored.
Carpal Tunnel Symptom Checklist
- Pain in your hand.
- Pain in your wrist, sometimes extending into the forearm.
- Weakness in the hand.
- Numbness and tingling in the fingers, wrist and hand, especially after several hours of use or at night.
If you have any of the symptoms of Carpal Tunnel Syndrome or other repetitive stress injury, see your health care provider or a physical therapist who specializes in repetitive motion injuries and the diagnosis and treatment of this condition. Sometimes subtle problems may compound and overlap. Pathology or injury may originate in the neck, shoulder, elbow or wrist. An expert in nerve injuries will be able to conduct the proper tests and correctly diagnose the problem. After your diagnosis, you can receive the appropriate therapy.
Be Persistent: Don't Take "No" for an Answer: Increasingly, some HMO practitioners will advise a wait and see attitude, or suggest to new moms that they try not to use their wrists and hands throughout the day as they care for their newborns. They may be advised not to pick up their babies. Certainly, since wrist pain can come from overuse and it can be wise to cut back on unneeded activity. But no activity is another matter. Don't take no for an answer from your health care provider.
Tips for Wrist Pain from Overuse
- Set up an ergonomically sound workstation.
- Refrain from all exercises that flex the wrist or bear weight on the hands, such as push-ups, bench presses, and quadruped exercises.
- Don't use tools or exercise equipment that require you to sustain or repeatedly apply a tight grip.
- Avoid tools that require you to repeatedly twist or flex your wrist.
- Take frequent breaks from keyboard work and other tasks that might compromise areas prone to repetitive motion injury, such as the carpal tunnel.
- Try to maintain a neutral wrist-position (neither flexed or extended) throughout your daily activities.
- When working at a repetitive motion task that makes it hard to keep your wrists in a neutral position, such as keyboard work, or when having a flare-up of symptoms at night, use wrist braces to hold your wrist(s) in the neutral position and reduce stress.
ADDITIONAL NOTES
Consider these suggestions to help you stay well and have an emotionally rewarding pregnancy:
- Define and resolve areas of concern or conflict involving family, occupation, civic, spiritual, emotional, or recreational activities. If you cannot resolve these problems alone, don't hesitate to seek help from family, friends, or competent counselors.
- Be moderate in all activities. Seek a balanced lifestyle of work, intellectual pursuits, recreation, reflection, and rest. Keep a positive attitude and make lifestyle changes as necessary.
NUTRITIONAL HEALTH IN PREGNANCY
During pregnancy, it is more important than ever to have a balanced diet that is high in nutrients and fiber and low in bad fats and cholesterol. The following are recommendations for maintaining health in pregnancy.
NUTRIENTS
VERY IMPORTANT
Vitamin B complex: As directed on label. To prevent deficiencies.
Ultimate B Complex Formula, Nature's Secret, 60 Tabs
Extra Folic Acid: 800 mcg daily. Adequate levels of folic acid reduce the chance of birth defects such as spina bifida.
Folic Acid (Vitamin B-9), 100% Natural, Nature's Way, 800 mcg, 100 Caps
Iron: 30 mg daily, or as directed by midwife or health care provider. Take with 100 mg vitamin C for better absorption. Extra iron is needed during pregnancy.
Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz.
Iron Gluconate, Nature's Way, 18 mg, 100 Caps
Or Floradix Iron + Herbs from Salus Haus or other natural food supplement with iron: As directed on label. A natural, nontoxic source of iron.
Alive! Whole Food Energizer, Multi-Vitamin & Mineral with Naturally Occurring Iron (No Iron Added), Nature's Way, 90 Tabs
Protein supplement: As directed on label. A lack of protein has been linked with birth defects and may be associated with toxemia of pregnancy. Use protein from a vegetable source, such as soy.
EcoTein Powder, Superfood Soy Protein, All Natural, Vegetarian, Natural Mixed Berry, NOW Foods, 16 oz.
EcoTein Powder, Superfood Soy Protein, All Natural, Vegetarian, Natural Vanilla, NOW Foods, 16 oz.
Quercetin: 500 mg daily. A valuable bioflavonoid that promotes proper circulation.
Vitamin C: 2,000-4,000 mg daily, in divided doses. Larger doses taken before delivery may help reduce labor pain.
Quercetin, NOW Foods, 500 mg, 100 VCaps
Zinc: 15-25 mg daily. Do not exceed 75 mg daily. Insufficient zinc intake may be a cause of low birth weight. Use zinc gluconate lozenges or OptiZinc for best results.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.
Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
Zinc Lozenges w/Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges
HELPFUL
Acidophilus: As directed on label. Take on an empty stomach. Provides necessary "friendly" bacteria to prevent candidiasis (yeast infection), protect the baby at birth, and ensure proper assimilation of nutrients.
Acidophilus Powder, Non-Dairy, 3 oz. Bulk
Lactobacillus Acidophilus Kosher Liquid, All Natural, Vegetarian Medium, Lactose-Free, Apple-Strawberry Flavor, 16 fl. oz., Dynamic Health
Body Language Essential Green Foods from Oxyfresh: As directed on label. Promotes health and protects the intestinal tract and blood cells.
Miracle Greens Nutrient-Rich Super Food Supplement, 12 Single Serving Packets
Miracle Greens Nutrient-Rich Super Food Supplement, 30 Day Supply
Calcium: 1,500 mg daily. Necessary for formation of healthy bones and teeth. may prevent hypertension and premature birth.
Calcium Citrate / Malate Complex, Nature's Way, 500 mg, 250 Caps
Magnesium: 750 mg daily. Needed to balance with calcium. Magnesium Citrate, 100% Pure, Vegetarian, NOW Foods, 200 mg, 250 Tabs
Liquid Calcium / Magnesium / Zinc (Liquimins), Natural Pina Colada Flavor, Trace Minerals, 32 fl. oz.
Coenzyme Q-10: As directed on label. Helps the body convert food to energy, enhances circulation, and protects the heart.
CoQ10, Vegetarian Coenzyme, NOW Foods, 30 mg, 60 VCaps
Kelp: As directed on label. Rich in necessary minerals.
Kelp Seaweed, Norwegian, NOW Foods, 100% Natural, 550 mg, 250 Caps
Multi-mineral & Trace Mineral Complex: As directed on label. For optimal health and to provide a balance of nutrients needed for fetal development.
Prenatal Multi-Vitamin & Mineral, 100% Natural & Complete, Nature's Way, 180 Caps
Women's Living Green Liquid: Gel Multi Vitamin, Irwin Naturals, 90 Softgels
Doctor's Choice for Female Teens, Multivitamin with Iron, Enzymatic Therapy, 120 Tabs
Alive! Whole Food Energizer Multi Vitamin & Mineral with Naturally Occurring Iron (No Iron Added), Nature's way, 180 Tabs
Selenium: 3 mcg per pound of body weight daily. May play a role in protecting the lung tissue after birth.
Selenium, Yeast-Free, NOW Foods, 200 mcg, 180 Caps
Natural Beta-Carotene: 25,000 IU daily. Precursor of vitamin A. Caution: Do not substitute vitamin A for beta-carotene. Excessive vitamin A during pregnancy has been linked to birth defects.
Beta Carotene, Nature's Way, 100% Natural, 25,000 IU, 100 Softgels
Vitamin D: 1,000 IU daily. Needed for calcium absorption and bone formation.
Vitamin D, 1,000 IU, NOW Foods, 180 Softgels
Vitamin E: 400 IU daily. Premature and low birth weight infants are often deficient in vitamin E.
Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels
Vitamin K or Alfalfa: As directed on label. Take for excessive bleeding.
Alfa Max, Alfalfa Extract, Nature's Way, 525 mg, 100 Caps
Lack of zinc, manganese, and folic acid, as well as amino acid imbalances, have been linked to fetal deformities and mental retardation.
All women of childbearing age should take a daily supplement of 400 mg of folic acid. Folic acid deficiency is linked to such neurologic birth defects as spina bifida and anencephaly. In order to prevent these disorders, this B vitamin must be present in the body during the first six weeks following conception, a crucial early phase in fetal neurological development. Since most women do not know they have conceived until several weeks afterward, the best way to prevent these birth defects is for women who have any chance of becoming pregnant to have an adequate supply of this nutrient at all times. Supplementation is recommended because many women do not get enough folic acid from dietary sources. Folic acid also helps alleviate heavy menstrual bleeding and hemorrhaging in childbirth and improves circulation.
Excessive intake of Vitamin A has been linked with cleft palate, heart defects, and other congenital defects. Foods rich in vitamin A may also cause problems. Food containing natural beta-carotene, however, are not harmful because the body converts beta-carotene to vitamin A only as needed, and not in amounts that may be toxic to the body.
One of the best things you can do for your child is to breastfeed your baby for at least the first three months of life - longer if possible. Mother's milk is not only the most nutritious food for a baby, but it also provides crucial disease-fighting agents. A new mother should consume 500 more calories per day when nursing than she ate during pregnancy. The diet should include substantial amount of liquids and extra portions of calcium-rich foods. If nursing is not possible and you must bottlefeed, use a well-balanced soy-based product. Goat's milk has also been recommended. Cow's milk does not supply a human infant with enough iron, linoleic acid, or vitamin E, and babies who are fed cow's milk have a greater chance of developing allergies to milk and dairy products later in life.
HERBS
Alfalfa is a good source of vitamins and minerals, especially vitamin K, which is essential for normal blood clotting.
Blessed thistle, blue cohosh, false unicorn root, and squawvine are beneficial taken in the last four weeks of pregnancy. They help to prepare the body for an easier birth and aid contractions. These herbs should not be taken in the first two trimesters of pregnancy, however. Consult with your midwife before taking these herbal supplements.
Burdock root, dandelion, ginger, and nettle help to enrich a mother's milk.
Red raspberry leaf tea helps the uterus contract more effectively. It also helps to enrich mother's milk. Drink no more than 1 cup per day until the last four weeks of pregnancy, then drink 1 quart daily.
St. Johnswort and shepherd's purse help uterine contractions at birth.
Avoid the following herbs during pregnancy: angelica, barberry, black cohosh, bloodroot, cat's claw, celandine, cottonwood bark, dong quai, feverfew, goldenseal, lobelia, Oregon grape, pennyroyal, rue, and tansy.
Organic Bulk herbs are available from Mountain Rose Herbs. See banner links below.
RECOMMENDATIONS
Eat a well-balanced, nutritious diet and be sure to get moderate exercise, fresh air, and plenty of rest. See Nutrition Information for more detailed dietary guidelines for pregnancy.
Do not consume junk food, highly seasoned or fried foods, or coffee.
Avoid eating rare or undercooked meats, poultry, or fish. Do not eat grilled meats. Grilling has been shown to produce carcinogens in meat.
Do not take supplements containing the amino acid phenylalanine. Phenylalanine may alter brain growth in the fetus. Also avoid food products containing the sweetener Aspertame (Equal, NutraSweet), which contains high levels of phenylalanine. See Is Aspartame A Safe Sugar Substitute? for more information.
Keep your vitamin A intake below 10,000 IU daily.
Do not take any preparations containing shark cartilage during pregnancy. Shark cartilage inhibits the formation of new blood vessels, which is essential during pregnancy.
Do not smoke, consume alcohol in any form, or use drugs, except as prescribed by your health care provider or midwife.
Do not use an electric blanket. Several experts warn that the invisible electromagnetic field emanating from an electric blanket may increase the risk of miscarriage and developmental problems. Researchers at the University of Washington found that pregnant women with previous health problems who used electric blankets, particularly in the first three months of pregnancy, were five times as likely as others to give birth to children with urinary tract defects.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has questions about pregnancy.
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