What can I do for constipation?

Constipation is incredibly common during pregnancy; in the 19th century, some people called pregnancy the Disease of Constipation. The good news is on of the remedies and treatments that you might normally use for constipation are still safe in pregnancy. You should start by increasing your water and fiber intake. Many women will add daily use of MiraLAX or a generic equivalent to their diet. This is a gentle agent that is non-stimulating and safe to use during pregnancy. If it’s been a few days (for a week) since you went, you may need to stimulate a bowel movement from below. Try using a Dulcolax suppository, and if this doesn’t work you can repeat it in two hours or so.

If these over-the-counter remedies are not helpful, talk to your doctor.

Heartburn! Help!

You’ve probably heard the folktale that a lot of heartburn means that your baby will have a lot of hair; this probably isn’t true, but dreams of a well-coiffed baby undoubtedly doesn’t make your pain any better.

Heartburn or indigestion or acid reflux is a common problem during pregnancy and likely gets worse throughout the third trimester for most women as the uterus grows and puts more pressure on the stomach. If you have occasional symptoms, then avoiding triggering foods and using some Tums may be enough; but for persistent symptoms, it is okay to use over-the-counter or prescription antacid medications, including both proton pump inhibitors and antihistamines. Click here for a list of medicines that are safe to use during pregnancy

Why am I itching?

Most itching in pregnancy is related to dry skin. A good lotion can go a long way to reducing or eliminating itching related to this problem. In some cases, itching confined to one area may be related to a reaction to something, for what is called a contact dermatitis. If you suspect this is the case, try to avoid whatever you came into contact with a consider using an antihistamine or over the counter steroid cream until you are better.

In rare cases, itching all over the body that is not associated with a rash can be due to intrahepatic cholestasis of pregnancy or ICP. ICP is an important diagnosis to not miss and your doctor may need to check some labs to make sure you don’t have this. If you do, she will prescribe medicine to improve the situation and she will likely deliver you a couple of weeks earlier than normal.

Why don’t I feel the baby moving?

The answer to this question depends on how far along you are. If you are less than 20 weeks or so, you probably are just too early to feel any fetal movement. First time moms don’t typically report feeling movements for the first time (quickening) until 20 weeks or so; women who have had children before often feel the first movements two or three weeks sooner. Even after these gestational ages, it is still common to go a few days without feeling fetal movement until about 24 weeks or so.

After 24 weeks, you should expect to feel some movement everyday but how much movement varies from pregnancy to pregnancy. You or your partner may not be able to feel the baby with a hand on the outside of your belly simply because you have an anterior placenta or the baby is turned and kicking in the other direction.

If you are concerned that you have not felt enough feeling movement, and you are after 24 weeks, then lie down on your left side and concentrate on feeling for movements. You should feel six movements of some sort in the first hour; if you have felt some movements but not six, then go another hour. You should feel a total of 10 movements or more in a two hour period and sometimes it takes a while because babies have periods of time when they are asleep. If it’s been two hours and you have not felt 10 movements then you may need to go to the doctor or the hospital for evaluation.

You might have read on the Internet that you should do “Kick counts” every day. Most pregnant women do not need to do this in the practice may actually be harmful overall to the pregnancy. Only do daily kick counts if your doctor has told you to for a specific reason.

Can I prevent stretch marks?

The short answer is no.

Though there are a lot of products marketed to pregnant women who are willing to spend a lot of money to prevent stretch marks, none of them have good scientific data that they work. Some products cite their own small studies, but don’t waste your money on that kind of evidence. If your belly is dry and it feels good to use a nice lotion or other skin care product, go for it! But don’t pretend that it will prevent any stretch marks.

Why are my legs and hands so swollen?

Ah, the joys of pregnancy! If constipation, hemorrhoids, and heartburn weren’t enough to make you feel glorious, just wait until your legs start swelling.

Most swelling or edema in pregnancy is normal. Swelling is common; about 60% of women will have significant lower extremity swelling and a large number of these women will also have swelling in their hands that make rings too tight and wrists hurt. Much of the conventional wisdom about swelling during pregnancy is related to a concern for the development of preeclampsia, but swelling is so common, that in most cases this is not really a concern at all. Your doctor checks your blood pressure at your regular visits to make sure that you’re not developing preeclampsia.

Most swelling in the legs is related to the uterus blocking the return of blood that is collected by gravity in the legs. As the uterus gets bigger, it blocks the veins that drain the legs back up to the heart. Since there are no pumps in the legs, then the blood tends to pool and this leads to swelling. You may be able to make this temporarily better by elevating your legs, particularly while laying on your side. But for most women who are up and working throughout the day, there is little opportunity for this. Wearing a pair of support hose may help tremendously.

If your hands are swelling, you may have symptoms of carpal tunnel syndrome which is very common during pregnancy. Wearing an over-the-counter wrist splint at night on one or both hands will lead to significant improvement of these painful symptoms.

One common myth about swelling is that a woman should drink more water when she is swelling to make the swelling better. This is simply untrue. If you’re having significant swelling in your legs, you may also find that you are lightheaded or having woozy episodes because your water content has left your blood vessels and gone into your soft tissues; in this case, drinking more water may help you not feel as woozy, but it will not affect how badly you are swollen.

My back is killing me. What can I do?

Back pain in pregnancy is almost universal. The bigger the belly, the more curved the spine, and the worse the back pain. As your center of gravity moves forward with ever increasing belly size, your hips rotate forward, the curvature of your back changes, and the muscle groups that you use In your back to maintain your posture change. Because you are not used to using these muscle groups to stay upright, and because all of your muscles are doing more work than normal carrying around the extra weight, then the result is chronic muscle strain, sprain, and fatigue.

What’s a girl to do?

  • For starters, you can use acetaminophen to treat the pain and, if you are less than 22 weeks pregnant, you can still use nonsteroidal anti-inflammatories like ibuprofen or naprosyn. A heating pad on the back, or heat releasing patches, or a nice bath may also help a lot.
  • Exercise can help tremendously. Gymnasts and ballet dancers rarely complained of back pain during pregnancy because they have well-developed back musculature and core abdominal muscles. Exercises that help strengthen the back in core abdominal muscles can provide relief and prevent worsening problems as the pregnancy goes on. This includes things like Pilates or Yoga.
  • Many women benefit from wearing a back brace or pregnancy support belt. These devices tend to change your center of gravity slightly and help redistribute the load. Typically, these are most helpful in the third trimester and even though you may not have needed one in your first pregnancy, because you likely carry the baby differently in your second or third pregnancy, you might find one helpful in those subsequent pregnancies.
  • A good massage is nice and some women will appreciate chiropractic therapy during pregnancy as well. In some cases, your doctor might order physical therapy.
  • It is unusual for back pain during pregnancy to require any testing or other treatments. However, if you have a history of chronic back pain or orthopedic abnormalities, be sure to tell your doctor.

Why can’t I breath?

Literally 97% of pregnant women complain of shortness of breath at some time during their pregnancies. Most of the time, this is related to some of the pulmonary physiologic changes of pregnancy that give women the sensation that they are not breathing and deeply or moving as much air with each inspiration; but their actual oxygen status remains unchanged. It is normal to feel as if you are not breathing as deeply or if your rate of respirations increase with less vigorous activity while pregnant.

Rarely, difficulty breathing is a sign of a more serious problem. If you’re having trouble catching your breath even while resting or if you have symptoms of low oxygen levels, like changes in the color of your skin or confusion, then you may need to seek medical care immediately. Women who have underlying asthma may also have shortness of breath related to uncontrolled asthma during pregnancy and this would be a reason to seek immediate medical attention. Also, if you noticed that you can’t sleep without propping your head up with several pillows, you may need to talk to your doctor.

Otherwise, if your shortness of breath is just with exertion and becomes improved with rest, this is likely normal.

What can I do for my headache?

Pregnancy is good and bad for headaches.

The good news is, migraine headaches are uncommon during pregnancy. Most chronic migraineurs thoroughly enjoy pregnancy because it is one of a few times in their lives when they don’t suffer from migraine headaches.

The bad news is, other types of headaches, particularly tension type headaches, can become more common during pregnancy with the musculoskeletal strains and intentions of pregnancy and the anxieties and stresses associated with pregnancy.

You can always use acetaminophen at anytime during pregnancy for headache. If you’re less than 20 weeks, you can still use Ibuprofen or Naprosyn. Other medications like Excedrin Migraine can also be used on a limited basis.

A good massage, a relaxing bath, or just a good night’s rest may be the cure for a tension type headache.

Sometimes headaches have other causes, like sinus infections or allergies. If you suspect that your sinuses are the problem try and over-the-counter antihistamine and if this doesn’t work talk to your doctor.

Some women in the first trimester have caffeine withdrawal headaches. If you have recently cut out all caffeine because you’re pregnant these types of headaches are all too common. Remember that you can have up to 350 mg of caffeine per day. You may need to add a little bit of caffeine back in order to prevent headaches. Caffeine also is a treatment for some tension type headaches as well. Taking your acetaminophen with a serving of caffeine maybe just what the doctor ordered.

What can I for my acne?

Unfortunately, acne tends to get worse during pregnancy. Blame your hormones and you’re beautiful, oily glow of pregnancy. Still, there are a few things that you can do. It is safe to wash your face with benzoyl peroxide during pregnancy. Benzoyl peroxide is the common ingredient of most over-the-counter acne remedies. Check the label.

If you wash your face at night and then go and lay down on your pillow from last night, you may find that you have re-contaminated your face with last nights oils and bacteria. One evidence-based trick is to place a fresh clean towelette over your pillow each night that you removed in the morning. This towelette can collect the new night skin oils and bacteria and not allow them to saturate into your pillow and pillowcase. Just change it each night.

Many other acne treatments are not safe during pregnancy. Ask your doctor before trying any other remedies.