Why is my heart beat so fast?

Due to some of the physiological changes of pregnancy, it is common for women’s resting heart rate to be about 10 to 15 beats per minute faster while pregnant. Pregnant women are also more likely to have bigger increases in their heart rate with exertion since they are doing more work while pregnant. This increased work starts even in the first trimester, as pregnant women have a blood volume expansion of over 40%. It doesn’t stop there, as pregnant women also do more work, moving around an extra 30 pounds or more in the third trimester.

As the uterus gets larger, the heart is pushed upwards and rotated to the left. This changing position of the heart allows women to become more aware of their heart beating and sometimes this is alarming because they don’t normally perceive that their heart is beating in their chest. Couple this with the fact that the heart may be beating faster than normal, then this can be quite anxiety-provoking. But if your heart rate isn’t too fast at rest and you don’t notice that it is beating irregularly, don’t worry too much. If you feel like your heart rhythm is irregular or your heart rate is persistently fast and staying that way, talk to your doctor.

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 the few times in their lives when they don’t suffer from migraine headaches.

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

You can always use acetaminophen at any time during pregnancy for headache. If you’re less than 20 weeks’ gestation, 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 headache.

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

Some women have caffeine withdrawal headaches, especially in the first trimester. These headaches are all too common if you have recently cut out all caffeine because you’re pregnant. 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 is also a treatment for some tension headaches as well. Taking your acetaminophen with a serving of caffeine may be just what the doctor ordered.

What can I for my acne?

Unfortunately, acne tends to get worse during pregnancy. Blame your hormones and your beautiful, oily glow of pregnancy. Still, there are a few things you can do. It is safe to wash your face with benzoyl peroxide during pregnancy. Benzoyl peroxide is the common ingredient in 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 night’s oils and bacteria. One evidence-based trick is to place a fresh, clean towelette over your pillow each night that you remove in the morning. This towelette can collect the new nightly skin oils and bacteria and not allow them to saturate into your pillow and pillowcase. Just change it each night. Oral retinoids (e.g., Accutane) should be avoided during pregnancy due to the severity of birth defects that a fetus may develop as a result of exposure. Many other acne treatments are not safe during pregnancy. Ask your doctor before trying any other remedies.

Oral retinoids (e.g., Accutane) should be avoided during pregnancy due to the severity of birth defects that a fetus may develop as a result of exposure. Many other acne treatments are not safe during pregnancy. Ask your doctor before trying any other remedies.

Is it normal that my boobs are leaking already?

Yes. Especially if you’ve already had children, you might notice that your milk comes in early or that you have occasional leakage, even in the first trimester. Even if you haven’t had a baby yet, it’s not uncommon at all for you to leak some milk. If this is a persistent problem (or an embarrassing one), you might need to change up your bra or wear nipple shields so that your nipples are less stimulated.

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 your ever increasing belly size, your hips rotate forward, the curvature of your back changes, and the muscle groups you use 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, the result is chronic muscle strain, sprain, and fatigue.

Things to try include using acetaminophen to treat the pain and if you are less than 20 weeks’ gestation, you can still use nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen or Naprosyn occasionally. A heating pad on the back, heat releasing patches, or a nice bath may also help a lot.

Exercise can help tremendously. Gymnasts and ballet dancers rarely complain of back pain during pregnancy because they have well-developed back musculature and core abdominal muscles. Exercises that help strengthen the back and 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 (belly band). These devices tend to change your center of gravity slightly and help redistribute the load. Typically, these are most helpful in the third trimester. Even if you did not need one in your first pregnancy, keep in mind that during your second or third pregnancy you carry the baby differently in your pelvis and it may be beneficial this time around.

Massage can be beneficial and some women may need help from a physical therapist. Your doctor can let you know if physical therapy or, in some cases, pelvic floor physical therapy, might be appropriate for your symptoms. In some cases, we may prescribe muscle relaxants but these tend to be sedating. Still, they can be useful at night.

It’s 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 or midwife. Various pains, particularly back pain, pelvic pain, and round ligament pain, are common in pregnancy.

Here is a list of things that can help relieve pains:

  • Stretch and do strengthening exercises like Pilates or Yoga
  • Wear a pregnancy support belt
  • Use Tylenol
  • Use warm compresses or pads
  • Wear low-heeled shoes with good arch support
  • Avoid lifting heavy items by yourself
  • Elevate one foot on a support if you must stand for a long period of time
  • Bend with your knees, not at the waist
  • Try to sleep on your side with one or two pillows between your knees
  • Place a board under your mattress to make your bed firmer

I have gestational diabetes. Now what?

If you failed your 1-hour glucose screen AND your 3-hour glucose tolerance test, then you have gestational diabetes.

Hopefully, you’ll get a chance to talk to a dietitian. In the meantime, try to cut down (if you can, cut them out completely) the simple sugary items from your diet: sodas, cookies, cakes, candies, and other sources of sugary carbs. Paying attention to portion size is the best thing you can do. Try to make your plate ½ greens, ¼ grains, and ¼ protein for every meal. If you’re not already, add in four to five 20 minute walks or other cardiovascular exercise sessions per week.

You’ll need to check your blood sugar several times per day, at least initially. You should check your blood sugar first thing in the morning (a fasting blood glucose), and then check it two hours after each large meal – breakfast, lunch, and dinner. Your fasting blood sugars should be below 95 and your blood sugars after meals should be below 120. If your blood sugars are running higher than this, you may need to take medicine to help lower your blood sugars.

Is also helpful, in the beginning at least, to track what you are eating. This can help your dietitian and your doctor decide if there are some things you should do differently in your diet. It can also help you understand why your blood sugar might spike – for example, after delicious pizza.

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 showing they work. Some products cite their own small studies, but they are usually poorly done or so small that it cannot be considered good evidence. Companies like to exploit new moms, so be leery. We don’t want that for you. Save your money. If your belly is dry and it feels good to use a nice lotion or other skincare product, go for it! But know that it will not prevent stretch marks. We promise the second we see something come out that is effective and has good data behind it, we’ll be the first to tell everyone.

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’ gestation or so, you are probably too early to feel any fetal movement. First time moms don’t typically report feeling movements (quickening) for the first time until 20 weeks or so; women who have had children before often feel the first movements two or three weeks sooner (around 17-20 weeks). 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 every day, but how much movement you feel 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 fetal movement and you are more than 24 weeks’ gestation, then lie down on your left side and concentrate on feeling for movements. You should feel at least six movements of some sort in the first hour; if you have felt some movements but not six, then continue counting for another hour. You should feel at least 10 movements during those two hours. Because of fetal sleep cycles, it’s not uncommon for it take two hours to feel the ten movements. Ideally, this is done during the baby’s active time. For many women, the baby’s active time is shortly after they have eaten dinner. So, maybe try eating a little something if you don’t reach the six kicks in an hour, and then extend to counting for the two hour mark. If you don’t reach 10 movements in two hours, then this is a reason to go to the hospital or office and be evaluated.

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

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 won’t make your pain any better.

Heartburn aka acid reflux aka GERD is a common problem during pregnancy and 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, avoiding trigger foods and using TUMS may be enough. For persistent symptoms, it is okay to use over-the-counter medications like TUMS, Gaviscon, Maalox, or Mylanta, as well as OTC or prescription antacid medications such as proton pump inhibitors (omeprazole, pantoprazole) and antihistamines (cimetidine).

Click here for a list of medicines that are safe to use during pregnancy.