Gas & Burping
The Cause: As the baby grows, space becomes tight in your belly. "Your bowels become crowded and your digestion may become more erratic, leaving you gassy and bloated," says Sheri Bayles, RN, a New York City-based childbirth expert and creator of the Laugh and Learn childbirth education DVD series. Plus, you may be eating differently (e.g., more healthfully) now that you're pregnant. All those good-for-you foods like apples, pears, cauliflower, beans, brussels sprouts, and broccoli can contribute to gassiness. Cravable foods like ice cream and greasy snacks may make you gassy, too. All that extra air has to escape from one end or the other.
The Relief: Eating smaller, more frequent meals often does the trick. It's also a good idea to avoid fatty foods like burgers and fried chicken, as well as carbonated soda -- especially ones with artificial sweeteners. A brisk, 20-minute walk after dinner (with your doctor's okay) can also stimulate digestion and relieve gas. For indigestion that keeps you up at night, try sleeping with your head propped up on an extra pillow or with your legs elevated to relieve some of the pressure on your intestines and to help you digest more easily. If none of this works, ask your doctor to recommend an anti-gas medicine.
When to Worry: Hey, passing gas and burping is normal for everyone -- pregnant women just seem to do it more often.
The Cause: Thank pregnancy hormones for this side effect. Increased estrogen levels boost the body's production of melanin, the natural substance that gives your skin pigment, resulting in your darkened nipples and "linea nigra," the line running down your tummy. You may also notice melasma -- dark splotches of skin on your face. These changes typically begin in the second trimester and tend to affect darker-complexioned women more noticeably.
The Relief: You really can't prevent the darkening, but slathering on sunscreen before you head outdoors can stop it from becoming worse. These pregnancy skin changes usually fade within a few weeks of giving birth, so try not to worry about them. In the meantime, if it embarrasses you, don't wear thin white shirts where the line can show through.
When to Worry: Don't.
The Cause: Feeling like you're spending way too much time in the bathroom? You're not alone. According to the American College of Obstetricians and Gynecologists (ACOG), most pregnant women get constipated at some point during their pregnancy. Soon after you conceive, ramped-up pregnancy hormones slow your digestive tract to a crawl (this allows more nutrients to be absorbed and passed on to your baby), which can throw off your digestion as early as eight weeks. Plus, over time, your growing baby also starts crowding your bowels, making it harder to process even tiny meals.
The Relief: Upping your fiber intake may get things moving, says Marjorie Greenfield, MD, associate professor of obstetrics and gynecology at Case School of Medicine and University Hospitals in Cleveland, Ohio, and author of The Working Woman's Pregnancy Book. Start eating more fresh fruit, veggies, beans, and whole grains. For a small change that can make a big difference, switch to a high-fiber cereal (like Kashi GOLEAN or Barbara's Bakery Ultima Organic High-Fiber Cereal). Also, remember to drink plenty of water. Guzzling prune juice (we know, ick) may do the trick, too. You could also talk to your doctor about trying a fiber supplement, like Metamucil, which is safe to take during pregnancy. If you're still uncomfortably backed up, your doctor may suggest a gentle laxative like Milk of Magnesia. Just be sure to avoid stimulant laxatives, such as Dulcolax, Ex-Lax, and castor oil, which can cause contractions.
When to Worry: Constipation is uncomfortable but rarely dangerous, so there's no need to stress. In very rare cases, untreated symptoms can lead to a fecal impaction, which your doctor will have to remove. Although this may be painful (and a little awkward) for you, it won't harm your baby.
The Cause: Blame it on your new cleavage. As you've probably noticed, your breasts and nipples are becoming super-sized in preparation for breastfeeding. As your breasts grow, the sensitive skin in this area stretches, which can trigger a persistent itch.
The Relief: Moisturize! "Dab a thick, emollient lanolin cream like Lansinoh on your nipples when you feel the need to scratch," suggests Bayles. Slathering on a cocoa butter or vitamin E body lotion after showering can keep your skin supple and prevent itching. It's also a good idea to avoid wearing potentially irritating fabrics like wool or cashmere blends. For extra comfort, trade the bras you're rapidly outgrowing for soft cotton nursing bras or camisoles with built-in support (you'll have to stock up in a few months anyway).
When to Worry: If you develop a rash or notice bloody discharge from one or both nipples, talk to your doctor. This could be a symptom of a bacterial infection or intraductal papilloma, a usually noncancerous condition, which account for most cases of bloody nipple discharge. In very rare cases, bloody discharge can be a sign of breast cancer, so your doctor may want to check it out.
Sharp Groin Pain
The Cause: These down-there pains tend to start up mid-pregnancy, when the round ligaments in your pelvis stretch to accommodate your growing baby, says Laura Riley, MD, director of labor and delivery at Massachusetts General Hospital in Boston, Massachusetts, and author of You and Your Baby: Healthy Eating During Pregnancy. You may feel them when you stand up suddenly or they may hit after a long day of being on your feet. Later on, the weight of your baby's head pressing down on your pubic bone can also cause groin aches.
The Relief: Take a load off your feet. The next time a pain hits, prop up your legs on a foot rest or pillows to relieve the pressure on your pelvis. If the ache comes on at work, sit down and rest a few seconds until it subsides, and then try to take it easy for the rest of the day. Wearing a belly support band under your clothes or doing a simple stretch, like flexing your knees toward your abdomen, can also ease the pain by soothing some of the strain on your lower midsection. You can also ask your doctor about taking acetaminophen (never ibuprofen or aspirin, which aren't safe during pregnancy) to relieve it.
When to Worry: If the pain is severe or accompanied by cramps, contractions, lower-back pain, pelvic pressure, bleeding, or increased vaginal discharge, call your doctor. It could be a sign of premature labor.
Nausea & Vomiting
The Cause: Welcome to the all-day-sickness club. According to the American College of Obstetricians and Gynecologists, while as many as 85 percent of women experience some degree of nausea during pregnancy, some expectant moms feel queasy around the clock. The verdict's still out on what exactly causes morning sickness, but experts believe it's linked to soaring levels of pregnancy hormones -- specifically estrogen and progesterone -- that hit you hardest in the first trimester.
The Relief: There's no one silver bullet for easing morning sickness for everyone, so you may have to try several strategies to see what works, says Dr. Greenfield. For early morning queasies, some moms-to-be swear by nibbling something light and bland, like saltines, before getting out of bed. Other remedies include sucking on ginger candy (the root is often effective as a nausea soother) or eating a light snack at bedtime to keep the tummy from becoming empty and unsettled overnight. As for puking in public, stow plastic bags and plenty of breath mints in your purse so you'll be prepared should a wave of nausea strike. You may also want to confide in a close friend at work, who can cover for you if you need to ditch a meeting or come in late. On the upside, most women start feeling better after 12 or 14 weeks. Trust us -- when the nausea finally lifts, you'll feel like a whole new person.
When to Worry: If you literally can't keep anything down, see your doctor because you could become malnourished or dehydrated. She may suggest you try an over-the-counter combo of vitamin B6 and the sleep aid Unisom, which has helped many women power through morning sickness. If that doesn't help, your doc may prescribe medication to get your symptoms in check.
The Cause: Talk about loosening up. "When you're expecting, certain hormones signal your pelvic muscles to relax so you can eventually deliver your baby," explains Dr. Greenfield. This makes you more prone to little leaks -- known as urinary incontinence -- while sneezing or giggling. What's more, during the second trimester, your growing baby starts to put pressure on your bladder, which resides right in front of your uterus. Many women experience some leaking during pregnancy, according to ACOG.
The Relief: Doing Kegel exercises (contracting your pelvic floor muscles as though you're trying to hold in your pee) in sets of 10, several times a day, can minimize the leakage by strengthening the muscles around your bladder. It also helps to take bathroom breaks every hour or two so your bladder doesn't get too full, Dr. Greenfield says. Try wearing a pad or pantiliner late in your pregnancy to help absorb accidents.
When to Worry: If the condition gets worse or you experience pain or burning when you pee, see your doctor to rule out a bladder or urinary tract infection.
Decreased Sex Drive
The Cause: Now that you're expecting, sex has likely dropped a few notches on your to-do list. For starters, the fatigue and nausea common in early pregnancy can derail anyone's sex drive; later on, an aching back and large baby bump can put a damper on getting in the mood (and can present, um, logistical challenges). Worries (unfounded) that sex could hurt you or the baby may give you pause before jumping into bed too.
The Relief: Low libido is completely normal. In fact, almost all women report feeling too much like Shamu for sex at some point in their pregnancies. Know that your mood may fluctuate throughout pregnancy -- you may be dreading the deed now, but find yourself raring to go next month. Sometimes just talking with your husband about your fears and insecurities may put you at ease and rev your sex drive, says Dr. Riley. And remember, sex is totally safe for you and the baby, as long as your doctor gives you the green light. "Your baby is floating in amniotic fluid and protected in the uterus, which is a thick, strong muscle," says Dr. Riley. It won't be harmed during sex. Still not feeling into it? Reassure yourself and your partner that this is a temporary phase and find other ways to stay close (like kissing, cuddling, taking a weekend trip or a longer babymoon vacay).
When to Worry: If the lack of sex is really interfering with your relationship, then you may want to speak to your doctor or a counselor.
Increased Sex Drive
The Cause: If you're feeling friskier than a kitten, there's good reason. First, there's increased blood flow to your nether regions (blood volume increases 40 to 50 percent during pregnancy), which can heighten your arousal and may even lead to more intense or multiple orgasms, says Yvonne K. Fulbright, PhD, coauthor of Your Orgasmic Pregnancy: Little Sex Secrets Every HOT Mama Should Know. You can also chalk it up to your pregnant state of mind. "Sometimes there's an extra closeness between partners because of this amazing occasion you're sharing," says Dr. Greenfield. Or your libido may be in overdrive because this is the first time you've ever been able to enjoy sex as sex -- without worrying about getting pregnant or not getting pregnant, she says.
The Relief: Unless your doctor has told you otherwise, you're good to get it on. It's generally safe to enjoy whatever was on the menu pre-pregnancy. "If sex doesn't hurt you, then it doesn't hurt your baby," says Dr. Greenfield.
When to Worry: If you're experiencing complications like placenta previa, incompetent cervix, or are put on bed rest, it may not be safe to have sex, so check with your doctor. And -- not like you'd really be in the mood anyway -- but you should never have sex once your water has broken because it can lead to infection.
Is It OK to Have Sex During Pregnancy?
Get answers to this question and more from Erika Schwartz, MD.
Breaking Out Like a Teenager!
The Cause: Pregnancy -- and its roller-coaster hormones -- can be like nine long months of PMS for some women, triggering bumps and blemishes you haven't seen regularly since age 14.
The Relief: Studies have yet to determine the safety of over-the-counter acne products like salicylic acid or benzoyl peroxide during pregnancy (although prescription Accutane has been linked to birth defects and should never be used during pregnancy). The best thing to do is avoid them entirely and talk to your doctor about safe alternatives. She may recommend that you use a mild facial cleanser and a pore-clearing clay mask once a week. Luckily, the acne usually goes away shortly after delivery or when your hormones rebalance during pregnancy.
When to Worry: An acne outbreak is a bummer, but in the big picture, it's really nothing to sweat over. Use it as an excuse to splurge on a good concealer and cleansing products.
Crazy Pregnancy Dreams
The Cause: Strange, unsettling dreams are a totally normal part of pregnancy. "When you're pregnant, you give up a lot of the control you once had," says Dr. Riley, which creates some feelings of nervousness about your future and impending motherhood. These anxieties, combined with fatigue and trouble nodding off, can lead to restless nights filled with weird dreams. It's common for expectant moms to report dreaming of things like horrible car accidents or giving birth to animals.
The Relief: Your subconscious scenarios may freak you out, but they're actually a healthy way to cope with uncertainties you may have over becoming a parent. Remember that what happens in your sleep is not a reflection of your or your baby's future. Talking about your dreams and rationalizing your fears may help you see that there's no reason to worry, says Dr. Riley. If you dreamed you gave birth to a Labrador, remind yourself that you've seen your baby in the womb and he's 100 percent human (you've got sonograms to prove it). Dishing about your dreams to your husband or other mom friends can help, as will jotting them down in a journal. Seeing how out-there they look on paper or sound as you recount them may bring you some peace of mind.
When to Worry: If the dreams are disrupting your sleep or making you anxious during the day, bring it up at your next doctor visit. It's best not to let excess stress or anxiety go unchecked.
Sexy Dreams About Old Boyfriends
The Cause: You're not the first pregnant woman to dream a late-night rendezvous or two with a college crush. Sexual dreams are common during pregnancy -- and when you're expecting they can be quite explicit. (Some women even orgasm while they sleep.) For one thing, different sleep patterns during pregnancy give you better dream recall, according to Dr. Fulbright. So it may be that you've always had sexy dreams, but you just didn't remember them until now. Second, "pregnancy is a very significant time in a woman's life, and it might be a time of significant reflection," says Dr. Fulbright. The dreams may be one way for your mind to celebrate your younger, carefree days as you prepare for the amazing future with your new baby. Third, all that extra blood coursing through your veins now that you're pregnant can cause you to experience sexual sensations a bit, um, more intensely. Lucky you.
The Relief: These dreams have no basis in reality, and they certainly don't mean you don't love your partner. Since you have zero control over them, there's no need to feel guilty. Just enjoy!
When to Worry: If your dreams make you feel anxious or depressed, let your doctor know.
The Cause: Hemorrhoids are dilated blood vessels around the anus -- sort of like varicose veins in your butt, according to Dr. Riley. They may appear as itchy, burning bumps and occasionally they'll bleed, which is why blood in your stool or on toilet paper is one of the most common hemorrhoid symptoms. Many pregnant women suffer from hemorrhoids, since they're often caused by the baby's weight pressing on veins in the groin. And chronic constipation doesn't help, since it forces you to strain more during bowel movements, aggravating things even more.
The Relief: Keeping constipation in check is your best defense against hemorrhoid flare-ups. Sip lots of water and nosh on fiber-rich foods like high-fiber cereals or bran muffins. (See slide 3 for more tips.) When you experience an episode, keep the area clean and dry, and swab it with witch hazel pads to soothe the swelling, suggests Dr. Riley. If they really hurt or don't seem to be getting better after a few days, your doctor may recommend a hydrocortisone cream to ease inflammation.
When to Worry: Hemorrhoids aren't dangerous to you or your baby, so there's no need to worry. However, you should let your doctor know if there's blood in your stool. He may want to rule out the extremely minuscule possibility of colon cancer.
The Cause: "Rising estrogen levels, especially in the third trimester, cause the vagina to produce more secretions and discharge," says Dr. Riley.
The Relief: You can't prevent or limit the discharge, but wearing cotton underwear may help you stay dry. It's more breathable and absorbent than synthetic fabric, not to mention comfier. Use a pantiliner too, but remember to change the pad frequently, says Dr. Riley. "A damp pad can rub against your skin and cause irritation." And never to douche or use a tampon while pregnant, which can introduce bacteria into the vagina or push already present bacteria closer to the cervix and cause an infection; recent studies have found that women who douche during pregnancy are more likely to have a preterm delivery than those who don't.
When to Worry: If the discharge itches, burns, has a strong odor, or is anything other than creamy and white, talk to your doctor. He may want to check to make sure you don't have a yeast infection, bacterial vaginosis, or a sexually transmitted disease. (Don't panic if you do; many are treatable with antibiotics during pregnancy.)
Pregnancy Skin Problems: Skin Darkening
The Cause: Leaky breasts are yet another sign that your body is getting baby-ready. "High levels of prolactin -- the hormone that preps your breasts for nursing -- at the end of pregnancy can sometimes cause fluid to leak from your nipples when they're stimulated," says Dr. Greenfield. Everyday things like showering, changing your clothes, or having sex can be enough to trigger sudden nipple secretions.
The Relief: You can't turn off the leakage, but you can prevent noticeable damp spots from appearing on your clothes. Stick nursing pads inside your bra to absorb the wetness. You'll need them in a few months anyway, when the baby comes. Extra perk: They'll also make your boobs look fuller.
When to Worry: If the leakage is bloody or foul-smelling, see your doctor to rule out a bacterial infection or intraductal papilloma, a usually noncancerous condition that accounts for most cases of bloody nipple discharge. In rare cases, bloody discharge can be an early warning sign of breast cancer, so your doctor should check it out.
Vulvar Varicose Veins
The Cause: Vulvar varicose veins, often called vaginal varicose veins, "are dilated veins on the labia," says Michele Hakakha, M.D., an ob-gyn in Beverly Hills, CA, and co-author of Expecting 411: Clear Answers & Smart Advice for Your Pregnancy. They're caused by the pressure that your growing uterus puts on the veins in your vagina, and if you have them in one pregnancy you're more likely to get them during the next one. The good news: "They cannot open up and bleed, regardless of how large they look," Dr. Hakakha says.
The Relief: They'll shrink after delivery -- in most cases going away entirely -- but there's little that you can do about the veins while you're pregnant. Dr. Hakakha suggests wearing a V-belt, a special type of maternity belt that offers extra support. She also recommends wearing a tight-fitting garment, such as Spanx (if it's comfortable for you), and staying active throughout your pregnancy.
When to Worry: Don't worry -- they're uncomfortable and sometimes unsightly, but they're not dangerous. "Vulvar varicose veins do not pose any risk to baby or delivery," Dr. Hakakha says.
Your Changing Belly Button
The Cause: That's just your body's way of making a little extra room for baby. "The stretching of your belly and the pressure from the baby inside can cause your belly button to stick out like a turkey timer," says Dr. Greenfield. The pop usually comes on slowly during the last trimester when your baby is at her biggest and most crowded.
The Relief: A protruding belly button doesn't hurt, though the skin may be sensitive when it rubs against your clothing. If it bothers you, wear a belly band that covers your belly button or stick a band-aid on it to prevent chafing and keep it from showing through your clothes. Your belly button should shrink back to normal shortly after your baby arrives.
When to Worry: A popped belly button is normal and no cause for alarm. In rare cases, an umbilical hernia can develop, which happens when a small part of the intestine pushes against the space around your belly button. So if you notice an extra little bulge around your navel, show it to your doctor. No need to panic if you do -- these types of hernias usually resolve on their own or only require a minor procedure to repair.
Your Water Breaking
The Cause: Your water breaking is a sign that labor may be under way. However, most women actually start having contractions before their membranes rupture so they're expecting it, according to Bayles.
The Relief: It's true your water could break anywhere at any time, but the reality is that just 20 percent of women have their water break someplace other than a hospital, according to Bayles. And when it does happen, it's rarely the major drop-everything-and-run-to-the-hospital event you may be imagining. The fluid may leak out or gush out, but it's colorless and (thankfully!) odorless, making it a cinch to clean up. Just call your doctor to let her know. She may ask you to call her back every few hours to update her on your progress. If you're really afraid of your water breaking in the supermarket, wear a high absorbency pad (we know, not lovely, but it will prevent a soaked chair).
When to Worry: No need to worry, just call your doc. And there's generally no need to head to the hospital when your water first breaks, except in the rare case that the fluid is brown or green, which could be a sign of infection. If this happens, don't panic, but it's best to get medical attention right away.
Grooming Down There
The Cause: Lots of people will soon be up close with your privates, and you may be worried that docs and nurses will be grossed out if you haven't "groomed" recently.
The Relief: Your doctor certainly won't be critiquing your grooming or lack thereof -- she'll be far too busy delivering your baby to notice. "Shaving and waxing are completely personal choices, and doctors really don't care how you look," says Dr. Greenfield. They've seen it all hundreds of times, and they're far more concerned about getting your baby out safely than when your last waxing was. If you want to go for it, remember that your skin is way more sensitive these days, so if you're not used to the pain, now's not the time to experiment with a Brazilian. Also, know that there's more bacteria on your skin for a day or two after shaving and waxing, says Dr. Greenfield. For this reason, it's best to avoid removing hair from the area near the top of your bikini line (where a c-section incision would be made) close to your due date, just in case.
When to Worry: Just do whatever makes you comfortable. If you normally don't wax or shave down there, you don't have to start now.
Your Husband Watching the Birth
The Cause: Birth is an amazing moment, but it does come with a little blood, sweat, and tears -- plus some potentially less-than-glamorous views of you from the waist down. Knowing your partner will witness all that might make you worried that he'll never look at you the same way afterward.
The Relief: Chat with your husband. Let him know your worries and ask what he thinks, says Dr. Greenfield. He may reassure you that he absolutely wants to be there and that seeing the baby come out will only make him love you more. Or he might say that he too is a little squeamish about the whole deal. If that's the case or if you really feel strongly about it, agree on a compromise -- an above-the-belly-button policy so he can still be in the room gripping your hand and rubbing your back, but won't have to peek at what's going on below the belt.
When to Worry: It's normal to have concerns about this, but the truth is, you and your husband won't know how either of you will handle labor until you're in the thick of it. And sex will be the last thing on your minds for the following few weeks when you're caring for a newborn 24/7 and recovering from delivery anyway. By the time you're both ready to get back in the saddle, all the details of baby's birthday will likely be a much more distant memory.
Going to the Bathroom During Childbirth
The Cause: To get that baby out, you're going to have to push hard -- and that means using the same muscles and bearing down the same way you go to the bathroom. (In fact, pushing like you have to poop is likely the direction you'll hear from the labor nurse.) Since there's no magical switch to ensure that baby comes out while everything else stays in, accidents can happen.
The Relief: Not every woman empties her bowels on the delivery table but when it happens, doctors and nurses really don't care. "Obstetricians are not squeamish people," assures Dr. Greenfield. In fact, if you do poop, it means you're doing the right thing and pushing correctly, says Dr. Riley. And delivery room nurses are prepared for this and will swoop in and discretely wipe away anything that comes out. Thanks to these quick cleanups and epidurals, many new mamas (and their delivery room guests) are blissfully unaware that anything but a beautiful baby came out.
When to Worry: You shouldn't.
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