Combating Pregnancy Constipation, Morning Sickness & Heartburn

I didn't have morning sickness during pregnancy—I had every-waking-moment sickness. For two months, I camped out on the couch nibbling one of the only things I could keep down: plain toaster waffles, which my husband called "Preggos." Mercifully, the nausea lifted during my second trimester, but many people suffer much longer.

Jenn Grassi, of New Hampshire, had terrible heartburn for all nine months and remembers the day after delivery well. "It dawned on me that the heartburn was gone, and I nearly cried tears of joy," she says.

While you wait for tummy troubles to naturally lift —or for baby's birth to save you from them—here's how to cope.

Morning Sickness Madness

It's called morning sickness because the queasy feeling often hits in the morning, when your stomach's empty. But the nausea (and sometimes vomiting) can occur any time. More than half of all pregnant people have morning sickness to some degree. Those who are more prone to nausea in general—from motion, for instance—seem to be most likely to suffer, says Sheila Crowe, M.D., an associate professor of internal medicine at the University of Virginia's Digestive Health Center of Excellence.

Your chances are also higher if you're carrying multiples because the level of nausea-provoking hormones is higher. Plus, morning sickness is believed to be genetic: If your mother was sick during her pregnancies, you likely will be, too.

Morning sickness strikes hardest during the first trimester, due to surging hormone levels. "Most women experience onset between six and ten weeks," says Ashi Daftary, M.D., an assistant professor of obstetrics, gynecology, and reproductive sciences at the University of Pittsburgh.

The same hormones that make you sick also help maintain the pregnancy, so take heart: It's a sign that your pregnancy is on track. During this time, don't panic if your appetite doesn't allow for the perfect diet. Taking a prenatal vitamin will help ensure that you're getting the nutrients you need.

Usually, morning sickness greatly improves or even vanishes between week 10 and week 14, when hormone levels decline. Roughly 10% of pregnant people will continue to be sick beyond week 20. About 1 % will be diagnosed with hyperemesis gravidarum, which means "excessive vomiting during pregnancy." This condition is marked by severe vomiting, dehydration, and weight loss, and requires medical treatment. If you have lost 5% of your pre-pregnancy weight, call your doctor for help.

Get Relief from Morning Sickness

Snacks: Crackers and other high-carb snacks help fight morning sickness because they're easy to digest. You may need to nibble on something small every hour, so keep snacks in your bag, car, and workplace, and never let your stomach get too empty—or too full, both of which can make you ill. Bland foods are best, because greasy and spicy fare tend to aggravate nausea. Sometimes sucking on something helps: Try sour candy, ginger candy, or lollipops.

Drugstore Cures: In addition, some people find relief in wristbands designed to prevent seasickness, such as Sea-Bands (in drugstores), which work through acupressure. Many obstetricians also suggest vitamin B6 supplements because morning sickness may be caused by a deficiency (consult your doctor before taking any).

Need more? Ask your doctor about over-the-counter medicine. Antihistamines— particularly Unisom in tablet form—are one of the rare medications that are considered safe because they have been "randomized controlled double-blind" tested (the gold standard in pregnancy).

Stomach acid tends to make nausea worse, so heartburn medicines like Zantac may also do the trick. If those fail and morning sickness has you miserable, discuss with your doctor whether stronger drugs are worth it. Over-the-counter antacids are considered safe with good "retrospective" data.

Constipation

Many factors conspire to make constipation a pregnancy problem. For one, progesterone slows down the intestine muscles, causing things to move slowly through your system (so you might also feel gassy and bloated). Your baby puts pressure on your rectum as well. An increased blood supply means you need a lot more fluid, so you can easily get dehydrated. Finally, the iron in your prenatal vitamin may be constipating, too.

To add insult to injury, constipation can lead to straining during bowel movements—and hemorrhoids, which occur when the blood vessels around the rectum become enlarged, itchy, and painful. You may even notice slight rectal bleeding; your doctor can confirm if it's from hemorrhoids. If you're prone to dilated veins (like varicose veins), you're more likely to get hemorrhoids, says Dr. Daftary. Also, if you had hemorrhoids during a previous pregnancy, they'll be quicker to reappear. "It's a repetitive injury," Dr. Daftary says.

Most people return to regularity after delivery, but constipation may linger for some. If you're breastfeeding, remember to keep drinking extra fluid. If you've had a C-section, it may take longer to get regular too: One of the common side effects of narcotic pain relievers is constipation. It can also occur as a result of recovering in bed.

Get Relief from Pregnancy Constipation

Fiber is your best defense, because it holds on to water and helps things pass through the intestine. Add fiber-rich foods such as a cereal, fruits, vegetables, and beans to your diet. If you can't get your fill from food, try fiber supplements. Finally, exercise is known to boost bowel motility.

If lifestyle changes aren't working, ask your doctor about over-the-counter stool softeners like Colace. (Steer clear of laxatives during pregnancy; they can cause an electrolyte imbalance.) For hemorrhoids, medicated pads and creams like Tucks and Preparation H are safe.

Heartburn

Experts don't know why some people experience heartburn and others don't, but it's no surprise that so many get it, especially during the last trimester. As the growing fetus pushes upward on your stomach and the pregnancy hormone progesterone relaxes the sphincter, digestive juices can back up into the esophagus.

Unpleasant? Definitely. Harmful? Not likely. "It's usually just a nuisance," says Dr. Crowe.

Get Relief from Pregnancy Heartburn

Eat small, low-fat meals; they empty more quickly from the stomach. "Spicy, acidic, and greasy foods aggravate some women," says Siobhan Dolan, M.D., associate medical director for the March of Dimes. Chewing gum may improve symptoms because it stimulates acid-neutralizing saliva. Keeping your head elevated can keep acid down, so avoid reclining after meals.

Over-the-counter antacids such as Tums, Maalox, and Mylanta are typically considered safe during pregnancy. Medications like Zantac may also help because they squelch your body's production of acid. But in some cases, a prescription drug may be in order. For Patty Nilsen, of Evergreen, Colorado, taking prescription Pepcid twice a day before meals was a lifesaver when she was pregnant with triplets. "It was the only way I could eat," she says.

Hopefully, once your tummy troubles are over, you'll look back and imagine it wasn't so bad. Either that, or you'll have a new set of baby issues to worry about!