Common Discomforts in Pregnancy
The following are common discomforts/conditions experienced during the prenatal period:
Abdominal Pain-
Overview: As the pregnancy progresses it's not uncommon for the pregnant parent to have an increase in abdominal pain. This is due to the growing abdomen stretching skin and muscles as well as a shift in center of gravity. This discomfort typically fades after birth when the muscles can slowly come back together and work as they did during prepregnancy.
Remedies: Good posture and correct walking/ bending will go a long way in preventing additional discomfort. Daily exercise or stretching can help build good muscles, specifically yoga or Spinning Babies. Belly band can help take some of the pressure off the abdomen by helping support the belly, a scarf works well for this too. If pain is persistent, consider seeing a chiropractor and/or a massage therapist.
When to Call: If the pain is sharp and in a specific spot, or if pain presents as consistent cramping in the lower abdomen, back, or inner thighs.
Back Pain:
Overview: Pain in the back due to shift in weight and center of gravity.
Remedies: Good posture, focus on body movement including squatting instead of bending over. Massage and Chiropractic care.
When to Call: When pain is severe or is accompanied by cramping or bleeding, or lower back pain (like menstrual cramps) that comes and goes in a rhythmic manner.
Breast Tenderness:
Overview: Breast soreness is a natural symptom of pregnancy. The increase of hormones estrogen and progesterone enable milk-producing cells to form and other changes that can result in tenderness.
Remedies: Many people find that limiting movement of the breasts can help reduce soreness. This can be achieved with a well-fitting bra or other supportive clothing. Avoiding additional stimulation also prevents tenderness. Lastly for some people applying a cool cloth to the breasts can be relieving.
When to Call: If lumps begin to form in breasts then it is important to get checked to ensure these are benign.
Bleeding Gums:
Overview: Blood flow to the mouth and gums increases during pregnancy. Increases in progesterone allows saliva to promote bacteria growth in the mouth.
Remedies: Routine dental care with soft bristled brush and regular flossing is the best prevention for bleeding gums. Overwise, regular warm salt water rinses can help ease irritation ( 1 teaspoon salt to 1 cup of water).
When to Call: Persistent and prolonged bleeding or pain.
Constipation:
Overview: Pregnancy hormones tend to slow down digestive functioning to allow the body to absorb more nutrients and water. As the uterus grows it may also put pressure on the intestines and rectum. Some types of iron supplements can also contribute to constipation.
Remedies: Motivate digestion by getting plenty of exercise. Make sure you are eating a variety of fruits and vegetables several times a day. The squatting position can help with elimination. To assist with this, use a small stool to put your feet on while you sit on the toilet.
When to Call: Before taking over-the-counter medications, if the constipation is severe, if your abdomen is painful, or if there’s blood in the stool.
Dizziness or Fainting:
Overview: During pregnancy, blood can more easily pool in your legs. Leading to a decrease in blood flow to the brain. This can cause dizziness or more rarely fainting.
Remedies: To prevent episodes of dizziness eat small meals frequently and keep well hydrated. Avoid standing for long periods, if you must stand then practice walking in place to keep up blood flow. Many find lying on their back in the second or third trimester also can cause dizziness, when rising from sitting or standing remember to take it slow.
When to Call: If there are accompanying symptoms of chest pain or significant shortness of breath.
Dyspareunia (Pain with Intercourse):
Overview: Dyspareunia is pain with intercourse. This typically presents as pain just before, during, or after intercourse. For most people, this condition has both structural and psychological roots. The pain may have root causes depending on if the discomfort is at entry or during deep thrust. Stress and anxiety can also play a large role in adding to dyspareunia.
Remedies: A good rule of thumb is; don’t engage in intercourse unless both partners are willing, relaxed, and emotionally engaged. If pain is at entry, then spend more time on foreplay and consider artificial lubricant. If pain occurs with deep penetration then try more shallow positions for intercourse. Be patient with your bodies and each other.
When to Call: If you are having recurrent pain with intercourse or if no relief can be found from these remedies. There may be a structural issue that can be addressed by the provider.
Dyspnea (Shortness of Breath):
Overview: Dyspnea is shortness of breath, not uncommon in pregnancy. Specifically, this condition is more likely to occur in the second and third trimesters. As the uterus puts more pressure on the diaphragm which makes it more difficult for the lungs to expand. This can add to or create a feeling of difficulty breathing or breathlessness.
Remedies: As always, listen to your body. Take breaks as needed, avoid physical exertion, and practice deep and measured breathing. Practicing good posture, engagement in moderate exercise, and avoiding air pollutants are all great ways to reduce shortness of breath.
When to Call: If dyspnea worsens or the following symptoms develop; wheezing, gasping, hyperventilation, rapid heartbeat, dizziness, chest pain, blueness around lips, if you develop a cough, or if you have asthma.
Edema (Swelling):
Overview: Edema is swelling or inflammation of the extremities due to the increased blood volume of pregnancy.
Remedies: Best methods of preventing swelling include decreasing caffeine and salt intake, avoiding heat and unsupportive shoes. Otherwise increasing potassium, dandelion root, and Epsom salts baths (helpful herbs to add are lavender and calendula) can help reduce swelling along with elevation of feet and legs.
When to Call: If the swelling doesn’t subside, or if there are accompanying symptoms like high blood pressure, vision changes, headaches, trouble breathing.
Fatigue:
Overview: First-trimester fatigue is a result of the flood of the hormone progesterone in the body. This is one of the most common pregnancy symptoms. It is also the most common symptom of anemia.
Remedies: To combat fatigue it is essential to get adequate sleep at night, eat frequently during the day, and accomplish 30 minutes of exercise daily. Taking naps during the day is recommended in addition to delegating household chores. When considering a diet, including adequate protein and iron.
When to Call: If fatigue is accompanied by symptoms of anemia like shortness of breath, dizziness, headaches, pale skin color, and/or coldness. Also, call if fatigue does not resolve after the first trimester or is greatly impacting the ability to handle daily tasks.
Headaches:
Overview: Headaches can be caused by tight muscles, eliminating caffeine, low blood sugar, sinus issues, dehydration, or allergies.
Remedies: Avoid strong scents, food additives like nitrates, sulfites, and artificial preservatives and sweeteners. Yoga and light to moderate exercise may also help loosen tight muscles. Make sure to drink plenty of water. Massage and acupuncture may help. An easy pressure point for relief is between the thumb and forefinger, squeeze this point firmly with the opposite hand. Hold for 45 seconds to 3 minutes.
You can enjoy a cup of skullcap tea for headache relief in pregnancy, it will make you sleepy, so use with caution.
When to Call: If the headaches do not subside after trying relief techniques. Sudden onset headaches, headaches that become more severe with comfort measures, or Headaches that are accompanied by a fast heart rate.
Heartburn:
Overview: In pregnancy, heartburn is a common occurrence. As the body produces more hormones the sphincter that helps keep acid in your stomach, where it can break down food, begins to relax. Allowing for more frequent and intense instances of heartburn.
Remedies: Eating smaller amounts of food more frequently, also avoiding spicy, greasy, or fatty foods. Most people find that certain foods like tomatoes can cause heartburn. Papaya enzymes work well in place of tums or for preventive use if taken daily.
When to Call: If there is difficulty swallowing, spitting up blood, weight loss, black stools, if you do take an antacid and soon after the heartburn returns, if there is an accompanying headache or other symptoms.
Hemorrhoids:
Overview: Hemorrhoids are swollen blood vessels in the lower part of the rectum. This is due to the changes that pregnancy causes in the vascular system. This clump of irritated skin and vascular tissue can feel itchy, burning, or bleed when you pass stool. Oftentimes hemorrhoids will fade after pregnancy.
Remedies: Most remedies are aimed at facilitating the easier passage of stool. The first step is to increase dietary fiber. Another option is to use over-the-counter pain relief, such as Preparation H. Avoid straining, or sitting on the toilet for a long time. Ensure that the area is kept clean after bowel movements.
When to Call: If the area becomes infected, forms an abscess, or no relief is found from over-the-counter remedies.
Insomnia:
Overview: Falling asleep may be difficult at times as well as staying asleep. Sleep may be interrupted by frequent urination, the baby’s movements, bodily discomforts, and anxiety.
Remedies: It’s important to practice good sleep hygiene. This includes avoiding caffeine, screens, and other stimulants in the afternoon/evening. Sleep routines such as winding self down with a book, warm bath, journaling, or sleep hypnosis track may be helpful. Herbal teas like chamomile are useful nervine relaxants and can help encourage sleep.
When to Call: If you are experiencing depression or anxiety, a harmful living situation, or substance use that is limiting your sleep. Please reach out if you are interested in further herbal suggestions to support healthy & restful sleep.
Leg Cramps:
Overview: Leg cramps are painful and involuntary muscle contractions of the calf, foot, or both. Most often leg cramps happen at night and typically begin to occur in the second or third trimester.
Remedies: To relieve leg cramps at home there are several options. When cramping it can be useful to straighten your leg and flex your toes back towards you. Massage can be another useful trick to relieve a cramp. Magnesium supplements can help prevent or reduce cramping, these can be taken orally or topically through magnesium lotions or even Epsom salt baths. Other prevention techniques include hydration, a well-balanced diet, and regular stretching.
When to Call: If the pain from cramping is severe and prolonged or you notice the area is swollen or red.
Nausea:
Overview: Nausea is most common in the first trimester of pregnancy and is often referred to as “morning sickness” although nausea can occur at any time and may last for hours.
Remedies: If nausea is most common in the morning be sure to eat plenty of protein before bed. Waking up on an empty stomach can increase nausea. Eat small meals frequently throughout the day and take small sips of water. Acupressure has been useful to many people during pregnancy. Other remedies are vitamin B supplements, peppermint teas, preggie pops, or ginger chews.
When to Call: If you are unable to keep down water/liquids for more than 4-6 hours, if you are unable to keep down food for more than 24 hours, if you are repeatedly vomiting more than 3-4 times a day, if you are losing weight, if you feel dehydrated if you also have a headache or fever or diarrhea or pain in your belly, and/or if this is new nausea in the third trimester.
Pruritus (Itchy Skin):
Overview: Pruritus is a chronic itching sensation involving the worsening of an existing skin issue, such as eczema or psoriasis, or the development of a new one. The itching is most often caused by stretching of the skin as well as increased blood flow in pregnancy. Pruritus is especially common in the last trimester. Most likely occurring on the abdomen, buttocks, thighs, arms, and breasts.
Remedies: The use of coconut oil, or lotions can help prevent itching to some degree. Otherwise using a cold compress to the affected area, cooling lotions (mint, lavender, juniper, etc), calamine lotion, aloe vera, oatmeal/baking soda bath, or drinking dandelion root tea can help reduce the itching sensation.
When to Call: If the itching becomes extreme, occurs on the palms of your hands/feet, there is no rash associated with itch, and is worse at night.
Ptyalism (Excessive Salivation):
Overview: Excessive salivation is an unusual pregnancy discomfort. Is often accompanied by nausea with or without vomiting. The cause of ptyalism is largely unknown, but most cases do subside by 12-14 weeks.
Remedies: If nausea is resolved, sometimes that will resolve the ptyalism as well. Other tips to consider include, carrying a spitting cup, using hard candy to encourage swallowing, and rinsing frequently with mouth wash to improve the taste. At night or while resting, it is recommended to sleep on the side with a towel underneath.
When to Call: If ptyalism is severe or prolonged enough, IV hydration may become necessary. Watch for symptoms of dehydration.
Sciatica:
Overview: In the last trimester of pregnancy the weight of the uterus can put pressure on the sciatic nerve, causing pain in the pelvis and buttocks that may radiate down the back of the legs.
Remedies: To relieve the symptoms of sciatica, start by resting in a side-lying position and contralateral side from the pain whenever possible. The application of heat packs or ice and an abdominal support belt can help support and relax nerves. Avoid twisting the torso and standing on uneven ground. Good chiropractic care with a chiropractor who is trained in working with the Webster Method can be very beneficial.
When to Call: If pain is prolonged and severe. If there is a loss of function of the bowel or bladder or a loss of strength or flexion.
Stretch Marks:
Overview: Stretch marks or Striae gravidarum can form on breasts, hips, abdomen, and thighs and affect 55-90% of pregnancies. Onset is usually in the latter trimesters where the majority of skin stretching occurs. Factors that are associated with stretch marks are skin stretching, genetics, and hormones. Typically these marks present as pink or red shiny lines that may become darker throughout pregnancy. Stretch marks can fade over time but likely will never disappear.
Remedies: Most cosmetic remedies have no evidence to support their effectiveness in reducing or eliminating stretch marks. However, there has been some success in topical creams that contain the herb Centella asiatica.
When to Call: This is a completely normal occurrence in pregnancy. Very rarely, if ever do complications arise. However, call if ever concerned.
Tingling of Hands:
Overview: Tingling, numbness, and even pain in the hands is a common symptom in pregnancy, especially in later pregnancy. These are usually caused by carpal tunnel syndrome, which is where the median nerve in the wrist is being compressed. Swelling that is typical in pregnancy can put pressure on the nerve and cause these discomforts. Thankfully, these symptoms fade after birth.
Remedies: Avoid activities that put pressure on the median nerve in the wrist. Take frequent breaks during repetitive activities (like typing or knitting). Also, it can be very helpful to protect your joints using a wrist splint or brace. Lastly, there are helpful exercises to strengthen and stretch the muscles in your arm and hand.
When to Call: If symptoms progressively worsen or become unbearable or if this condition does not resolve after pregnancy.
Urinary Incontinence:
Overview: Incontinence or leaking urine is common during and after pregnancy. It may be caused by stress on the pelvic floor and bladder that can weaken the muscles. Which may result in leaking urine when you cough, sneeze, exercise or laugh.
Remedies: Avoid carbonated or caffeinated drinks, and drink plenty of water. Maintain a well-balanced diet with good variety. Kegel exercises are an option for strengthening the pelvic floor. Try to do 5 sets of them a day. A referral may be made for physical therapy or for holistic pelvic therapy for strengthening the pelvic floor.
When to Call: If there are any other symptoms with the urinary incontinence such as burning or pain when urinating, it may be a sign of a urinary tract infection. If you are pregnant and are experiencing any abdominal cramping or back pain, as well as if the leaking is a big gush or slow trickling that will not go away, be sure it is urine and not amniotic fluid.
Urinary Frequency and Urgency:
Overview: In the first 12 weeks of pregnancy the uterus presses on the bladder as it grows. This often causes the sensation of bladder fullness and urgency. After 12 weeks the uterus rises and sits in the abdominal region. This allows some relief from these discomforts until later pregnancy when the baby's head descends into the pelvis.
Remedies: Avoiding carbonated and caffeinated beverages can help relieve urinary, frequency and urgency. Void whenever the urge arises (don't hold it!) and try not to void without the feeling of needing to go. Reduce liquid intake at night to help sleep longer in between bathroom breaks. Lastly, remember to void before and after intercourse to avoid infection.
When to Call: If the urinary frequency is accompanied by a burning sensation, fishy smell, or there are other concerns.
Vaginal Discharge:
Overview: Normal vaginal discharge during pregnancy is called leukorrhea and is thin, white, milky, and mild smelling. This is normal, especially in the last trimester as birth gets closer. This helps maintain the natural acidic environment of the vagina, prevent incoming bacteria, and provide lubrication during birth. Although annoying at times, vaginal discharge is a protective measure in pregnancy.
Remedies: Breathable cotton underwear or no underwear can help to minimize staining clothing. No soap, fragrance, douche, should be used in or on your vaginal area. If concerned about bacteria (like Group B Strep) probiotic supplements can balance out vaginal health.
When to Call: Any discharge that seems different from usual: different color, it has an odor, or it has a different texture (thick or watery or curdy). A thick, whitish discharge from the vagina and itching can be a sign of a yeast infection or bacterial infection. Call if discharge worsens, changes or bleeding occurs.
Varicosities:
Overview: Varicose veins are enlarged veins that are close to the surface. This is a common side effect of increased blood flow and progesterone during pregnancy. Legs are most commonly affected because the blood flow is working against gravity. This may cause minor swelling of the feet or constant itching. Complications are rare and for most people are just a cosmetic nuisance.
Remedies: Exercise like walking is a great way to prevent varicosities in the legs specifically. Avoid standing for long periods. Other at-home remedies are wearing compression socks, elevating the legs whenever possible, and avoiding crossing the legs when sitting.
When to Call: If the veins are inflamed or infected, or if the area is red and hot to the touch.
Client Resources
Moses, S. (2003). Pruritis. American Family Physician, 68(6), 1135-1142. Pruritus
Cohen, E. C. (2017). Nurture: A modern guide to pregnancy, birth, early motherhood- and trusting yourself and your body. Chronicle Books.
Romm, A. J. (2014). The natural pregnancy book: Your complete guide to a safe, organic pregnancy and childbirth with herbs, nutrition, and other holistic choices (3rd ed.). Ten Speed Press.
