Although a normal pregnancy can bring you a great deal of satisfaction, certain discomforts may be connected with it. These are not serious but if any of them bother you, do what you can to counteract them. It is not good for you to be uncomfortable if you can help it. If you have a discomfort that is not mentioned here, ask your doctor what you can do about it.

Fatigue

During the first three or four months, many pregnant women complain of being tired. Fatigue is natural in the early stages of a pregnancy. Your body is getting accustomed to the many complicated changes taking place within it, and the many new demands being made upon it.

Nature's way of taking care of at least some of this exhaustion is to make you sleepier than usual, so you get more rest. This sleepiness disappears as you make the necessary physical and emotional adjustments to your pregnancy. The best way for you to cope with this discomfort is to get plenty of regular sleep at night and take the rest prescribed for you during the day.

Frequent urination

Soon after your pregnancy begins, you will notice that you are getting up at night to urinate and that you need to empty your bladder more often than usual during the day.

The reason for this is simple. Your bladder is normally located just in front of your uterus. When the uterus starts to enlarge, it may put pressure on the lower end of the bladder. This makes you feel like urinating, even when there is hardly anything in the bladder to void. This condition is normally relieved after about the fourth month by a change in the position of the uterus. In the last month of your pregnancy when the baby moves down to get into position to be born, you will again be feeling the urge to urinate more frequently. Since a cough, a hearty laugh or a hard step down may cause the bladder to leak a little, some women regularly wear a sanitary napkin for protection.

There are times when frequent urination is more than a discomfort. If the urge to urinate is extreme, and if you have pain or a burning sensation when you do, report this to your doctor. He will want to find out what may be causing the difficulty.

Food cravings

Pregnant women often experience cravings for certain foods. These may be due to physiological disturbances not directly connected with food, or they may be a sign of emotional disturbance. They are not a necessary part of pregnancy and should not be confused with normal food likes and dislikes.

If you are bothered by an extreme desire for a certain kind of food, talk with your doctor about it. He may want to go over your entire food plan with you to spot weaknesses or excesses in your diet. He may ask you to keep an accurate record of everything you eat for a week or two in order to obtain a picture of what you consume. With this information, he will know better how to advise you. Food you do not need may upset your weight gain. If your diet is too restricted or otherwise inadequate, you will need more of certain foods. It is a fact that most women who have had a balanced diet before they become pregnant do not have intense cravings if they continue to eat the right foods during pregnancy.

Mouth watering

Occasionally, a pregnant woman finds that her mouth is watering more than usual. We do not know why this happens. The flow of saliva usually becomes normal again after a while without any special treatment. Excessive salivation is unpleasant, but not serious. It sometimes helps to chew gum or to eat several small meals rather than fewer larger ones. If this is really a problem to you, consult your doctor.

Morning sickness

Today, most expectant mothers have little trouble with "morning sickness." As your body gets used to the changes of pregnancy, any feelings of nausea you may have should disappear. This "sickness" is not confined to the morning hours, by the way. It seldom lasts longer than the third month. Avoid vomiting if possible and never encourage it. If vomiting should persist and you cannot keep fluids down, see your doctor immediately.

If your trouble is just a sickish feeling when you wake up, there are several simple things you can do for it. Starving yourself will do no good, because this kind of stomach upset is relieved by food. Try eating some dry crackers before getting out of bed. Don't take a drink right away; liquids often make matters worse. Get out of bed slowly and move slowly for several hours. Brush your teeth gently or don't brush them at all until later in the day. Don't try to make beds or do dishes until you feel better. It may help to eat four or five dry meals a day instead of the usual three, taking fluids only between meals. These must be counted, however, in your total daily food allowance. There are many drugs available now for the relief of "morning sickness." Your doctor may want you to try one of these medicines.

Heartburn

During the last three months of pregnancy, the growing baby presses up against the stomach and may interfere with the normal movements of digestion. The result may be a pain in the chest which is near the heart but has nothing to do with the heart at all. It is a form of indigestion, commonly called heartburn.

There are medicines that help this pain. Tell your doctor if this is a problem to you. Never take baking soda unless your doctor advises you to do so.

Constipation

If you are bothered by constipation, there are things you can do about this, too. Work out a routine for yourself that will keep your bowels working as naturally as possible in their normal rhythm. For some people, this means movements only every other day, or every two or three days.

To prevent constipation, doctors usually advise their patients to get plenty of exercise, eat plenty of fruits and vegetables and drink plenty of water. Some recommend two glasses of water before breakfast. Prunes are a natural laxative and may be taken raw, stewed, or in the form of juice. It may help you to put your feet up on a stool or low waste basket when you sit. This gives you a better body alignment. Try to go to the bathroom for a bowel movement at the same time each day, preferably just after breakfast.

If you do become constipated, ask your doctor what to do about it. He will tell you not to make a habit of taking laxatives. These keep the bowel lining irritated, and prevent the formation of good habits of elimination. He will also warn you to avoid harsh laxatives, such as castor oil and Epsom salts. These are likely to upset your stomach and cause cramps in your lower abdomen. If yours is a stubborn case, your physician may prescribe a tablespoonful of milk of magnesia to be taken each night before going to bed.

Hemorrhoids

Hemorrhoids are small groups of enlarged veins located at the lower end of the bowel. They are often called piles. Many people have them but they are more common in pregnancy because of the pressure of the baby on the veins of the lower part of the body. A little petroleum jelly placed just inside the rectum before a bowel movement may make it easier for the stool to pass and, therefore, unnecessary for you to strain.

Straining may squeeze hemorrhoids out of the bowel opening. They are often painful anyway, and this makes them more so. If this happens to you, your doctor can show you how to wrap a piece of cotton around your finger and push them back in again. Lie down on your side, with your hips on a pillow and use mineral oil or petroleum jelly to lubricate your finger.

A compress made of a few folds of clean gauze soaked in ice-cold witch hazel or a solution of Epsom salts will relieve the discomfort. If your hemorrhoids bleed, as some do, let your doctor know.

Muscle cramps

During your pregnancy, you may be bothered by cramps in the muscles of your legs, and in the wall of your uterus.

Leg cramps are often due to a slowing up of the blood circulation in the legs because of the pressure of the baby in the uterus on the large blood vessels in the lower part of the abdomen. This usually happens when you lie on your back. If this is the cause, you may be able to get relief by rubbing your legs gently, by bending your foot upward with your hands, or by putting a hot-water bottle against the muscles that are cramped. To avoid leg cramps of this kind, "point with your heels and not your toes" whenever you stretch your legs.

Sometimes leg cramps are due to nutritional deficiencies, particularly to lack of calcium and certain vitamins. Your doctor will look into this possibility as a matter of course and prescribe supplementary calcium and vitamins, if you need them.

Cramps in the uterus are common throughout most of pregnancy. They are due to contractions of the muscles of the uterus. They usually go away if you take a short rest. If they persist or become increasingly uncomfortable, your doctor should know about them.

Backache

Backache is often relieved by changing to shoes with medium or low heels if you have been wearing higher ones. A well-fitted girdle may also help. Your doctor may prescribe exercises to improve your posture. Ask someone to give your back a good rubbing now and then.

Varicose veins

Varicose veins are enlargements of the veins lying just beneath the skin. They occur most frequently in the veins of the legs, although some people have them in the form of hemorrhoids. Some women get them more easily than others. They usually get smaller and disappear during the first few weeks after delivery. Consult your physician if you have some that are giving you trouble.

Doctors know what causes varicose veins but are not always able to prevent them. The leg veins empty into the large blood vessels in the lower part of the abdomen. During pregnancy, pressure of the baby on these large blood vessels slows up the circulation of blood in the legs and may cause varicose veins to develop or get worse. It is important to take proper care of these enlarged veins because they can become quite painful. If you sit with knees slightly bent and your legs not crossed, you will be more comfortable.

Frequent rest periods with your feet up may help to arrest the swelling of the veins, perhaps even to reduce it. You may need to wear an elastic bandage or stocking during the day. This should be removed at night. You can get attractive elastic stockings now that hardly show under thin hose. Your doctor or the nurse in the clinic will show you how to wear these properly. Put these on before you get up in the morning, before your legs' veins have a chance to fill. If you use an elastic bandage, be sure to wrap it once or twice around your instep as you put it on. This will anchor it, and keep your foot from swelling. If you wear stockings, do not keep them up by rolling them tightly either above or below your knees. Do not use round garters.

Some pregnant women have an enlargement of the veins around the vulva, the vaginal entrance. This condition is more common after several pregnancies. It also is due to the pressure of the baby in the lower abdomen and will probably disappear after the baby is born. No treatment is usually necessary although rest or a tight T-binder may help to relieve discomfort.

Vaginal discharge

During pregnancy, the tissues of the vagina change in preparation for the baby's birth. The lining becomes softer and thicker and more elastic. At the same time, the glands in the cervix increase their normal production of mucus in order to lubricate the vaginal passage. This mucus is the slight, whitish, sticky discharge from the vagina that most pregnant women notice. This discharge should not inconvenience you. If it stings, burns or itches, check with your doctor.

Changes in the skin

You may have noticed that little red streaks have appeared on the skin of your abdomen or breasts. These are due to the stretching of the skin and are not serious. They will fade into thin white lines after the baby is born.

Another change sometimes takes place in the skin that worries some women more than the streaking. It occasionally happens that blotches appear on the nose and on the breasts. For a while these may be rather unsightly but there is nothing abnormal about them and they usually vanish promptly after childbirth. There is nothing to do but put up with them while they last. Brunettes have them more often than blondes. Exposure to the sun makes them worse.

Shortness of breath

In the last month or two of pregnancy, you may be a little short of breath when you climb stairs or engage in certain activities. This is probably because the baby is taking up enough space in your abdomen to interfere with your breathing. This is usually a temporary discomfort, something that goes away as soon as the baby is born. The best way to handle it is to move more slowly, avoid stairs when you can, and practice deep chest breathing. Be sure to tell your doctor if breathing becomes difficult while you are lying flat.

Marcus Siegel

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