“I started writing when I sneeze”, “Advise something for constipation”, “Have you had hemorrhoids?” – in online communities of pregnant women, such questions are not at all uncommon. That’s just the advice from the public can not always be trusted. And obstetrician-gynecologist Victoria Evseeva, on the contrary, can – for our project “9 months” she answers questions about pregnancy that you were embarrassed to ask the doctor.
1. Is this definitely toxicosis?
In the people, toxicosis is called about any discomfort in the early stages of pregnancy. And running to the doctor because of each such symptom (sick again, dizzy, all the time you want to go to the toilet) seems strange. At the same time, doctors themselves warn: not every nausea, vomiting or fainting can be attributed to toxicosis. It’s one thing when a woman is slightly nauseous in the morning and after eating the nausea goes away, and it’s quite another if a pregnant woman is constantly nauseous, and even vomits several times a day.
Why do pregnant women feel sick at all
With the onset of pregnancy, many metabolic and physiological processes in our body are rebuilt. The malaise that occurs during this reconfiguration is called toxicosis. For example, it can manifest itself in the form of drowsiness, absent-mindedness, fatigue, morning sickness. In the early stages, all this is a variant of the norm, but on condition that the quality of life of a woman worsens slightly.
Another cause of nausea during pregnancy is the abundance of vitamins taken. The story when a woman is simultaneously prescribed both multivitamins (1-2 tablets per day), and magnesium with vitamin B6 (6 tablets per day), as well as folic acid, iodine and vitamin D, is still very common. And nausea here begins simply as a response to an excessive amount of substances entering the body.
At the same time, it is important to understand that such appointments are most often redundant.
Multivitamins are generally needed for those who cannot afford to eat well. In other cases, those vitamins that a woman receives with food are enough. Magnesium + vitamin B6 is also shown not to everyone without exception, but to those who complain of insomnia and constipation. In other cases, you can only get by with B vitamins: they are just responsible for the synthesis of amino acids and proteins necessary for the development of the fetus, and reduce the severity of toxicosis.
The main advice that doctors give to pregnant women who feel sick is to try to eat. A banana, a sandwich, even a juice bag – anything that contains glucose can be beneficial. Trite, but nausea during pregnancy can be the result of ordinary hunger – it’s just that your body now reacts to it this way.
situations, when you should not be shy to go to the doctor:
- prolonged loss of appetite;
- systematic refusal of meals;
- weight loss;
- the frequency of vomiting is more than 3-5 times a day.
You will be surprised, but all this is not at all the norm: if you are constantly bothered by at least two of the four symptoms listed above, the doctor may even suggest hospitalization.
2. Burning in the throat and chest – what is it all about?
It’s most likely heartburn. In ordinary life, those who have chronic diseases of the gastrointestinal tract face it – then it is logical that during pregnancy the condition can worsen, even in the early stages.
But sometimes it happens that heartburn occurs in quite healthy pregnant women. More often – with the growth of the abdomen or in the later stages, after 28-30 weeks. The reason for this discomfort is easily explained: the uterus increases, takes up more and more space in the abdominal cavity, begins to put pressure on the digestive tract (stomach, diaphragm, esophagus). As a result, there is a reflux of the contents of the stomach into the esophagus and its irritation occurs. In the esophagus we have a non-acidic environment, but in the stomach, as we remember, hydrochloric acid – hence the burning sensation.
Provoke or intensify heartburn can, including foods:
- any cabbage;
- black bread;
- legumes;
- smoked meats;
- roast;
- fatty;
- salted, marinated.
But still, the first point of the plan for the prevention of heartburn during pregnancy is an early examination of the digestive tract (you can easily not know about chronic diseases) and the treatment of all problems, if any.
What else can be done
- eliminate food that provokes heartburn;
- eat often, but in small portions;
- after eating for 40 minutes to be in an upright position;
- move more;
- sleep with a raised head end;
- during an exacerbation, use dairy products (kefir, fermented baked milk, milk with a low percentage of fat content).
In general, heartburn is a completely normal condition during pregnancy. An obstetrician-gynecologist leading a pregnancy can recommend a number of drugs to a woman that alleviate her condition. These are, as a rule, enveloping drugs, as well as antacids, which quench hydrochloric acid in the stomach.
3. What to do with gases?
We have already said that the organs of the gastrointestinal tract during pregnancy begin to work differently – due to the pressure of the uterus, and also due to hormonal changes. Bloating, increased gas formation, flatulence also often become companions of pregnant women, but, as a rule, not for long.
Flatulence most often occurs in the early stages, around 6-8 weeks, and lasts until about 11-13 weeks – just during the period of the most active hormonal changes.
What to do? Adjust nutrition – yes, again. Frequent smaller meals with the exclusion from the diet of foods that cause bloating and fermentation (legumes, yeast baked goods, carbonated drinks, and so on) can alleviate this condition or even minimize it.
If a woman has a burdened history of gastrointestinal diseases, flatulence can accompany her throughout all 9 months of pregnancy – and this is also quite normal.
4. I think I have hemorrhoids…
Hemorrhoids and varicose veins of the genital organs are very common conditions at the end of pregnancy. This is an inevitable problem for many, but it just needs to be experienced.
In ordinary life, a woman’s uterus is no larger than a fist in size, and that is how much space it takes in the abdominal cavity. By the end of pregnancy, it reaches the size of a well-inflated balloon and, of course, begins to put pressure on other internal organs, the veins of the pelvic organs and lower extremities. And now a woman sees a huge dot of a dark purple color on her labia or begins to suspect hemorrhoids.
As such, there is no prevention of hemorrhoids, except perhaps the good old dietary control (preference should be given to healthy, high-fiber, non-constipating foods). Physical activity (without fanaticism!) can also help. Rarely, if there is a history of vein problems, women may also be given courses of vein medications.
5. Why does it hurt to walk?
A pregnant woman in the later stages can often be recognized even from the back – by a specific waddle, “duck” gait. Walking during long periods of pregnancy can be really uncomfortable and hard. But there shouldn’t be any pain.
In the presence of pain (it can be either aching or sharp and shooting), it is important to consult a doctor. You may need to do an ultrasound to rule out symphysitis, a separation of the symphysis pubis. If the diagnosis is confirmed, you will simply be prescribed a short course of drugs that will help to cope with the problem.
However, this may not be a symphysis at all. During pregnancy, a strong load goes to the lumbosacral spine. And it contains an incredible number of nerve endings, and many of them lead to the organs of the small pelvis, the pubic zone. That is, pain (especially in the groin area) can also be associated with neurology.
Sore pubis? Side? Leg? We talk about this to our obstetrician-gynecologist and check the back. And even better – we are engaged in strengthening the muscles of the back at the stage of pregnancy planning.
6. Why did I start writing? For example, when I laugh or sneeze
Urinary incontinence in the early stages is not the most typical situation; during this period, we can rather talk about frequent urination, which is also a consequence of hormonal changes. But in the later stages, when the uterus begins to put pressure on the abdominal organs, incontinence problems are a very common complaint.
Normally, this should go away after childbirth. But that doesn’t always happen. Childbirth is a natural, but still traumatic process. Restoration of the perineum and pelvic organs can take at least 2-3 months. And complaints of urinary incontinence during this period may persist.
If the symptom persists even six months to a year after childbirth, be sure to tell your gynecologist about it. You may need examination and treatment.
Prevention (and even therapy) of this condition in certain cases can be the strengthening of the muscles of the pelvic floor. What specific exercises to do (and whether you need them at all), the attending physician will also tell you.
Not so long ago, for example, there was a technique of biofeedback therapy. She teaches a woman how to pump her pelvic floor muscles under the control of a special sensor (the results of exercises can be observed in real time on the monitor screen) with the help of a specialist who tells her what to do and how to do it. Then the woman trains at home, and then comes to take a conditional exam. But it is better to do this at the stage of pregnancy planning.
Important: Speaking of urinary incontinence, it is very important to differentiate this condition from water leakage.
The problem is that it is difficult to assess the volume of water in the uterus by ultrasound. Water must leak for a very long time for this to become obvious – there is already a threat to the fetus. At the same time, water can be confused with vaginal discharge: during pregnancy, they become more liquid, plentiful, sometimes they really look “like water”.
Pharmacy tests for water leakage are ineffective: they lie in one direction or the other. And the specialized tests that medical facilities have are quite expensive.
The solution may be the use of PH test strips, the so-called colpo tests. They are usually used to detect problems with the microflora of the vagina, but indirectly they can also help in determining the leakage of water. Water is alkaline, while the vagina is normally acidic. And, accordingly, if such a test shows a large amount of alkali in the discharge, you must definitely tell the doctor about it.
7. I stopped liking my reflection in the mirror.
Problems with hair, pigmentation, acne – an individual story that depends on many factors. Thus, women with overweight are more likely to experience acne during pregnancy, and women with high levels of testosterone in the blood are more likely to experience increased hair growth in the male pattern.
If you find these symptoms in yourself, as well as a dark line in the middle of the abdomen, darkening of the skin in the armpits, groin, or in the crease in the neck, do not worry. And if white or dark spots appear on the skin – too. This is how your body responds to hormonal changes. This is a temporary and reversible condition: everything will return to normal in about 12-18 months after giving birth. And if it does not return, again, do not hesitate to talk about it with your gynecologist: believe me, the doctor is no stranger to such questions and he will hardly call them stupid.
Illustrations: Irina Popova st / Shutterstock / Fotodom