- Discharge (‘witvloed’)
- Ligament pain
- Pelvis- and Backache
- Nosebleed/gingival bleeding
- Carpal- tunnel syndrome
- Restless legs
- Stretch marks
- Fluid retention
- Pregnancy mask
The walls of the womb weaken because of the pregnancy hormone progesterone. This also happens in the blood vessels around the anus, which may result in haemorrhoids. Furthermore, haemorrhoids may occur more as a result of constipation (hard stools) and an increasing pressure from the uterus on your blood vessels.
It is not always possible to prevent haemorrhoids during the pregnancy or after the delivery. Keeping your stools loose may reduce the problem. It is also important to drink plenty, to exercise enough, and to eat foods high in fibre. Fruits like prunes, kiwis, and pears contribute to a better stool. If you are suffering from haemorrhoids you can use cold packs to relief the pain. There are also various crèmes with a narcotic effect. Feel free to ask us for advice if you’re experiencing these issues.
During the pregnancy all you organs have an increased blood flow, including your genitals. As a consequence the glands in the vagina release more moisture, which can result in increased discharge. Wear cotton underwear and try to minimise the use of panty liners. If your discharge is no longer clear or white or if you are experiencing itchiness you could have a vaginal fungal infection. This can be easily treated, also during a pregnancy. If you have symptoms like this, it is best to let your GP check if you have an infection.
The uterus is connected to your pelvis with ligaments. Tension on these ligaments is caused by the growth of the uterus or the baby subsiding into the pelvis. This may result in a shooting or nagging pain towards the groin area, which sometimes radiates to the lower back. In case of ligament pain, take a hot shower or place a warm water bottle on your belly. The heat will relax the ligaments, which may reduce the pain.
Pelvis- and backache
The pregnancy hormone progesterone will soften the cartilage and the joints in the pelvis. The pelvis joints need to become more flexible in order to create sufficient space for the birth of your baby. Both halves of the pelvis are connected by the pubic bone (symphysis) and the lower part of the spine (sacrum). In case of too much softening the pelvis parts can shift, which means the muscles and ligaments have too work harder to keep the pelvis stable. This can result in a painful sensation in the pubic bone and/or lower back area, which can radiate to the hips, buttocks, and upper legs. In some cases we will advise you to make an appointment with a pelvis therapist (physiotherapist specialised in pelvis issues). (see also ‘Useful addresses’)
During the pregnancy it is more likely that you will get cystitis. Due to the changed positioning of the bladder and weakening of the urethra, urine can remain in the bladder. This creates a good breeding ground for bacteria. Therefore cystitis during the pregnancy is a common ailment that is easy to treat with antibiotics. During a pregnancy however, the symptoms connected to cystitis are not as clear as usual. Symptoms that may indicate cystitis are a constant nagging sensation in the lower abdomen or Braxton Hicks contractions. If you think you might have cystitis, we recommend that you have your urine examined by a GP.
During the pregnancy there is an increased risk of nosebleeds or gingival bleeding, because the small capillaries are engorged due to the increased blood flow. You cannot always prevent this. In case of regular gingival bleeding, please contact a dental hygienist.
Carpal tunnel syndrome
In carpal tunnel syndrome a nerve in the tunnel of the wrist is compressed. The wrist bones and the membrane that holds the bones together form this tunnel. During the pregnancy most women retain more fluid. Oedema in the wrist leads to symptoms of nerve compression: pain and tingling in the fingers, numbness in the fingertips, and loss of strength in the hand. In some cases the symptoms may be reduced by wearing a splint (skate glove) around the wrist at night.
Many pregnant women suffer from dizziness and sometimes even fainting, especially in the first 24 weeks of their pregnancy. This is often caused by a sudden drop in blood pressure, which is common in this phase of the pregnancy. Getting op quickly after lying down or standing up for long periods of time in a warm room may cause such a reduction in blood pressure. Salt will temporarily increase your blood pressure a little. If you have experienced dizziness or lowered blood pressure in the past, make sure you always carry something salty with you, like liquorice. If you are feeling dizzy, liquorice can make you feel better instantly. Furthermore, it is important that you drink plenty and sit down if you start feeling bad. Dizziness does not pose a threat to you or your baby.
For most women the pregnancy is a period full of changing emotions. It is normal that you experience feelings of happiness as well as fear. If the negative emotions dominate it is important that you talk about this. Feel free to let us know. There are free e-books with more information about changing (negative) emotions during and after the pregnancy on the website https://jadevoorjou.nl.
It is possible that you get the flu during your pregnancy. This will not harm you or your baby. Make sure that you keep drinking plenty of water and rest a lot. If you have a fever then try to suppress it. You may take a maximum of 6 paracetamol tablets of 500mg a day for this. In case of prolonged fever contact your GP.
During the pregnancy your body produces one to two extra litres of blood. This is required to supply your womb and your baby with enough blood. It also means that your heart needs to work harder to pump all the blood through your body and sometimes it can start racing. There is no harm in this. Just make sure you take a moment to sit down and in most cases the sensation will disappear within a few minutes. In case of long-lasting or repeating issues it is wise to visit your GP.
You may have more headaches than normal when you are pregnant. No clear cause of this has been identified. Hormonal fluctuations during the pregnancy may affect this. Moreover, your body needs more fluids and headaches may indicate a shortage. This is why it is important to drink at least 1,5 litre a day. Besides these, there may be other causes of headaches, which are not connected to the pregnancy. You may take a maximum of 6 paracetamol tablets of 500mg a day. If you suddenly get intense headaches after the 24th week of the pregnancy, make sure you contact us immediately.
The pelvic floor muscles will weaken under the influence of the pregnancy hormones. This is needed to create sufficient space for the birth of your baby. However, sometimes this causes some unwanted urine loss. It is recommended that you start training your pelvic floor muscles again after your pregnancy. We will give you some exercises on paper in the first week after the delivery. In most cases the muscles will become strong enough to stop the incontinence after the delivery. In a few cases slight incontinence remains post delivery. If so, contact a pelvis therapist. She can provide you with exercises to train specific muscle groups and this way gain better control over your bladder again.
If you suffer from on-going fluid loss, please contact us. We can check if it is amniotic fluid.
During the pregnancy different types if itchiness may develop. Often it is only itchiness on the belly and chest caused by the stretching of the skin. Try not to scratch and keep the skin oily with a crème or use menthol gel to reduce the itching somewhat. Sometimes the itchiness can be spread all over your body, or specifically on the palms of your hands and the soles of your feet. This may be an indication that the pregnancy hormones are causing engorging of the liver. As a consequence certain bile substances enter the blood, which causes the itching. If this is the case, it will show up in a blood test.
If you are experiencing itchiness, do let us know. This enables us to determine if it is required to carry out further examination.
A common complaint during the pregnancy is muscle cramp in the calf or foot. The exact cause of this is not known. The metabolism and the disposal of waste products from your muscles may play a part in this. It could help to retract the toes towards the body while keeping the leg stretched out. If you have this problem regularly, you could take Magnesium/Calcium tablets. These are available at the pharmacy.
The muscle between the oesophagus and stomach weakens because of the pregnancy hormone progesterone. On top of that, the angle between the stomach and the oesophagus is less sharp, which means the heartburn can more easily enter the oesophagus. Towards the end of the pregnancy the pressure of the uterus against the stomach may also cause heartburn. You may have this issue especially in the evenings after dinner and at night when you are lying in bed. Tips that may help in case of heartburn:
- Eat small potions throughout the day instead of three big meals
- Avoid spicy or fatty foods
- Do not drink carbonated drinks
- Milk, Vanilla “vla” or a peppermint may reduce heartburn
- Try to sit up straight so there is more space in the abdominal cavity
If you keep suffering from heartburn despite the above tips then there are several drugs available at the pharmacy or chemist that you may take during your pregnancy.
Approximately 70% of all pregnant women suffer from nausea in the first three months of their pregnancy. Also vomiting, especially in the mornings, is something many pregnant women experience. What is causing this is not entirely clear, but we do know that hormones play an important part in this. In most cases the complaints diminish between week 12 and 16 of the pregnancy. This is when the hormonal fluctuations reduce a little. Things you can do when you are experiencing nausea:
- Eat something before you get up, like a rusk or a cracker
- Eat small potions throughout the day instead of three big meals
- Don’t eat spicy or fatty foods
- Ginger can reduce nausea. At a pharmacy or health store you can buy ginger tablets or you can make tea with fresh ginger root.
- Try to drink enough
If you are suffering from extreme nausea and have to vomit multiple times a day then make sure to contact us. Also if you are experiencing nausea and vomiting again after week 24 in your pregnancy, it is important that you get in touch.
When you are pregnant your bowels are a bit slower that usual due to hormones. You may have constipation (blockage) issues as a result of this. Try to drink at least 1,5 litres a day and eat high-fibre foods. Besides that, it is important to get enough exercise. (See tips under “Haemorrhoids”)
Restless legs is a common ailment during the pregnancy. This sensation is often present at night. You may experience tingling, tickling or a painful sensation. In some cases it may help to take Magnesium/Calcium tablets. These are available at the pharmacy.
Problems with sleeping can occur during the pregnancy. In particular sleeping through the night can be difficult. You will have to get out of bed more often and the baby may be especially active at night. You may find it difficult to find a comfortable position or you may lie awake without any reason. If you lie awake because a lot is going through your head, then write it down. This may help you to set aside your ‘worries’. Take a hot shower before going to bed and have a cup of hot milk. Relaxation- or breathing exercises you learnt at the pregnancy course may help as well. Try to make up for lost hours during the day and make sure to lie down for a while in the afternoon.
Because of the increased blood circulation the mucous membranes are swollen. Therefore, snoring is more prevalent.
Lie on your side or use a nose spray with physiologic salt, which will reduce the swelling of the mucous membranes. This is available at the chemist.
Stretch marks are caused by stretching of the skin. The stretching may cause small scars (stretch marks). Often these are visible on the breasts, belly or hips. Initially the marks have a red-blue colour, but after a while they will become less visible. However, they will never disappear completely. Unfortunately, you cannot prevent stretch marks. It may be pleasant to keep your skin smooth and apply body lotion/ belly balm.
Hormonal changes will result in fatigue. Most women suffer from this most during the first 12 weeks of the pregnancy and the last few weeks prior to the delivery. The growth and development of the baby require a lot of energy from your body. It is best just to give in to this and rest more if possible. In case of extreme fatigue we will have you iron level checked again. If your iron level is too low we will prescribe medicine.
Many pregnant women develop fluid retention, particularly in the last phase of the pregnancy. This causes swollen feet and ankles and at times also swollen hands. If the latter is the case, your fingers may start to tingle a little (see ‘Carpal tunnel syndrome’). You are more likely to retain fluid when it is warm and if you exercise too little.
It is important to drink at least 1,5 litres a day. The more you drink, the more fluid your body discharges as a consequence (please note: drinking too much is not good for you either). Certain vegetables have diuretic properties; especially stem vegetables (for example celery, fennel, leek).
Place your legs a little higher than your hips when you are sitting or lying down and try to switch between standing and sitting.
Without additional symptoms like headaches, nausea or pain in the upper belly, there is no harm in fluid retention. If these additional symptoms are present, please contact us immediately.
The increased production of hormones leads to an increased production of pigment cells. Because of this pregnant women tan more quickly and freckles and pigment patches become darker. This may not always disappear after the pregnancy. Therefore it is best to avoid direct sunlight on your skin and protect your face with a hat and/or parasol. Use sunscreen with a high protection factor. Use of sunbeds may also promote the development of a pregnancy mask.