Nikki Macfarlane

Pregnancy is a special time. Your body changes in appearance, you experience feelings you've never have had before and strangers smile at you in the street. However, you may also experience unpleasant discomfort throughout pregnancy that can make it difficult for you to enjoy this period in your life. Knowing how to help yourself cope with the minor problems while being aware of the symptoms of more serious problems can help to alleviate some of your concerns.

Common discomforts
During pregnancy, your body produces hormones to help maintain your pregnancy and prepare the body for birth. Unfortunately, they also contribute towards some unpleasant symptoms.

• Morning sickness. This is most common in the first 12 weeks of pregnancy. Usually, this is experienced as nausea or vomiting on waking or when smelling certain foods. You may feel ill throughout your pregnancy and it is best that you seek medical help to ensure the health of both your baby and yours. Simple techniques for easing the discomfort of morning sickness include:

- sipping ginger or peppermint tea throughout the day

- eating dry crackers on waking

- chewing crystallised ginger

- wearing motion sickness bands on the wrists
(available from the pharmacy).

• Heartburn. Commonly experienced from week 30, heartburn is caused by the softening of the opening through to your stomach, allowing acids to come up the oesophagus. That is why, you often have a burning feeling in the chest. Try eating smaller, more frequent meals and avoiding spicy, rich or fatty foods. You may find it helpful to have your last meal of the day at least two hours before bedtime and sleeping propped up on pillows. A glass of milk in the evening may help. Discuss the use of antacids with your doctor before taking them.

• Constipation. This condition results from the hormones in pregnancy making the intestine more sluggish. This, together with increased blood volume, can lead to haemorrhoids or piles. Try to keep your diet high in fibre, eating plenty of raw fruits and vegetables, wholegrain cereals, dried fruits, nuts and seeds. Reduce the amount of red meat you eat if you suffer from constipation and replace it with fish and chicken. Drink at least 4-5 glasses of water a day and try to do some gentle exercise each day. Never put off the need to move your bowels and always discuss treatments with your doctor before resorting to laxatives. If you are taking iron supplements you may find you get constipation - discuss alternatives with your doctor and increase the amount of natural iron you eat. If you have haemorrhoids, seek medical advice.

The importance of antenatal care
Antenatal care helps you understand your baby's progress and identifies potential problems. Choose an obstetrician whom you feel comfortable with and whom you feel has similar philosophies to yours in regards to pregnancy and birth. You will probably see your obstetrician monthly until 32 weeks, then fortnightly or weekly.

Many women worry about serious problems developing throughout pregnancy. The most common problems that can develop are bleeding, placenta praevia, gestational diabetes and pre-eclampsia.

• Bleeding. If bleeding occurs in early pregnancy, this can indicate a threatened miscarriage. Bed rest may help you feel better, although there is no evidence that it changes the outcome. Most women who experience bleeding in the first 12 weeks continue their pregnancies with no further problems. If serious bleeding occurs later in pregnancy this is called an antepartum haemorrhage and it may threaten the well being of the baby. It is usually caused by the placenta beginning to separate from the uterine wall and may occur as a result of a low-lying placenta (placenta praevia). You should seek immediate medical advice if you experience bleeding during pregnancy. Slight bleeding or spotting, especially in the last few weeks of pregnancy, can be a sign of impending labour. This is called a show and one of the indicators that the body is preparing for labour. If you are less than 37 weeks pregnant, or the bleeding is severe or bright red, seek immediate medical advice.

• Gestational diabetes. Your sugar levels will be regularly checked by your doctor to ensure that you are not developing gestational diabetes. This condition can result in the baby growing very large and make a vaginal delivery more difficult. Your doctor may recommend a strictly controlled diet to manage the diabetes and regular checking of blood-sugar levels. Some women require insulin to manage their condition. The diabetes usually goes away after the birth, but this is not always the case.

• Pre-eclampsia. This is a serious condition which is life threatening to both mother and baby. "The signs of pre-eclampsia are high blood pressure, protein in the urine and oedema (swelling)," says Dr Paul Tseng, an obstetrician/gynaecologist in private practice. He recommends that if a women experiences morning headaches, swelling of the legs and general irritability she should go to see her doctor for a check-up. "We would usually prescribe bed rest and possibly anti-hypertensive drugs to control the blood pressure. However, in some cases an induction or immediate caesarean may be necessary. This would depend on the severity of the illness and the stage of pregnancy when the pre-eclampsia occurs."

It is important to always seek medical help if you are at all concerned about your health or of your baby's. Many minor discomforts can be eased by an improvement in diet, rest and exercise. You should always seek advice from a trained practitioner before self-treating any problem. Understanding the signs of the major problems and knowing how to ease the minor ones can help you to enjoy your pregnancy and look forward to the arrival of your new baby.

Nikki Macfarlane is a childbirth educator. She is also the editor of the Pregnancy and Babycare Guide (1999 issue).

Date reviewed: 11 February 2000