Minor Pregnancy Discomforts

• Back Ache: This is a common problem of pregnancy due to the gravity shift that comes with a growing uterus. Flat shoes, chiropractic care, nor standing in one position for too long, utilizing a body pillow during sleep, proper lifting, and a belly support belt can all be helpful techniques to alleviate back pain of pregnancy. Any back pain that is located near the kidney area should be examined for UTI or infection of the kidney
 
• Colds, Flu, and Fevers: During illness such as cold and flu, staying hydrated is crucial to the health of mother and baby. Especially during fever, hydration becomes critical. Treatment of fever can be 1000-2000mg vitamin C every 4 hours, 250,000IU beta carotene daily, divided into 50,000IU doses, 2 droppersful Echinacea tincture, 4 garlic capsules. The doses can be rotated every waking hour, for example the vitamin C the first hour, the beta carotene the second hour, etc. Elder flower infusion can also be used as a fever regulator, mixed with equal parts peppermint to relieve cold symptoms and regulate temperature.

• Constipation: Hormonal changes lead to relaxation of muscle tissue, this includes the intestines. Some things that can aid with this common issue are: Prunes or prune juice adequate hydration Drinking warm fluids upon rising Establish a bowel emptying routine Light, regular exercise Eating roughage foods Mild laxative or stool softener

• Edema: This can be due to the increased fluid and blood volume of pregnancy. Most cases present as swelling below the waist. In the event of swelling above the waist coupled with high blood pressure, headaches, vision disturbances, tests for preeclampsia should be done to rule out any serious complications. Sodium depletion can cause excessive swelling. Remedies can include making sure to eat enough unrefined salt, staying hydrated, dry skin brushing, changing positions frequently, Epsom salt soaks for feet, daily exercise, and eating protein and nutrient rich foods.

• Fatigue: During early pregnancy, hormonal changes cause fatigue whereas during the later trimesters other pregnancy discomforts that disrupt sleep are the cause. Any measures to aid in comfortable sleep can be utilized to maximize sleep time. Avoiding fluids before bedtime to minimize nocturia can help. Making Sure B12 and iron levels are adequate is helpful.
 
 • Headaches: Common causes are hypoglycemia and dehydration. Remedies include staying well hydrated and eating regularly, but also ensuring food eaten is nutrient dense. May also be due to caffeine, nicotine, or sugar withdrawal. If swelling or edema and blood pressure elevation is present, check for preeclampsia signs.

• Heartburn: Hormonal relaxation of the epigastric muscles causes acid to escape back up into the esophagus. Growth of the uterus in the later months also causes pressure which also contributes to acid backup. Remedies include eating small meals, not drinking fluids with meals, liquid calcium/ magnesium supplement prior to bedtime, various herbal remedies we can discuss. Avoid cold foods. Antacids slow digestion compounding the problem, and inhibit iron absorption, and may lead to calcification of the placenta. Walking after meals will help digestion. Chew food thoroughly to aid natural digestion. Avoid fatty, spicy food, carbonated beverages and chocolate.  
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Hemorrhoids: The distension of blood vessels in the rectum leads to itchy, swollen and painful varicosities. Prevent them by avoiding constipation can be achieved by staying well hydrated, maintaining adequate fiber and healthy dietary choices. Remedies include witch hazel compresses, analgesic cream, reinsertion of hemorrhoids, squats for core and pelvic muscle toning. Sitz baths can also be helpful, as well as application of grated potato on the hemorrhoid. Iron supplements can be constipating, so try to utilize food sources of iron as much as possible to prevent anemia and the necessity for supplements.

• Insomnia: Common causes include emotional distress, physical discomfort, and hypoglycemia. Remedies include a glass of warm milk, chamomile tea, a warm bath with chamomile or catnip, talking to a friend, partner or midwife about emotional issues, and alleviating any physical discomforts which may be contributing to the insomnia.

• Itchy Skin: May be due to liver congestion, inadequate fat soluble vitamin levels or appropriate dietary fat intake to synthesize vitamins. Be sure dietary fat intake is adequate, run liver panel to ensure proper function, avoid mineral based skincare products. Choline from foods can help, or a supplement can be taken, but be sure to take it with a B-complex vitamin because over time choline supplementation can lead to B12 deficiency. Organic meats are best, as avoiding environmental toxins can exacerbate the problem. Add unrefined olive oil to the diet, as well as beets, dark green leaves, and lemon juice. These are all gentle foods which support the liver and will aid with this problem.
 
 • Leg Cramps: This discomfort may be caused by a calcium and phosphorus deficiency or may be due to the added weight of the uterus putting pressure on the nerves and vessels of the lower extremities. Remedies can include getting more exercise to increase circulation, Dietary increase of calcium and phosphorus sources. If the pain presents with a swollen varicosity which is Hot, DO NOT MASSAGE and call for examination to Rule out thrombosis.

• Morning Sickness/Nausea and Vomiting: Contributing factors may include hormonal changes, hypoglycemia, decreased gastric emptying times. Can occur between 5 and 14 weeks of pregnancy, but can also occur throughout the entire pregnancy. Severe vomiting may the hyperemesis gravidarum and may need medical treatment to avoid dehydration. Remedies for nausea can include eating frequent, small meals instead of large meals, keeping snacks on hand to eat before rising, ginger ale or tea, avoid teeth brushing just after meals, also avoid strong smells. Acupressure bands can aid with nausea too. Make sure to get enough protein throughout the day

• Nosebleeds: Hormonal changes and the increased blood volume of pregnancy make the small blood vessels of the nose more likely to rupture. These are more common, but not necessarily normal. Adequate diet with special attention to getting enough vitamin C, bioflavinoids and calcium can help prevent this common pregnancy discomfort.

• Pica: Non-nutritive food cravings such as clay, coffee Grounds, baking soda, etc. indicate a severe Nutritional deficiency and this should be addressed immediately. If the nutritional deficiency is due to Resource inadequacy, food assistance programs can be referred to help meet needs. This issue is Serious and can lead to iron malabsorption, prematurity, toxemia, perinatal mortality

• Round Ligament Pain: Round ligament pain is a sharp pain or jabbing feeling often felt in the lower belly or groin area on one or both sides. It is one of the most common complaints during pregnancy and is considered a normal part of pregnancy. It is most often felt during the second trimester. Get plenty of exercise to keep your stomach (core) muscles strong. Doing stretching exercises or prenatal yoga can be helpful. Ask your midwife which exercises are safe for you and your baby.A helpful exercise involves putting your hands and knees on the floor, lowering your head, and pushing your backside into the air.
 
 • Salivation (ptyalism): This condition occurs when a woman has excessive salivation in pregnancy. It typically occurs during the first trimester, and will normally go hand in hand with nausea and vomiting of pregnancy. Physical: Women with this condition may salivate up to 1,900 ml per day. They may have difficulty swallowing, especially if she is experiencing nausea and vomiting. She may also find that her saliva tastes bitter. It seems to run in families. Increasing carbohydrates in the diet, decreasing fluids, limiting fats. Eating smaller meals more frequently, and chewing gum or using oral lozenges may help between meals. Herbal Cinnamon bark tea has been useful for some women with this condition, but should not be used in the first trimester since it is a uterine stimulator.

• Sciatica: Nerve compression due to extra weight and pelvic shifting can cause sciatic nerve pain through the buttocks and leg. Chiropractic care can be helpful. Heat packs can also help. St. John's Wort tincture, 5-20 drops may help, it may not.

• Shortness of Breath (Dyspnea): Shortness of Breath During the second trimester, hormonal changes Cause this common discomfort. The enlarged uterus compressing the lungs during the third trimester is a Common underlying cause. Maintaining good posture and frequent stretching of the arms above the head can help ease pressure and aid in deep breathing.

 • Stretch Marks: May be due to genetics, rapid Tissue expansion; deficiency of Fat soluble vitamins may make them worse. Massaging cocoa Butter into the skin may help. ½ Cup virgin olive oil, ¼ cup aloe Vera gel, 6 capsules vitamin E, 4 capsules vitamin A, mixed in a Blender and stored in the Refrigerator can be massaged into the skin. Elastin creams May also help. Ensuring enough Dietary fat intake for fat soluble Vitamin synthesis

• Vaginal Discharge: Gradual increase in the amount of discharge in pregnancy is normal. This makes the woman more prone to infections of the vagina because of the influence of pregnancy hormones. Using good hygiene practices surrounding the vagina as outlined under vaginal infections should help to curb the development of infections.

• Vaginal Infections: During pregnancy the vaginal flora changes which may lead to infections such as candidiasis or bacterial vaginosis. These may have side effects such as preterm labor and ineffective post-op healing after surgical delivery, and should be treated. Eliminate sugars from diet, and practice good vaginal hygiene practices such as front-to-back wiping, urinating and mild cleansing after sex. During treatment of these infections, avoid intercourse. Avoid prolonged exposure to panty liners, use mild soaps, bubble bath and wear breathable material underwear. Report any unusual vaginal discharge to allow for prompt treatment. Symptoms include burning, itching, swelling, pain, redness.
 
 
• Varicosities: These are enlarged veins in the legs or vulvar area, which may be caused by genetic predisposition, hormonal changes weakening the walls of veins, increased intravenous pressure with reduced circulation, constrictive clothing and prolonged periods of standing. Remedies can include wearing support hose, periodic leg elevation throughout the day, Avoid leg crossing while seated, prolonged standing, and tight underwear and be sure to get regular exercise to increase blood circulation. If a varicosity presents with hotness and pain, do not massage and seek medical examination quickly for thrombosis.

 • Visual Disturbances: A common normal variation of pregnancy due to fluid retention. A non-normal variation is disturbance due to vascular pressure caused by high blood pressure of toxemia. If visual disturbance is encountered, signs and symptoms of preeclampsia or toxemia should be looked for and ruled out.

Bibliography
(2004). In H. K. Varney, Varney's Midwifery. Ontario, Canada: Jones and Publishers.
Frye, A. (2013). In Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice Vol. 1. Portland, OR: Labrys Press.