Changes in mom during pregnancy

When you are pregnant your body must change in many ways to support your baby’s growth. Changes in hormones, body structure, and the baby’s growth may cause some unpleasant symptoms. Many of these symptoms are very normal and can be managed at home, but if they become severe or you become worried it is never wrong to call the doctor or the health unit with questions. This page will highlight normal symptoms in pregnancy, why they happen, what you can do to feel better, and when you should call your doctor. Some women may have many of these symptoms and others may have very few; each person is unique in which symptoms they have and in how they present. The good news is that with proper education and care many symptoms can be managed so you can enjoy this time with your family!

First Trimester

During the first trimester (the first 3 months of pregnancy) there are many symptoms that may occur as your body adapts to support your baby’s growth.

Symptom	Cause	Management	When to seek medical help
Urinary Frequency Peeing many times a day Often goes away during second trimester and comes back in the third	As the uterus grows to allow for the baby it pushes down on your bladder	Limit number of drinks Limit drinks 2-3 hours before bedtime Limit caffeine intake (coffee, tea, pop) Do Kegel exercises to avoid leaking urine (also called urinary incontinence)	If you experience: Pain Burning Bleeding while peeing call your doctor as these may be symptoms of a bladder infection.
Fatigue feeling extra tired or weak very common during the first and third trimester	The many changes both in your body and your emotions during pregnancy take up extra energy to support yourself and the baby	arrange for naps throughout the day relaxation tools exercise daily allow help from family and friends for work, house chores, or for the care of your other children	If fatigue effects your daily life, and these tools are not helping, you may need to see the doctor to rule out other causes.
Nausea and Vomiting up to 90% of women feel sick to their stomach and may throw up during the first trimester may happen at any time during	Exact cause is unknown but research shows it may be due to high hormone levels and a lack of vitamin B6	eat 5-6 small meals during the day have dry crackers or cheerios before you get out of bed in the morning get out of bed slowly and avoid sudden movements eat foods high in vitamin B6 (meat, chicken, bananas, green leafy vegetables, peanuts, raisins, walnuts,	If you are vomiting many times during the day, have symptoms of dehydration (tired, dark urine, dizzy, weak), or have nausea and vomiting that continues into the

Some of these symptoms stop in the second trimester and come back again in the third.

Second Trimester

By the second trimester (months 4-6) most women notice that the fatigue, nausea, and vomiting have gone away. Most women feel a sense of well-being and are better able to enjoy this time of pregnancy. Though the first symptoms of pregnancy are leaving some other symptoms may take their place. These symptoms are less predictable and occur differently in every woman, some may not experience any while others may experience all of them.

Symptom	Cause	Management	When to seek medical help
Backache	As the baby grows and your belly pushes further out from your body’s centre of gravity your muscles are strained to carry the extra weight. The high level of hormones in your body also causes your cartilage to soften and your joints to become loose adding more strain on your back muscles. Upper back pain can be caused by increased breast size.	Maintain posture with your head up and your shoulders back Wear shoes that have good support and low or no heel Use proper posture when lifting When sitting down use foot supports and pillows behind your back Use the pelvic tilt and rocking exercise to take pressure off of your lower back. On all four put your hands under your shoulders and your knees under your hips, with your back, head, and neck aligned in a straight line. Arch your lower back, hold for a few seconds, and then return to a straight back. Repeat this several times throughout the day.	If you have burning during peeing or think you may be having contractions call your doctor.
Leg Cramps	There are many reasons why leg cramps may occur during pregnancy: The pressure from the growing baby may push on the nerves or blood vessels in your pelvis. Having a diet low in certain minerals such as calcium or magnesium can cause cramping. As your body changes quickly the leg muscles may be quickly stretched and can cause cramping.	Stretch your leg muscles by sitting down with your legs out and flexing your feet up toward you and then relaxing them. Do this a few times throughout the day. Stretch your legs by standing about 3 feet from the wall with your heels flat on the floor and arms bent. Lean forward, and place your lower arms on the wall keeping heels flat on the floor. Wrap a warm towel around your legs Avoid stretching your legs or pointing your toes Wear shoes with good support and low or no heel Ensure a well-rounded diet Elevate your legs frequently Wear supportive stockings or panty-hose Avoid crossing your legs Avoid standing for long periods of time, or if necessary, switch position at least every two hours Drink 8 glasses of water a day	If the pain is interrupting your daily life and these suggestions are not helping see your doctor.
Varicose veins	The growing baby may cause pressure on the veins in your pelvis. Hormones cause your blood vessels to relax and widen. These two things may cause blood that should be pumped back to your heart to begin to pool. With extra blood pooled in a vein it may become larger and you may see it become larger. This most often happens in the legs but may occur in other places. Sometimes there is an ache in the area of the vein. Other factors such as your genetics, lack of exercise, being over weight, and having poor muscle strength may make you more at risk for this.	Wear support hose or stockings Before putting the support hose on raise your legs above the level of your heart while lying down for about 10 minutes before getting out of bed in the morning. Raise your legs above the level of your heart for 5-10 minutes at least two other times during the day Avoid crossing your legs Wear low-heeled shoes Avoid long periods of standing or sitting, and change your position often	See the doctor about your varicose veins to receive appropriate treatment and monitoring.
Hemorrhoids A varicose vein of the rectum May be inside or outside the body	Pressure from the growing baby in the uterus and hormones causing relaxed veins may cause this. Women who have constipation, who don’t get enough fluids, don’t eat a proper diet, who smoke, or who have had previous hemorrhoids may be at more risk for this.	Prevent constipation by getting enough fibre in your diet, drinking your regular 8 glasses of water a day, and getting daily exercise Use an ointment such as Preparation H or Anusol which you can buy from most drug stores. This will help the pain, itching, and swelling. Try a warm sitz bath Use an iced pack or a compress with witch hazel on the area During bowel movements sit on the toilet with your feet on a stool to elevate your legs in order to avoid straining Avoid standing or sitting for long periods of time	If these measures are not helping make an appointment with your doctor to assess the area discuss other ways to decrease discomfort.
Gas Increased flatulence (farting), burping, and bloating	All of the things that cause constipation as mentioned above may also cause a build of gas in your stomach. As the baby becomes even larger it may press on your bowel and slow the movement of food through your system which may also cause a build-up of gas.	Avoid foods that create gas such as beans, cabbage, and onions Avoid foods that are high in white sugar Add more fibre to your diet Drink 8 glasses of water a day Increase your daily exercise Avoid chewing gum and smoking as both cause you to swallow air Avoid carbonated drinks and cheese Try eating mints

Third Trimester

During the third trimester (months 7-9) many women notice that some of the symptoms from the first three months come back. Most commonly these are fatigue, peeing more frequently, constipation, and discharge from the vagina. As the baby continues to grow it will begin to press on more of your body’s structures, your hormones will continue to rise, and the baby will require more nutrients and energy. All of these needs of the baby put extra stress on the mother in addition to the discomforts of increasing size, problems sleeping due to uncomfortable positions and much more. Though you may become more uncomfortable during these months you can take comfort in the fact that many of these symptoms mean that the baby is growing and developing as planned and will soon be ready to meet you and your family!

Symptom	Cause	Management	When to seek medical help
Shortness of breath	As the baby grows it may press on your lungs and muscles that help you to get a full breath. This may worsen when you are lying on your back. This should only last until the baby drops into the pelvis to prepare for birth at which point the pressure on your lungs will be relieved and it will be easier to breathe.	Avoid eating large meals Raise the head of your bed on blocks and place pillows behind your back to minimize pressure on your lungs Lie on your side instead of your back Avoid heavy exercise that may increase shortness of breath Avoid overheating Though smoking is not recommended at any point during or before pregnancy if you are still smoking quitting at this point will help your lungs and your breathing	Call your doctor or go to the emergency room if your shortness of breath worsens or becomes severe, you are dizzy, your lips, finger tips or toes develop a bluish colour, you have chest pain, or you are having a faster heart rate than normal.
Heartburn and Indigestion A burning sensation in your stomach, chest, neck, or throat. The burning feeling may worsen when you lay down, bend over, eat, or wear tight clothing around the stomach	High levels of hormones may cause the muscle that closes off your stomach to relax and allow food or stomach juices to wash back up. The acid in your stomach being washed back up irritates your tissues and causes a burning feeling. Indigestion, or a discomfort in your stomach after eating, may be caused by eating too much, eating too fast, eating when tired or emotionally disturbed, eating food that is fatty or spicy, or that has been poorly cooked or prepared.	Limit foods that create gas Limit fatty foods Limit foods that are heavily spiced Avoid chocolate, coffee, alcohol, soda, spearmint, and peppermint Avoid large meals, eat 6-8 small meals per day After eating stay up right (sitting or standing) for at least 1-3 hours Avoid eating late at night Eat slowly, chewing all food completely Prevent swallowing air (chewing gum, smoking)	If heartburn or indigestion is causing extreme discomfort and cannot be avoided with dietary changes call your doctor or inquire about medications to aid with heart burn.
Swelling of the legs and feet Usually is worst at night and better when you wake up in the morning	During pregnancy hormones may cause your body to hold on to extra sodium and water which allows fluid to pool often in your legs and feet due to gravity. Warm weather and sitting or standing for long time periods may make swelling worse	Raise your feet above the level of your heart for many periods of time during the day Wear support hose or stockings Go for little walks to help your muscles push the fluid back up to your heart If standing for long times rock back and forth from your heel to your toes to help move the fluid Lay on your left side Avoid foods high in salt Avoid foods high in sugar and fats Drink your regular 8 glasses of water a day	If swelling occurs in the face, hands and feet and you feel dizzy, nauseous, have stomach pain, or have blurred vision call your doctor or go the emergency room. These are all signs of preeclampsia and can be dangerous to yourself and the baby if left untreated.
Carpal Tunnel Tingling, numbness, or burning in the fingers and hands	During pregnancy changes in your body may compress the nerves in your hands	Do gentle motions with your wrists and fingers moving them in circles and stretching each finger Avoid repetitive motions Take frequent breaks from work involving the hands	Call the doctor for an appointment to assess the discomfort and suggest ways to help.
Round Ligament Pain pain felt at the bottom of your baby bump near the pelvis	Can be caused by pressure on the area due to increasing size of baby and strained muscles/ligaments.	Change positions slowly Tuck your knees in by your stomach to decrease pain On your hands and knees push your head down and buttocks up in the air to relieve pressure	Call your doctor if pain is worsening or severe.
Braxton Hicks contractions Contractions that are irregular (do not happen at regular time intervals and aren’t getting worse over a period of time), are not painful, and happen without dilating the cervix	Sone people may mistake Braxton Hicks contractions for the contractions that occur during labour. Though they may feel kind of the same they have very different patterns. When you have contractions due to labour over time they will become longer, stronger, and more frequent. Braxton Hicks contractions do not follow this same pattern; they happen at random times, do not become stronger over time, and are not often painful. Walking during labour contractions usually causes them to strengthen whereas walking with Braxton Hicks causes them to decrease. Braxton Hicks contractions are normal and should not cause you to worry. These happen in order to increase the strength and tone of the muscles in your uterus to prepare for birth.	Drink 8 glasses of water a day Lay on your side during rest or sleep Try using relaxation and breathing techniques (insert link to area of relaxation or breathing technique education) Go for a walk when contractions start	If you are unsure if your contractions are a sign of labour or Braxton Hicks call the health unit or your doctor, or go to the hospital.