Pregnancy Discomforts

Is it normal to feel uncomfortable while pregnant?

Mention the words “pregnancy discomforts” to anyone who’s given birth, and you’ll likely get a knowing look, nod or sigh. Medical professionals can describe the massive changes your body goes through during each phase of fetal development. But embodying a pregnancy requires new knowledge and skills for managing the aches, pains and minor annoyances — including patience.

What kinds of pregnancy pains and discomforts are normal to expect?

Here’s a snapshot of what to expect while pregnant:

• First trimester (first day of your last period until week 13): Hormones that support a pregnancy (like estrogen and progesterone) rise sharply, along with your blood volume. You may start to feel extremely tired, moody, and sore in places like your breasts. You may get headaches, feel nauseated and find you have to pee more often.
• Second trimester (weeks 14 to 27): The fatigue and queasiness from the first trimester improves in the second trimester for most women. As the fetus grows, so does your body. You may start to feel more aches and pains from the pressure and stretching. You may notice swelling and stretch marks.
• Third trimester (weeks 27 to week 40): The third trimester is the most uncomfortable for most women because the fetus is heaviest. The added weight places pressure on your joints, bladder and gut. You may notice new aches and pains and struggle with heartburn, constipation or dribbling pee. You may feel out of breath easily when you’re active because of your growing uterus pushing against your diaphragm and lungs.

Changes that feel uncomfortable, mildly painful or even weird are normal during pregnancy. But you’re not powerless here. There are things you can do to manage discomforts while you wait to meet your new baby. Knowing what’s normal can also help you identify pregnancy complications, so you can get timely treatment if you need it.

What do common pregnancy discomforts feel like, and how can I cope?

Common pregnancy complaints include:

• Fatigue
• Headaches
• Nausea and vomiting
• Breast changes
• Pain and discomfort
• Swelling and varicose veins
• Bleeding gums and nosebleeds
• Skin changes
• Dizziness
• Unpredictable uterine contractions
• Urgency and bladder control problems
• Vaginal discharge
• Heartburn or indigestion
• Constipation
• Hemorrhoids
• Trouble sleeping

Fatigue

You may feel so fatigued during pregnancy that you can’t power through your usual routine. Given all the new work your body’s doing, it’s no wonder you’re exhausted. Fatigue is most common during the first trimester and the last few months of pregnancy. Usually, energy levels improve in the middle.

Sometimes, fatigue is a sign of anemia, or low red blood cells. Anemia during pregnancy may mean you’re not getting enough iron, folic acid or vitamin B12. If your iron is low, you may experience pica symptoms, or the urge to eat non-foods, like dirt, paper or ice.

Recommendations

• Maintain a regular schedule. Try to go to bed and wake up at the same time each day. Make daily exercise a part of your schedule, but don’t overdo it. Talk to your provider about a workout schedule that’s healthy and safe for you.
• Get plenty of rest. Take brief naps during the day if you need them. Avoid napping after 3:00 p.m., though. It may be harder to fall asleep at night and stick to a consistent sleep schedule.
• Get a blood test. A complete blood count (CBC) can show if you have anemia. Your provider typically checks your blood at the beginning of your pregnancy and early in the third trimester. They can recommend treatments based on your results.

Headaches

Headaches during pregnancy are common, especially in the first trimester, when the biggest hormonal changes are happening. Other causes include the increase in your blood volume, the stress of adjusting to pregnancy, and even not getting enough fluids or rest.

Recommendations

• Apply an ice pack to your forehead or the back of your neck
• Drink at least 10 to 12 glasses of water a day
• Rest, sit or lie quietly in a low-lit room

If nothing’s helping or if your headache’s severe, you should contact your healthcare provider. Typical headache medicines, like NSAIDs (aspirin, ibuprofen and naproxen sodium), aren’t always safe to take during pregnancy. Your provider may recommend acetaminophen (Tylenol®) instead. Follow their guidance.

Nausea and vomiting

Although it’s called morning sickness, that queasy feeling that makes you brace yourself to throw up can happen anytime during the day. Up to 70% of pregnant women experience morning sickness in the first trimester. Usually, it goes away before the second trimester, when your body adjusts to changing hormones.

Contact your healthcare provider if you’re experiencing severe nausea and vomiting that’s preventing you from getting the nutrition and hydration your body needs. It may be that you have hyperemesis gravidarum, which is much more severe than morning sickness and requires special treatment.

Recommendations

• Choose bland foods. Try the BRAT diet (bananas, rice, applesauce and toast) and other foods that are gentle on your stomach, including broth and baked potatoes. Avoid greasy or spicy foods.
• Drink plenty of (non-caffeinated) beverages. Sip small amounts of water throughout the day instead of drinking large amounts of fluid at one time. If you’re not a fan of water, try fruit juices, such as apple or grape juice or ginger tea. Avoid caffeine, which can irritate your stomach.
• Time your meals. Eat dry foods such as cereal, toast or crackers for breakfast to prevent nausea in the morning. Eat small meals or snacks every two to three hours during the day instead of three big meals. Try eating a high-protein snack, like lean meat or cheese, before bed.
• Try vitamins and supplements. Prevent nausea by taking 25 milligrams (mg) of vitamin B6 three times daily and 12.5 mg of doxylamine at bedtime. You can also take 125 mg to 250 mg of ginger extract every six hours.
• Avoid triggers. Certain smells, temperatures and environments may make your nausea worse. Note your triggers so you can steer clear of them.

Contact your provider if your vomiting is so severe that you can’t keep food or fluids down. Dehydration poses risks to you and the fetus and should be treated immediately.

Breast changes

Your breasts may get bigger and feel tender or sore as they prepare to produce milk for a newborn. This can happen as early as weeks six to eight of pregnancy. Bluish veins may appear as your blood supply increases, and your nipples may darken. As early as the second trimester, your breasts may leak a clear fluid called colostrum. These changes are normal.

Recommendations

• Support your breasts. Expect to go up a cup size or two during pregnancy. Take the time to get fitted for a bra that feels comfortable. Try cotton bras or bras made from natural fibers, and choose wider straps that won’t dig into your skin. It’s a good idea to try maternity or nursing bras that make it easy to breastfeed when the time comes.
• Absorb leaky fluid. Tuck a cotton handkerchief or gauze pad into each bra cup to absorb leaking fluid. Nursing pads, which you can buy in a pharmacy or online, are another option.
• Go gentle on your breasts when showering. Wash your breasts with warm water only. Avoid soap or other products.

Pain and discomfort

During pregnancy, your hormones loosen your ligaments so your body can accommodate a growing fetus. The flexibility also allows your bones to widen during childbirth. At the same time, you’re carrying the added weight of the fetus. These things together can strain your body and hurt.

Common pain experiences include:

• Abdominal pain: You may feel sharp, shooting pains on either side of your abdomen, where your tissue has stretched as your belly’s gotten bigger.
• Round ligament pain (the ligament that supports your uterus): This can feel like sharp pain in your abdomen, hip or groin area. You may feel it on one side of your body or both. It’s most common during the second trimester.
• Leg cramps. Leg cramps are most common in the second and third trimesters and usually happen at night. You may also notice cramping in your feet.
• Backaches: Back pain can result when the extra weight you’re carrying in the front of your body strains your back muscles and pulls your posture forward. The pain may range from slightly annoying to so severe that you need to see your provider.

Recommendations

Regular exercise can help with aches and pains by strengthening and stretching your muscles. Drinking enough fluids can lubricate your joints so that you can move more easily with fewer aches and pains. You can also:

• Find comfortable positions. Try not to stay in one position for too long, and shift if you’re starting to feel uncomfortable. Elevating your feet on a footstool when sitting can help with leg and back pain. Sleeping on your side with a pillow between your knees reduces back pain.
• Support strained body parts. Using a lumbar pillow behind your lower back or wearing a maternity belt can help with back pain. Wearing comfortable, low-heeled shoes that fit can help with leg and back pain. Support hose (that aren’t too tight) or compression socks can help with leg pain.
• Use heat therapy and massage. You can loosen tight, painful muscles by using hot water bottles and heating pads on achy body parts. Warm baths or showers can help, too. Pregnancy is also a good time to treat yourself to a massage.
• Get the nutrients you need. Electrolytes (found in sports drinks) and calcium can reduce cramping and pain. Good sources of calcium include milk, broccoli and cheese. A good prenatal vitamin can also help.
• Use proper body mechanics. When lifting objects, bend at your knees and not at your waist.
• See a physical therapist. See a physical therapist to learn specific exercises to help with pain and discomfort. Or, participate in a lower back and pelvic pain shared medical appointment (SMA). Your provider can refer you.

Swelling and varicose veins

Pressure from the growing fetus can squeeze your blood vessels, slowing blood flow. This can cause swelling (edema) in your legs and feet. The slowed circulation can cause the veins in your legs to become larger or swollen. Varicose veins during pregnancy usually appear around the second trimester and tend to stand out more as the fetus grows. They usually improve after you have your baby.

Recommendations

Many of the steps you can take to relieve aches and pains also help prevent swelling and varicose veins, including:

• Wearing comfortable shoes and support stockings or compression socks
• Staying hydrated (and avoiding salty foods that cause your body to retain water)
• Elevating your legs and feet when you’re sitting (not crossing your legs can help, too)
• Changing positions frequently (and avoiding sitting or standing in the same place for too long)

Severe swelling that doesn’t get better may be preeclampsia. Preeclampsia is a complication that can occur about halfway through pregnancy (after 20 weeks). It’s essential to get treated if you have this condition.

Bleeding gums and nosebleeds

The added pressure on your blood vessels from increased blood flow can cause your gums to swell or even bleed. It can increase your risk of gingivitis (inflammation in your gums). The increased blood volume can also cause nosebleeds. Nosebleeds during pregnancy affect up to 20% of pregnant women.

Recommendations

You can’t always prevent nosebleeds, but you can encourage productive blood flow by staying hydrated. Use a humidifier to moisten the air when you sleep. Elevate your head with an extra pillow to prevent mucus from blocking your throat. You can also use plain saline nose drops to prevent the membrane inside your nose from being dry.

Continue to care for your teeth and gums by practicing good oral hygiene, which includes brushing, flossing and seeing a dentist regularly.

Skin changes

Your body’s response to pregnancy hormones and skin stretching (especially in the second and third trimesters) can cause your skin to look different. Skin changes can include:

• Stretch marks: Stretch marks form when your skin’s normal elasticity isn’t enough for the stretching required during pregnancy. They most often appear on your abdomen, breasts, butt or thighs. They won’t disappear completely, but they usually fade once your baby’s born.
• Melasma (mask of pregnancy): Melasma is a harmless condition that causes freckle-like spots or flat patches on your face or other body parts exposed to the sun. The freckles are usually brown or blue-gray. Melasma affects up to 50% of pregnant women and usually fades after pregnancy.
• Linea nigra: Linea nigra is a darkened vertical line that goes from your belly button to your pubic area (but can extend upward, too). It usually appears during the second trimester and fades over time after pregnancy.
• Acne: During pregnancy, your body produces more oil than usual, which can clog your pores and cause acne or worsen it. This change usually happens in the first trimester.

Recommendations

You can’t prevent most pregnancy-related skin changes, but you can care for your skin so that it’s healthy. If you don’t already have a skincare routine to protect your skin, pregnancy is a good time to start.

• Clean, moisturize and protect your skin. Wash your skin with warm water at least once daily (and after sweating) with a gentle cleanser, and apply an oil-free moisturizer to keep your skin soft. Use sunscreen to protect your skin from sun damage.
• Eat foods that promote healthy skin. Be sure your diet contains enough foods for healthy skin (especially foods high in vitamins C and E).
• Stay hydrated. Drinking plenty of water and steering clear of caffeine (which can lead to dehydration) can help your skin’s elasticity.
• Check with your provider about acne medicines. Most acne medicines aren’t safe to take during pregnancy. Talk with your healthcare provider if you take acne medication and become pregnant.
• Try tretinoin (but only after pregnancy). Miracle creams that claim to get rid of stretch marks don’t work, but tretinoin (an acne treatment) can improve their appearance. Tretinoin isn’t safe during pregnancy, though. Wait until after you’ve given birth to talk to your provider about tretinoin.

Dizziness

During pregnancy, you may notice signs of dizziness, like feeling unsteady or lightheaded when standing or lying down. Dizziness can disrupt your sense of balance and put you at risk of falling. Dizziness is more common in the second and third trimesters.

Recommendations

To prevent dizziness:

• Move around often if you’re standing
• Turn to your side before rising when you’ve been lying down
• Rise slowly when you go from sitting to standing (and avoid sudden movements in general)

Unpredictable uterine contractions

The muscles in your uterus will tighten and relax (contract) from about the fourth month of pregnancy (second trimester). Unlike labor contractions that occur increasingly close together and become more and more painful, these contractions (Braxton Hicks contractions) are irregular and infrequent. Their timing may be irregular, but they’re a normal part of pregnancy.

Recommendations

To reduce discomfort while you’re having a Braxton Hicks contraction:

• Change positions. If you’ve been moving, rest. If you’ve been still, take a walk.
• Relax. Ease the tension by doing something that calms you, like taking a bath or reading a book.
• Empty your bladder. A full bladder may cause cramping.

Contact your provider immediately if your pain is severe and the cramps don’t let up. Call if you’re less than 36 weeks into your pregnancy and experiencing symptoms like bleeding and back pain alongside the contractions. This may be a sign of preterm labor, which requires immediate care.

Urgency and bladder control problems

You may have to pee more, especially at the beginning of your pregnancy. Incontinence during pregnancy, or bladder control problems, can cause you to dribble urine when you laugh or cough. It can cause you to have a sudden, uncontrollable urge to pee. It’s common, especially in the third trimester. But bladder problems can happen at any stage.

The good news is that things usually return to normal once you have your baby.

Recommendations

• Try Kegel exercises. Training your pelvic floor muscles with Kegels can help you hold your pee better, so you’re not leaking or dribbling as much.
• Train your bladder. Note when and how often you’re going to the bathroom, and try stretching out your bathroom breaks little by little so you get better at holding your pee.
• Be on the lookout for urinary tract infections (UTIs). Contact your healthcare provider if it burns or stings to pee, or if you feel like you have to pee constantly. This could be a sign of a UTI and should be treated right away.
• Don’t reduce your fluids. Don’t drink less to pee less. It’s important for you and the fetus that you stay hydrated when you’re pregnant.

Vaginal discharge

Increased blood supply and hormones cause your vagina to increase its normal secretions during pregnancy. Normal vaginal discharge is white or clear, nonirritating and odorless. It might look yellow when on your underwear or panty liners. Don’t worry. This is a sign of a healthy vagina.

Recommendations

When it comes to vaginal discharge, the best thing you can do is recognize what’s normal and when you need to contact a provider about a possible vaginal infection.

• Don’t be self-conscious. It’s natural to have more discharge and even dribble pee during pregnancy. Don’t overcompensate by douching (which can lead to infections) or overwashing. Cleaning your vulva (genitals) with soap and water is enough.
• Recognize signs of an infection. An itchy or irritated vulva can signal an infection. Other symptoms include vaginal discharge that’s smelly, bloody, thick, frothy, yellow or green. Contact your provider to get checked.
• Protect yourself from infection. Protecting yourself includes avoiding douching and not wearing tight-fitting jeans or pants. Wear breathable underwear and wipe from front to back when you go to the bathroom. Don’t wait too long to bathe or shower if you’re sweaty.

Heartburn or indigestion

Heartburn during pregnancy affects over half of pregnant women. Heartburn is a burning feeling that starts in your stomach or chest and seems to rise in your throat. It happens when stomach acid leaks upward into your food tube (esophagus). Most women report heartburn symptoms in the third trimester.

Recommendations

Many of the same tips to prevent nausea and vomiting can prevent heartburn, too. This includes eating several small meals daily instead of a few big ones and avoiding spicy or greasy foods. You can also:

• Avoid acidic foods. Citrus and tomato-based foods (like salsa or ketchup) may aggravate your symptoms.
• Try dairy. Eating yogurt or drinking nonfat milk can coat your stomach lining, protecting it from acid and easing symptoms.
• Avoid lying down for two to three hours after eating. Lying on your back makes it easier for stomach acid to travel to your throat. If you need to lie down, prop your head up with a pillow. Or, adjust your bed so the head is higher than the foot.
• Ask your provider about safe medicines. Not all heartburn medicines are safe to take during pregnancy. For example, some over-the-counter (OTC) antacids contain ingredients that may be harmful. Ask your provider for a recommendation.

Constipation

Constipation during pregnancy makes it harder to poop or empty your bowels completely when you go. Changing hormone levels, the iron in your prenatal vitamin and the added weight of the fetus on your bowel can make your bathroom visits strained. You may experience symptoms as early as the first trimester (when there’s an uptick in pregnancy hormones). Most women who experience constipation have it in the third trimester, when the fetus is heaviest.

Recommendations

• Add more fiber to your diet. Foods with fiber, such as whole grain foods, fresh fruits and vegetables, soften stools so they’re easier to pass. Aim for 25 to 30 grams of high-fiber foods each day.
• Drink plenty of fluids daily. Drink at least 10 to 12 glasses of water and one to two glasses of fruit or prune juice. This number is higher than the standard eight glasses of water, but you need more fluids when you’re pregnant.
• Exercise daily. Try to get 20 to 30 minutes of moderate-intensity exercise weekly.
• Ask your provider about safe medicines. Laxatives relieve constipation, but not all laxatives are safe during pregnancy. Ask your provider for a recommendation if you’re constipated and lifestyle changes aren’t doing the trick.

Hemorrhoids

Hemorrhoids are swollen veins that appear as painful lumps on your anus (butthole). The increased pressure from a growing fetus can strain these veins, causing them to swell and hurt when you’re pooping. Hemorrhoids during pregnancy are common, especially in the third trimester.

Recommendations

Taking steps to prevent constipation can prevent hemorrhoids, too. Constipation during pregnancy increases your chances of getting hemorrhoids. Related, treatments for constipation can help with hemorrhoids. In the meantime:

• Don’t strain to poop. Straining when you’re constipated only makes hemorrhoids worse.
• Avoid placing pressure on your hemorrhoids. Don’t wear tight-fitting underwear, pants or pantyhose. Also, avoid sitting or standing for too long. Change your position frequently or lay on your side to relieve pressure from your pelvic area.
• Try soothing products. You can place pure aloe or coconut oil on your hemorrhoids to relieve pain. Witch hazel can help with pain or itching.
• Try hot or cold treatments. You can apply ice packs or cold compresses to the area. Sitting in a warm bath or a sitz bath can help ease the pain, too.

Trouble sleeping

It’s no wonder, with all the discomforts that go along with pregnancy, that sleep may be hard to come by. Insomnia is common in pregnancy, especially in the third trimester. Getting enough rest is important all on its own, but it can also ease many other discomforts, like fatigue and muscle and joint pain.

Recommendations

Tips for avoiding fatigue, managing bladder control issues and taking pressure off your joints can all help you sleep better, too. You can also try:

• Drinking warm milk before bed
• Meditating or doing light stretches before bedtime
• Taking a warm shower or bath before bedtime
• Keeping your bedroom quiet and at a temperature that’s comfortable for you
• Using extra pillows for support while sleeping. When lying on your side, place a pillow under your head, abdomen, behind your back and between your knees to prevent muscle strain. You’ll probably feel better lying on your left side. This improves circulation throughout your body.

Don’t take sleep medications while you’re pregnant. Instead, talk to your provider if you’re struggling to get the quality sleep you need.