Appendix B

COMMON DISCOMFORTS DURING PREGNANCY

Pregnancy Discomfort	Suggestions
Morning sickness, nausea It occurs due to pregnancy hormones which peak at 8‐10 weeks. It settles after the first trimester and does not harm the developing baby even if weight is lost in the first few months of the pregnancy. In extreme cases, anti‐vomiting medications and hospitalization for intravenous hydration may be required.	Have small and frequent meals and keep yourself hydrated. Avoid foods that make you uncomfortable while cooking or because of their taste, smell or appearance. Most women have some food that helps them keep it down, it could be chocolate, crackers or dry snacks, etc. Find the one that appeals to you. Try smelling a lemon or ginger to calm your stomach. Take your prenatal supplements with food so that they don’t upset your stomach. Get plenty of rest and fresh air.
Backache Changing centre of gravity and posture causes back strain. Lifestyle changes like adopting the right posture, using a firm mattress and taking adequate rest can help.	Avoid lifting heavy objects Wear flat or low heeled shoes. When picking things up, squat down and keep your back straight instead of bending from the waist. When getting up from the bed, roll onto your side first and then use your hands to push up. Aqua aerobics, Acupuncture, Hot packs Massages may help.
Swollen ankles, feet, fingers and varicose veins, leg cramps, fatigue Feet and hands often swell a little in pregnancy as your body is holding more fluid than usual. Varicose veins appear as swollen, knotty, bluish veins that may develop on your legs.	Avoid standing for long periods. Wear comfortable shoes; avoid tight straps or anything that might pinch if your feet swell. Put your feet up as much as you can in the day. Try sleeping with your legs higher than the rest of your body using pillows or cushions. Do foot exercises and other stretching exercises such as walking and swimming, to improve your circulation.
Headaches Headaches during pregnancy may be caused by: Hormonal changes Lack of sleep or stress Low blood sugar Dehydration	If you have a sinus headache, apply a warm compress around your eyes and nose. If you have a tension headache, apply a cold compress or ice pack at the back of your neck. Maintain your blood sugar by eating smaller, more frequent meals. Get a massage; massaging your shoulders and neck is an effective way to relieve pain. Take a warm shower or bath.
Heartburn and acidity A burning sensation in your chest, especially after meals, may cause great discomfort in pregnancy. It is caused by the slowing down of your gastrointestinal tract and the relaxation of the muscles at the opening of the stomach, resulting in the reflux of the acidic gastric juices.	Drink fennel tea and use cardamom, cinnamon and bay to dispel gas. Use coriander, cumin, fennel, methi and ajwain while preparing meals. Alfalfa in the form of pill or tonic can be soothing to the stomach. You can take an antacid solution or tablets that is suitable to use in pregnancy. You can also prevent it by eating slowly small, easily digestible meals and avoiding fatty and spicy foods. Heartburn can be worse if you lie down after a big meal. Raising your head a little may help with heartburn at night. Sometimes, drinking cold milk or eating some yoghurt may help.
Constipation It is a common complaint during pregnancy as food moves more slowly through the body to give you a better chance to absorb nutrients. This is aggravated by your womb putting pressure on your bowels.	Increase the fibre in your diet by eating wholegrains, fresh and dried fruit, vegetables, nuts and cooked lentils. Aim to eat 30‐40 gms of fibre every day. Drink a cup of chamomile tea or warm milk with cardamom, nutmeg or a pinch of saffron before bed. Drink enough water. Get plenty of gentle, regular exercise; walking is a great choice.
Haemorrhoids Haemorrhoids, also known as piles, are enlarged and swollen veins in or around the lower rectum and anus. Haemorrhoids may itch, ache or feel sore or may also bleed a little and can make going to the toilet uncomfortable or painful.	Eat plenty of food that is high in fibre. Take regular exercise to improve your circulation. Rubbing an icing pad against the haemorrhoids may ease pain. Constipation may also cause them and if this is the case, try to keep your stools soft and regular. Avoid straining to pass stools as this may make them worse. Clean the anal region with moist instead of dry toilet paper. Pat gently and avoid rubbing.
Bleeding gums Many pregnant moms have swollen, red, tender gums that bleed when flossed or brushed. This occurs because of hormonal changes that make them more sensitive to the bacteria in plaque.	Clean your teeth gently and carefully twice a day. Brush with a small‐headed toothbrush with very soft filaments. Avoid sugary drinks and sugary foods too often, rinse with water afterwards, if possible. Avoid acidic foods, snack on vegetables and fruits. Avoid strong alcoholic mouthwashes. Stop smoking.
High blood pressure and pre-eclampsia Some women develop high blood pressure during their pregnancies. Usually, this happens in the last trimester and eases after birth. It can increase the risk of certain complications for both mother and baby.	Let your doctor know if you have a serious headache, vision changes, abdominal pain, decreased amounts of urine, or excess swelling of your hands or feet. You may need medication, bed rest, and healthy eating to get your blood pressure down.
Frequent urination More of a problem in the first and last trimester. Body fluids as well as the efficiency of your kidneys increases. In the last trimester, the additional weight of the womb on the bladder may also worsen this symptom.	Avoid caffeine. Avoid fluids in the late evening and before bedtime; drink more fluids during the rest of the day to make up. Do not suppress your urges. When you urinate, lean forward to help the bladder empty better.
Urinary tract infection It is also triggered due to hormonal changes. In addition, a growing uterus presses on the bladder, preventing the complete emptying of urine and this stagnant urine is the likely source of infection.	Needs to be diagnosed through a urine test and treated. Drink plenty of fluids, especially cranberry juice and coconut water. Urinate frequently and keep your genitals clean and dry.
Urinary incontinence When you are pregnant, you may leak a little bit of urine when you cough or laugh.	Strengthening your pelvic floor muscles will help to prevent this problem now and after your baby is born. Speak to your doctor if you have a continuing problem with urinary stress incontinence.
Vaginal discharge and vaginal thrush It is normal, unless the discharge becomes excessive, itchy, and uncomfortable or has an unpleasant smell. Thrush is a fungus that commonly lives in the vagina, but doesn't cause problems unless it starts growing too fast.	If you think you may have an infection, talk to your doctor. Apply a cold compress to the itchy, inflamed area. Eat natural yoghurt to restore the balance of 'good' bacteria. Wear cotton underwear. Drink more water.