Common problem at the time of Pregnancy
Fatigue and tiredness
In the first months, of pregnancy especially it is not uncommon for a normally energetic woman to feel permanently tired and lethargic, uninterested even in what is going on around her, and such fatigue is usually seen as ‘nature’s way’ of making her slow down. She is probably experiencing a sudden drop in blood pressure, her heart has to work much harder and hormonal changes may affect her energy level too. Anemia is another possible cause of tiredness in pregnancy, as are nausea and heartburn which affect how much nourishment she is getting.
The greatest lassitude is usually felt between six and fourteen weeks, though in second or later pregnancies it lasts longer and is more sever – up to twenty weeks in some cases. All you can do is get plenty of rest, not only by sleeping but by taking it easy and resting with your feet up in the afternoon, indeed whenever and wherever you can. Don’t try to fight your fatigue; you will only make yourself miserable and probably those around you too.
Many mothers-to-be find that they regain energy and feel on top of the middle section of their pregnancy. Take care though not to exhaust yourself. As you increase in size and weight fatigue usually catches up towards the end of term; again, don’t force ‘yourself to do more than you feel is enough, however much or little that is.
Because of the progesterone in the body during pregnancy the gums often soften and become almost spongy. In this state they are vulnerable, easily damaged by harsh brushing, for instance, and are prone to infection. They may become red and swollen and recede from the base of the teeth, exposing them to decay.
For this reason it is important to maintain a high level of dental hygiene in pregnancy; brushing with a soft nylon brush, gently using dental floss between the teeth, and perhaps also rinsing out with a mouthwash of one part hydrogen peroxide to five parts water. Visit the dentist (dental care is free while you’re pregnant), but make sure that if you need an X-ray you are protected below the neck by a screen or lead apron.
Eat foods rich in calcium to strengthen the teeth – milk and its derivatives being the most obvious – and avoid sweet things, especially between meals. Eat fresh fruit and vegetables for vitamins; apples will also help to harden your gums.
Headaches can be the result of tension, anxiety or stress as well as physical problems caused by eye strain or poor posture. A number of women find that they suffer more from headaches during pregnancy, but are anxious about taking the ordinary across-the-counter remedies, particularly during the first three months of pregnancy.
If you are troubled continually by headaches, or if you suffer from migraines, find that your pattern of migraine has altered; consult your doctor who will be able to advise you on the safest type of painkiller to take.
Planning ahead can help you avoid unnecessary tension, rush and anxiety, and regular relaxation exercises can also help (see Breathlessness for an example).
Progesterone relaxes the valve at the upper end of the stomach so that the stomach contents, which are normally acid, escape up into the lower part of the esophagus (food pipe or gullet), irritating its sensitive lining. The lining becomes inflamed so that the next escape of gastric acid results in the burning sensation we call heartburn. It is not strictly in digestive although the medicines used are similar.
The enlarging uterus contributes to the problem by putting upward pressure on the stomach, and by pushing out the lower ribs so that the gap in the diaphragm through which the esophagus passes is opened slightly making it easier for the acid to escape up the gullet. This is why heartburn occurs or worsens as you gain in bulk – and why you are make likely to suffer from it if you are carrying twins or just excess weight.
The answer is not to do you up with strong antacids as the strong ach will react to their alkali by becoming even more acid. Instead, take a small dose, then suck an antacid: put half a tablet between cheek and gum and just let it dissolve slowly over a couple of hours. This should give the inflammation a chance to subside. Ask your doctor what allowed to take; milk of magnesia is usually acceptable.
Also, don’t overload your stomach – take small meals more often – and avoid spicy or fried foods, and possibly also alcohol. Try sipping milk or eat yogurt, to neutralize the acid.
Don’t eat immediately before bedtime and bed prop yourself up on several pillows to keep your head above your chest. In the day try to maintain a good upright posture and avoid bending over if possible – this often triggers off heartburn.