A number of common problems beset even the most normal pregnancies, but most can be combated with simple self-help approaches. A number of people find that complementary and alternative therapies offer relief for many of these problems, and suggestions for this type of approach are given in the tinted columns of this section.
If you are always tired and lacking in energy as well as perhaps looking rather pale, you may well be anemic. This means that your blood hemoglobin level is low and this is tested when you book in for antenatal care and later, at about 30 then 36 weeks (a level below 10 g is not now acceptable).
Hemoglobin performs a vital function carrying oxygen round the body, and to the growing baby, and is contained in the red blood cells.
During pregnancy anemia can result from the increase in the volume of blood in your body and the dilution of red blood cell concentration with extra plasma (fluid). Sometimes, however, there is an overall increase in red blood cells, especially if you are eating properly.
A second reason for anemia in pregnancy is that an essential ingredient of hemoglobin is iron, which the growing fetus is taking for itself – one-third of a pregnant woman’s iron reserves pass over to her baby. If you are anemic, to boost your hemoglobin level and to ensure both your baby and you have enough iron you will be given supplements of iron and folic acid, which also aids the manufacture of new blood cells.
These supplements are sometimes prescribed routinely though a health and well-nourished woman may have sufficient iron reserves in her body to cope with the extra demands of pregnancy.
Many women, however, do enter pregnancy with no iron reserves, especially if they have heavy periods. The only drawback of iron pills is that they often give rise to heartburn and constipation though change to a different type of iron pill will sometimes solve the problem. You may be offered iron injections as an alternative if your level is particularly low or fails to rise after a spell on iron. To avoid anemia, eat a well-balanced diet including plenty of foods rich in iron; these include red mead, kidney and liver, shellfish, green leafy vegetables, mushrooms and beetroot, whole foods such as grains and pulses, sprouted seeds and grains, dried fruit, nuts, egg yolks and molasses. You might also consider avoiding drinking tea with or soon after a meal as this may inhibit the absorption of iron from that meal.
Pregnancy is not only a time for joyous anticipation. You may be outwardly blooming while inwardly full of anxiety; few women get through their nine months without some niggling worry which may seem foolish to someone else but is real nonetheless.
You are committed to having a baby and may worry that you have made a mistake: will it ruin your relationship with your partner; will he; can he still love you when you’re big and ungainly? – And what about your job, your independence?
You may also worry about coping when the new arrives; will you be able to feed and care for him or her properly – what if you make some dreadful mistake? And if you have other children, how will they react and will you find space in your heart to love the new baby as much as you do them?
But among the most common anxieties to beset the expectant mother are those connected with labour, especially with losing control and coping with pains; will you make a scene, screaming? – What if the pain becomes too great to bear? – What if I empty my bowels in front of everyone? – What if I just can’t do it?
Finally there can be very few mothers who have not at some point been anxious about their baby being born with some abnormality, how-ever small. Pregnancy is a period of transition and both your body and mind you are preparing for the new baby; it is only natural that you should think – and worry – about what the future holds.
But try not to let your anxiety get out of hand and don’t suppress it: speak up, tell your partner and the doctor or midwife you see for antenatal care about your fears. They may not be able to give iron-clad reassurances but they may offer information or words of experience that help.
Find out as much as you can about childbirth and child care from other mothers and from books – fear is often a result of ignorance – but don’t frighten yourself listening to old wives’ tales or look for one-in-a million horror cases in obstetric textbooks! Accept that your anxiety is normal and just try to be positive: things usually work out all right and even when they don’t people usually cope.
The hormone progesterone produced by the placenta Serves to soften and stretch the ligaments of the body so that in labour the pelvic joints will be able to move freely to let the baby through. In the process the ligaments of the spine are also affected with the result that it becomes easier to or the lower joints especially those between spine and pelvis.
Pregnant women tend to throw back their shoulders to offset the load they carry in front which puts great strain on the lower back and frequently results in discomfort, sometimes quite acute.
To prevent backache, try to stand upright1 holding in as far as possible both buttocks and abdomen, and when sitting don’t slouch with your back unsupported, try to keep your back straight. You would be well advised avoid wearing high-heeled shoes as these throw your whole body forward putting even more strain on the spinal muscles, and sleep if possible on firm mattress. In the later months try to avoid standing or bending over any lengths of time, or carrying heavy shopping bags, and get plenty of rest. Last, keep an eye on your weight: excessive weight gain will surely leave bad posture and thus backache.
If you have a history of back problems see your doctor about any backache. Mention it in any case at your ante-natal visit.
Occasional breathlessness after some exertion is not uncommon at any stage of pregnancy but becomes generally more marked and more frequently in a greater number of women in the last ten weeks. This is because the enlarging uterus forces the diaphragm up into the chest so that there is simply less room for you to breathe efficiently. There is no need to worry about it. If however you find yourself short of breath when you haven’t really exerted yourself it may be that you are simply unfit but another possible cause is anemia so see your doctor about it. You should certainly seek his advice if your breathlessness comes on suddenly or is associated; with any sort of bad cough, cold or fever.
If you think you are unfit (and have ruled out other possibilities) try to get a bit more exercise on a regular basis – for instance gentle walking or swimming – but don’t – overdo it or you will end up with a different set of problems! If you are short of breath at night prop yourself up in bed with a couple of pillows to reduce the pressure of the uterus on your diaphragm. If you are having your first baby you may notice some relief at about thirty-sixty weeks as the baby’s head descends into the pelvis (‘engages’), giving the diaphragm a chance to descend a little again.
To relax, choose a time and place when you know you won’t be disturbed. Make it somewhere quiet – at least while you’re getting the hang of this. Later you will even be able to use this technique when conditions aren’t ideal. Loosen any tight clothing; sit or lie down comfortably. Concentrate on tight head. This way you will become conscious of any physical tension you’re holding. Loosen each muscle, and feel your body become heavy.
Stay like this for 10 or 15 minutes, feeling you breathing slowly and calmly. Try and keep your breathing or an image that reminds you of something pleasant, or simply by chasing them out when they do occur.
To relieve backache, get down onto all fours and arch your back gently upwards.