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Pregnancy health

Pregnancy can be an exciting time in your life. During pregnancy, your body undergoes a number of changes as your baby develops inside your womb (uterus).

Open our infographic about the stages of pregnancy.

There are a number of signs that you may notice early on in your pregnancy, although these can vary from woman to woman. Below are some of the most common symptoms.

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How your baby develops, stages of pregnancy by Bupa UK

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  • Common symptoms of pregnancy Common symptoms of pregnancy

    One of the first signs of pregnancy is that you may notice you miss a period about two weeks after you became pregnant.

    Your breasts will start to change as your body begins to make tissue for producing and storing milk. They may be more tender and swollen than usual and your nipples may be larger and darker.

    Your energy levels may be affected by all the changes going on in your body in early pregnancy. This means you may feel far more tired than usual.

    Your pregnancy hormones make your kidneys produce more urine. And, as your pregnancy progresses you will need to pass urine more often because your growing baby will press on your bladder. It's important that you drink enough fluids, even if this means frequent trips to the toilet.

    Many women feel sick and some vomit in early pregnancy. This is often called 'morning sickness', but it can happen at any time of the day.

    You may find you go off foods or drinks that you normally like. For example, you may not like the taste of tea, coffee or fatty foods. It’s also common to have a strange taste in your mouth. This is often described as being a metallic taste.

    It’s common to have some bleeding from your vagina (sometimes called spotting) in the early stages of pregnancy. If you have vaginal bleeding, contact your midwife or GP for advice.

  • Pregnancy-related conditions Pregnancy-related conditions

    There are a number of health problems that are common during pregnancy and you may be more likely to have these as your pregnancy progresses. These conditions can cause many different symptoms, but they aren't usually serious and can often be easily treated.

    Always speak to your pharmacist or GP if you're buying over-the-counter medicines to treat your symptoms, or have a prescription for a medicine. This is because it’s important to check that they are safe to take during your stage of pregnancy.

    Here is a guide to some of the most common health problems of pregnancy, to help you know what to expect.

    Feeling sick and vomiting

    One of the most common conditions women have in their first trimester of pregnancy is feeling sick or vomiting. This is usually referred to as morning sickness. Most women find this eases by weeks 16 to 20.

    You can try getting up more slowly in the mornings and eating something plain like toast. Having regular healthy snacks may help prevent you feeling sick. There is a little amount of proof that ginger can help reduce feeling sick or vomiting, so some women eat ginger biscuits or drink ginger tea. The National Institute for Health and Clinical Excellence (NICE) recommends trying a complementary therapy called acupressure on your wrists. This may help prevent you feeling sick or vomiting.

    If feeling sick or vomiting means that you’re unable to eat or drink, or keep food or fluids down, see your GP. It’s important to stay hydrated, especially when you’re pregnant. Your GP can prescribe medicines for you if your vomiting is so severe that you find it difficult to stay hydrated.

    Iron deficiency anaemia

    Anaemia is a lack of red blood cells in your bloodstream. There are many different reasons why you may develop anaemia, but among pregnant women the most common cause is a lack of iron. If you’re extremely tired, dizzy or feel faint when you’re pregnant, it could be that you have anaemia. You will need to see your midwife to have a test. You may be offered a blood test to check for anaemia. Your GP or midwife may give you iron tablets to treat your iron deficiency anaemia.

    Urinary tract infections

    Urinary tract infections (UTIs) are common in pregnancy. The infections can be caused by bacteria such as Escherichia coli (E.coli), which usually lives harmlessly in your bowel. You may have symptoms, such as pain when you urinate, pain in your lower abdomen (tummy) and the urge to pass urine frequently. However, you can also have an infection without any symptoms. Your GP or midwife will test your urine at each antenatal appointment to look for signs of an infection. You can be treated with certain antibiotics that are suitable to use during pregnancy. You need to get advice early if you have symptoms because urinary tract infections can lead to complications with your pregnancy, such as pre-eclampsia and premature labour.

    Urinary incontinence

    You may get urinary incontinence, which means an uncontrolled leakage of urine, when you’re pregnant. Throughout your pregnancy, your womb gets larger as your baby and placenta grow. This presses on your bladder. At the same time, your kidneys produce more urine. Also, your pelvic floor muscles, which are found below your bladder and support it, may become more relaxed in response to your pregnancy hormones. This means you’re more likely to need to pass urine more often and may have more trouble controlling the urge to urinate. Stress on your bladder caused by coughing or sneezing may also cause incontinence. Your midwife may encourage you to do pelvic floor exercises before, during and after pregnancy to help maintain the strength of your pelvic floor muscles.

    Piles (haemorrhoids)

    Piles often appear during pregnancy, particularly during the third trimester. If your piles become very large or painful, speak to your midwife or GP. You may be able to treat piles with suppositories (capsules you put inside your back passage) or creams.

    Constipation

    The relaxing effect of your hormones on the muscles of your digestive system can slow the movement of waste through your bowels. This can lead to constipation. Eating a diet that’s high in fibre by including fruit and green leafy vegetables and drinking enough fluids can help to prevent and ease constipation. This may help prevent piles too. If changes in your diet don’t help, there are certain laxative medicines you can take, such as lactulose. For more information, see our topic on constipation.

    Indigestion (heartburn)

    Your hormones cause the muscle at the end of your oesophagus (the pipe that goes from your mouth to your stomach) to relax. This means acidic juices from your stomach may flow back up into your oesophagus. This causes indigestion (heartburn), an uncomfortable pain in the centre of your chest that is usually worse after eating. You may find it helpful to avoid eating spicy foods. If your heartburn tends to occur at night, you could try sleeping in a slightly propped up position and avoid lying down immediately after eating.

    If changes to your diet and lifestyle aren’t helpful, you may be offered certain indigestion medicines, such as antacids.

    Varicose veins

    Varicose veins are a common symptom of pregnancy, particularly during the later stages. They usually appear in your legs and may begin or get worse when you’re pregnant. You may find these swollen veins itch or make your legs ache. Wearing compression stockings may help improve the symptoms and help your legs feel more comfortable. However, stockings won’t completely prevent varicose veins. Resting with your feet raised may reduce swelling and discomfort. You will probably find that the veins reduce in size after your baby is born.

    Carpal tunnel syndrome

    Carpal tunnel syndrome is common in pregnancy. The hormonal changes you go through during pregnancy can cause fluids to build up, which leads to swelling in your hands or wrists.

    Your hands may feel painful or numb because of swelling in the tissues in your wrists. You may need a wrist splint if the pain is severe. Carpal tunnel syndrome may be worse at night, but usually gets better within six to 12 weeks after your baby is born. If you still have severe pain, it’s possible to have an operation after your baby is born.

    Bleeding gums

    Your gums may bleed if they become inflamed because of plaque caused by bacteria. Your hormones may increase the inflammation and make your gums more likely to bleed. You can help prevent this by brushing your teeth carefully, at least twice a day. Reducing how many sugary foods and drinks you have and limiting these to meal times can also help prevent the build up of plaque. Your dentist can give you advice on the best way to look after your teeth and gums. Once you’ve had your baby, your gums should return to normal. When you’re pregnant and for one year after the birth of your baby, NHS dental treatment is free.

    Backache

    Pregnancy hormones cause your muscles to relax throughout your body. As your pregnancy progresses, you will naturally arch your lower back to maintain your centre of gravity. This strain on your joints can lead to backache. Taking care with your posture, resting often, not lifting heavy objects and wearing low-heeled shoes can all help. You may also find that massage therapy, exercising in water and back care classes might help ease pregnancy backache. If your back is uncomfortable in bed, you could try sleeping on a firm mattress. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aren’t recommended during pregnancy. If backache is severe, contact your GP or midwife. They may suggest you see a physiotherapist, who is a health professional that specialises in maintaining and improving movement and mobility.

    Vaginal discharge

    Pregnancy causes increased blood flow to your vagina and increased cervical secretions, which can lead to more vaginal discharge. This is normally nothing to worry about, especially if it’s clear, white and not smelly. However, if the discharge changes to coloured, blood-stained or watery, this could be a sign of an infection or that your baby’s waters have broken. There may be a change in how your discharge smells and it may cause itching. If you have any of these symptoms, contact your GP or midwife.

    Pelvic girdle pain

    During your pregnancy, you may have pain in your pelvic joints. This is called pelvic girdle pain but used to be called symphysis pubis dysfunction, so you may see both words used. Walking, climbing stairs and turning over in bed often causes your pain to be worse. Pelvic girdle pain may be caused by a combination of factors related to pregnancy. These may include your posture, the extra weight of your unborn baby and the hormones that cause your muscles to relax. Pelvic girdle pain can be treated with pelvic support bandages and physiotherapy. It’s important to treat the symptoms because you may find your pain is severe enough to limit your mobility and day-to-day life when you’re pregnant. It’s also possible that if pelvic girdle pain isn’t treated appropriately, you may get long-term pain and mobility problems after your baby is born.

  • Changes to your body Changes to your body

    Stretch marks

    As your skin around your abdomen (tummy) stretches to accommodate your growing baby, you may find you get reddish-purple stretch marks. These are caused by a combination of the stretching of your skin and your pregnancy hormones. Stretch marks fade to silvery lines after some time. Although many creams and lotions claim to prevent stretch marks, none have been proven to be successful.

    Weight gain

    It’s expected that you will gain some weight when you’re pregnant. The amount of weight you gain can vary. Only some of it is due to increased body fat. Factors that add to your weight during pregnancy include the size and weight of your growing baby and the placenta. Other factors may include the amniotic fluid surrounding your baby and increases in the amount of fluid in your body.

    The idea that you should ‘eat for two’ when pregnant is a myth. Eating a healthy diet, with plenty of fresh fruits and vegetables, is good for both you and your baby. In fact, your energy needs do not change during the first six months of pregnancy. They increase slightly in the last three months, but only by about 200 calories per day.

    Gaining too much extra weight when you’re pregnant can lead to complications, such as:

    • gestational diabetes (high blood sugar that begins in pregnancy)
    • pre-eclampsia (high blood pressure that can lead to fits and damage to your internal organs)

    Swelling in your ankles, feet and hands

    You may find that your ankles, feet and hands become swollen. This usually happens because of a build up of water. Try to rest with your feet raised to help stop water pooling in your legs.

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  • How do I know if something is wrong? How do I know if something is wrong?

    Attending all your antenatal appointments helps the people who are looking after you pick up any problems early. If you have any concerns, speak to your midwife, GP or obstetrician. They can carry out any tests you might need and reassure you, or give you treatment to help.

    You will have tests at each antenatal appointment, including:

    • urine samples
    • blood pressure monitoring
    • blood tests

    These tests can pick up a range of problems that can occur when you’re pregnant. If you think that something is wrong, contact your midwife or GP − there’s no need to wait for your next antenatal appointment.

  • FAQs FAQs

    Are sleep problems common in pregnancy?

    Answer

    Yes, it’s common to have some problems sleeping, especially in late pregnancy. There are a number of reasons why you may find it difficult to get to sleep, or to sleep through the night. For example, you may feel uncomfortable because of pregnancy-related symptoms. These may include heartburn, or finding it difficult to get into a position to sleep in because of your larger abdomen (tummy) or sore breasts.

    Explanation

    As your pregnancy progresses, you may be affected by different symptoms that can disturb your sleep. You may be able to relieve some pain and discomfort caused by backache, heartburn and your growing baby bump. You can do this by sleeping on your side and using pillows to raise your head, under your bump and between your legs. Try sleeping on your left side, as this allows the best flow of blood to your abdomen, womb (uterus) and kidneys and can be more comfortable when you’re pregnant.

    Having a good nighttime routine can help encourage better sleep. Cut down on caffeine during the day and use the evening to spend time winding down, maybe having a warm bath, dimming lights and not eating too near to bedtime.

    No type of sleep aid, whether available on prescription, over-the-counter, herbal or complementary is recommended when you’re pregnant. If you’re already on maternity leave, you may find that a daytime nap helps to make up for your lack of sleep at night. Try not to sleep for more than 30 minutes at a time to ensure your daytime naps don’t interfere with sleeping at night.

    What are Braxton Hicks contractions?

    Answer

    From week 20 onwards you may have some tightening of your womb, which is known as a Braxton Hicks contraction. The contraction, which starts at the top of your womb, usually lasts for between 30 and 60 seconds and tends to be more uncomfortable than painful.

    Explanation

    Braxton Hicks contractions are practice contractions as your womb gets ready for labour. You may feel them more often and more strongly as you get nearer your due date.

    It’s common for Braxton Hicks contractions to be mistaken for labour starting. However, real labour contractions will continue to get stronger, more frequent and more painful over time. Braxton Hicks contractions will start and occur once or twice an hour, or a few times a day, then fade away.

    Braxton Hicks can be triggered if you or your baby are very active, if your bladder is full or you’re dehydrated. You may find that changing your position, such as sitting down instead of standing up, may help. As Braxton Hicks can be brought on by dehydration, having a glass of water might help too.

    If you start to get contractions that get increasingly painful and strong, this could be labour happening – even if you aren’t due yet – so you need to get medical advice straightaway.

    Is it common to have headaches during pregnancy?

    Answer

    Getting headaches when you’re pregnant is common. Persistent headaches, especially after week 20, may be a sign of a more severe pregnancy-related condition called pre-eclampsia. Because of this, it’s important to contact your GP or midwife for a check up.

    Explanation

    You may find that your headaches improve by getting some rest and relaxing. Painkillers, such as paracetamol, can be taken at the recommended dose when you’re pregnant. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aren’t recommended, especially from week 30 onwards because they can affect your baby’s circulation.

    Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    By checking your urine and blood pressure at each antenatal appointment, your midwife or GP will pick up early signs of pre-eclampsia. These include protein being found in your urine, or a raised blood pressure reading.

    Signs of pre-eclampsia must be investigated as soon as it’s suspected because it can cause serious complications for you and your baby, such as premature labour. Your regular antenatal tests will pick up signs of pre-eclampsia. Even so it’s important to contact your midwife or GP sooner if you get a severe headache or migraine during pregnancy.

    Other symptoms of high blood pressure include swelling of your face, hands or feet, pain below your ribcage, feeling sick or vomiting and problems with your vision. These symptoms can be caused by other problems, but if you have them, you should contact your midwife or GP.

    Can I fly when I am pregnant?

    Answer

    If your pregnancy hasn’t already led to health complications, then there’s no evidence that flying is unsafe for you or your baby. There are recommendations for when during your pregnancy you may be best to stop travelling by plane. Airlines have their own guidelines and rules for taking pregnant passengers.

    Explanation

    If you choose to fly from week 28 of pregnancy, your airline will ask you to provide a letter from your doctor or midwife. This should confirm your due date and that he or she doesn’t think you’re at an increased risk of complications. After 37 weeks, if you’re pregnant with one baby, there’s a much higher chance that you will go into labour soon. This is because most babies are born within two weeks either side of their due date. If you’re pregnant with more than one baby, this chance is increased from week 34 because twins (or more) often have shorter pregnancies.

    Some airlines won’t let pregnant women fly from 37 weeks, while others have an earlier cut−off date. Check with the airline before you book the tickets. It may also be more difficult to get travel insurance after a certain point in your pregnancy.

    Talk to your doctor or midwife if you have complications that have come about because you’re pregnant, or because of health conditions you had beforehand. They can advise you about how flying could affect you. If you’re planning a long-haul flight, the risk of deep vein thrombosis (DVT) caused by sitting still for a long time may be higher when you’re pregnant.

    Flying hasn’t been shown to increase the chance of premature labour. It’s worth bearing in mind that if you were to go into labour while on a plane, you would be far away from medical help. It’s also worth thinking about any risk of infection and availability of health facilities at your destination in case you develop problems while you’re away.

  • Resources Resources

    Further information

    Sources

    • The Pregnancy Book. Department of Health. www.dh.gov.uk, published 1 February 2013
    • Collins, S, Arulkumaran S, Hayes K, et al. Oxford Handbook of Obstetrics and Gynaecology. 3rd ed. Oxford: Oxford University Press; 2013: 50−4,90−3
    • Antenatal care. National Institute for Health and Care Excellence, (NICE). www.nice.org.uk, 2010
    • Matthews A, Haas DM, O'Mathúna DP, et al. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews 2014, Issue 3. doi: 10.1002/14651858.CD007575.pub3
    • Anaemia – iron deficiency. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published February 2013
    • Physiology of pregnancy. The Merck Manuals. www.merckmanuals.com, published November 2013
    • Urinary tract infection (lower) – women. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2013
    • Urinary tract infections in pregnancy. Medscape. www.emedicine.medscape.com, published 5 February 2014
    • Urinary incontinence. Office on Women’s Health. www.womenshealth.gov, published 16 July 2012
    • Varicose veins. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published May 2014
    • Carpal tunnel syndrome in pregnancy. National Childbirth Trust. www.nct.org.uk, published 24 January 2013
    • Carpal tunnel syndrome. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2012
    • Dental care for mother and baby. British Dental Health Foundation. www.dentalhealth.org, accessed 16 September 2014
    • Pregnancy-related pelvic girdle pain. Association of Chartered Physiotherapists in Women’s Health. www.acpwh.csp.org.uk, published 2011
    • Weight management before, during and after pregnancy. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published July 2010
    • Managing your weight. Tommy’s. www.tommys.org, published March 2014
    • Sleeping well. Royal College of Psychiatrists. www.rcpsych.ac.uk, published July 2014
    • Primary insomnia. Medscape. www.emedicine.medscape.com, published 25 August 2014
    • Sleep tips for pregnant women. National Sleep Foundation. www.sleepfoundation.org, accessed 16 September 2014
    • Napping. National Sleep Foundation. www.sleepfoundation.org, accessed 16 September 2014
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 16 September 2014
    • Normal labour and delivery. Medscape. www.emedicine.medscape.com, published 2 May 2014
    • Braxton hicks. American Pregnancy Association. www.americanpregnancy.org, published January 2014
    • Antenatal care – uncomplicated pregnancy. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published March 2011
    • Air travel and pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published January 2011
    • Pregnancy symptoms − early signs of pregnancy. American Pregnancy Association. www.americanpregnancy.org, accessed 16 December 2014 
    • Bleeding and pain in pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published January 2008 
    • Pregnancy. Oxford handbook of general practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published April 2014 (online version)
    • E coli. Centers for Disease Control and Prevention. www.cdc.gov, accessed 16 December 2014
    • Heartburn and pregnancy. American Pregnancy Association. www.americanpregnancy.org, published March 2014
    • Pre-eclampsisa. BMJ Best Practice. www.bestpractice.bmj.com, published 20 June 2013
    • Hypertension in pregnancy. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2010
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