COMMON DISCOMFORTS DURING PREGNANCY
You may have a number of minor ills and temporary disturbances during pregnancy which are not serious but capable of making you very uncomfortable, and which you may sometimes relieve yourself. But should they be severe or persistent, you should consult your doctor at once. The most common of these minor discomforts may be grouped as digestive disturbances and “pressure symptoms.”
Chief among the digestive disturbances are “morning sickness,” “heartburn,” “distress” and flatulence or “gas.”
“Morning sickness” is probably the commonest discomfort of pregnancy as it occurs in about half of all cases. Because of the expectant mother’s tendency to nausea during the early months, it may be brought on by slight causes which would not produce nausea under ordinary conditions. While it is true that grief, anxiety, fright, shock, incessant worry, fits of temper or brooding may induce nausea when the diet is entirely satisfactory, nausea and even vomiting may be caused in the expectant mother just as they may in any one else by indiscretions in diet, rapid or overeating. On the other hand, simple, light food taken in small quantities, five or six times daily, eaten slowly and masticated thoroughly; the cultivation of a happy frame of mind; exercise and fresh air all tend to prevent this very uncomfortable condition.
Prevention is of great importance, as the habit of vomiting is acquired easily but broken up with difficulty.
When “morning sickness” occurs, however, the sufferer is often relieved by eating two or three hard, unsweetened crackers or crisp toast, immediately upon awaking and then lying still for half or three quarters of an hour. She should then dress slowly, sitting down as much as possible while doing so, and eat her regular breakfast. Lying flat, without a pillow for a little while after meals, or whenever having the slightest feeling of sickness, will frequently prevent, and also relieve nausea. Sometimes comfort is derived from the use of either hot or cold applications over the stomach. Some expectant mothers find that they can prevent nausea by having hot coffee, or even a full breakfast before arising. But the habit of having breakfast in bed should not be cultivated lightly, for in spite of yourself it is likely to make you feel like an invalid, the thing you should carefully avoid. So don’t do it unless your doctor orders it.
“Heartburn,” so called, which is suffered by so many expectant mothers, has nothing to do with the heart. It is due entirely to too much acid in the stomach and is usually felt as a burning sensation, which starts in the stomach and rises into the throat. It may be prevented, as a rule, by taking a tablespoonful of olive oil or a cupful of cream or rich milk fifteen or twenty minutes before meals and avoiding fat and fried food at the meals themselves. Or, it may be enough simply to avoid eating fats and fatty foods. Since the painful, burning sensation is directly due to too much acid in the stomach, it usually may be relieved by taking a tablespoonful of lime water; a teaspoonful of sodium bicarbonate in water; a small piece of magnesium carbonate; or a drink of any alkaline water that one fancies.
“Distress.” Another common discomfort of pregnancy is called “distress” by the sufferers themselves, and occurs after eating. It may be neither heartburn nor pain, but resemble both and make the expectant mother very miserable. It is usually suffered by women who eat rapidly, do not chew their food thoroughly or who eat more at one time than the stomach can hold comfortably. This is one more reason for taking small amounts of food at a time, eating slowly and masticating thoroughly.
Flatulence, or “gas,” may or may not be associated with heartburn, but is fairly common among expectant mothers, and is rather uncomfortable. A daily bowel movement is of prime importance in preventing and relieving flatulence and at the same time foods which form gases should be carefully omitted from the diet. The chief offenders are parsnips, beans, corn, fried foods, sweets of all kinds, pastry and very sweet desserts. Yeast cakes and artificially fermented milk sometimes help to prevent flatulence.
Pressure Symptoms. Under the general heading of pressure symptoms are several forms of discomfort resulting from pressure of the enlarged uterus (containing the baby) on the blood-vessels which return from the lower part of the body, thus interfering with the flow of blood back to the heart. The commonest pressure symptoms are swollen feet, varicose veins, hemorrhoids (piles), cramps in the legs and shortness of breath. They may appear at any time during the last half of pregnancy and they grow worse as the weeks wear on.
Fig. 14.—Right-angled position to relieve swelling or varicose veins of the feet and legs. (By courtesy of the Maternity Centre Association.)
Swelling of the feet is very common, and when very slight may not be serious or particularly uncomfortable. The swelling may be confined to the back of the ankle, which grows white and shining, or it may extend all the way up the legs to the thighs. Sitting down, with the feet resting on a chair, or lying down with the feet elevated on a pillow will give a certain amount of relief. If the swelling and discomfort are extreme, the expectant mother may have to go to bed until they subside, but very often she will be relieved by elevating her feet or assuming the right-angled position shown in Fig. [14], for even a little while, several times a day. But while employing these harmless measures to make yourself comfortable, you must remember that the swelling of your feet and ankles is one of the symptoms that your doctor wants to know about. For this reason you should promptly report to him even the slightest swelling and begin to measure and save your urine for examination.
Varicose veins are not peculiar to pregnancy but they are among the pressure symptoms which frequently appear during the later months, particularly among women who have borne children. The enlargement of the veins is not usually serious but it may cause a good deal of discomfort. While varicose veins may occur in the vulva, they are usually confined to the legs, and both legs are about equally affected. Sometimes, however, the veins in the right leg are more distended than those in the left, or the right side alone may be affected.
Considerable relief may be obtained by keeping off the feet, particularly by elevating them, and also by the use of elastic bandages. When an expectant mother finds it difficult or nearly impossible to sit or lie down for any length of time, she may secure great relief in a few moments by lying flat on the bed with her legs extended straight into the air, at right angles to her body, resting against the wall or head board, as shown in Fig. [14]. This right-angled position for five minutes, three or four times a day, will accomplish wonders in reducing varicose veins.
A spiral elastic bandage, also, will give comfort and help to prevent the veins from growing larger, if applied freshly after each time that the leg is elevated. The most satisfactory bandages, from the standpoint of expense, comfort and cleanliness, are of stockinette or of flannel cut on the bias, measuring three or four inches wide and eight or nine yards long. If made of flannel, the selvages should be whipped together smoothly so that there is neither ridge nor pucker at the seam. The bandage should be wrapped around the leg with firm, even pressure, starting with a few turns over the foot to secure it, and leaving the heel uncovered, carried up the leg to a point above the highest swollen vessels. As a rule the bandage may be left off at night.
There are satisfactory elastic stockings on the market, but they are fairly expensive, often cannot be washed and seem to offer no practical advantage over the bandages.
Swollen veins in the vulva may be relieved by lying flat and elevating the hips, or by lying on the side with the hips elevated on a pillow for a few moments several times a day, as shown in Fig. [15].
Fig. 15.—Lying on the side with hips elevated to relieve swelling or varicose veins of the vulva. (By courtesy of the Maternity Centre Association.)
Hemorrhoids, or “piles,” are virtually varicose veins which protrude from the rectum, but, unlike those in the legs, are extremely painful. As it is the straining in constipation that causes these enlarged veins to protrude from the rectum, this is one more reason for preventing constipation, for a pregnant woman whose bowels move freely every day rarely has hemorrhoids. If hemorrhoids appear, and give pain, the first step is to soften the fingers with vaselin and gently push the hemorrhoids back into the rectum. You can do this quite easily for yourself. You should notify your doctor if you have hemorrhoids, but while waiting to see him, if you are very uncomfortable you will be almost certain to find relief in lying down with your hips elevated on one or two pillows; applying an ice bag to the rectum, or ice-cold cloths or cloths wrung from equal parts of water and witch hazel. Sometimes the hemorrhoids are worse during the first few days after the baby is born but as a rule they disappear when the ultimate cause is removed, which in this case is pressure made by the baby.
Cramps in the legs, numbness or tingling may be caused by pressure of the large, heavy uterus upon nerves supplying the lower extremities. Lying down, applying heat and rubbing the painful parts will usually relieve the discomfort.
Shortness of breath is sometimes very troublesome toward the end of pregnancy, and as may be easily understood, is due to the upward, and not downward pressure of the uterus. For this reason the discomfort is made worse by lying down and relieved by one’s sitting up or being well propped up on pillows or a back rest.
Vaginal Discharge. Although the normal vaginal discharge is increased during the later months of pregnancy you should tell your doctor if your discharge is very free. You should not take douches to remove it, unless your doctor orders them, for the normal discharge gives you a certain amount of protection against infection. If it is irritating or causes itching or burning you may obtain relief by avoiding the use of soap and by bathing the uncomfortable parts with water, containing a teaspoonful of sodium bicarbonate to a pint, or with olive oil.
Itching of the skin is a fairly common discomfort, and is possibly a result of irritating material being excreted by the skin glands and deposited upon the surface of the body. The local irritation usually may be relieved, if not very severe, by bathing the uncomfortable areas with the solution of sodium bicarbonate as above, or a lotion consisting of a pint of lime water, half an ounce of glycerin and thirty drops of carbolic acid. It is a good plan, also, to drink more water, in order to promote the activity of the skin, kidneys and bowels, and thus dilute the material that may be responsible for the itching and increase its elimination through all channels.
Some women complain of discomfort caused by the stretching of the skin over the enlarged abdomen. There is a very old belief that rubbing the skin with oil will relieve this sensation and also prevent the appearance of the purplish streaks described in a previous chapter. There seems to be little foundation for this belief, but if a woman fancies that she is safer and more comfortable after oiling her abdomen, there is certainly no reason why she should not do so.