The Big "C" (constipation)

Constipation is one of the most common conditions of pregnancy and it can compound the risk of developing painful hemorrhoids so it's worth dealing with now. There are measures you can take to reduce these unpleasant symptoms.
Because the digestive process slows in pregnancy, constipation is even more common than in the general population. Here are some suggestions by Dr. Mercola, not specifically addressing pregnancy constipation but some of his suggestions are excellent. He is a proponent of natural products and his website does promote his own line. WeeCare does not endorse these products but his video about constipation is excellent so click the post title to see his video. We encourage you to discuss any supplements or medications with your doctor. While laxatives are helpful in pregnancy, this is not the best solution. Prevention and bowel training along with exercise, water intake and diet will make a difference.

Ideas from his website, along with our own suggestions that particularly help pregnant women follow:

• Try squatting. This is the best, natural position to help expel stool from your colon and reduce your risk of hemorrhoids, and it’s still the way many people around the world go to the bathroom. In your home, you can get many of the same benefits by placing a stool near your toilet to raise your knees, purchasing a special squatting device to modify your toilet, or simply squatting on your own toilet.

• Eat plenty of fiber-rich foods. Vegetables are phenomenal sources of fiber. Fruits with skins, whole grains (not just darker-colored white bread), beans are very good. See this chart for fiber content of foods. For added fiber to help normalize your stool, try whole organic flaxseeds. Grind the seeds in a coffee grinder, then add a tablespoon or two to your food.You can also try psyllium. Psyllium is unique because it's an adaptogenic fiber, which means it will help soften your stool if you’re constipated, or reduce frequency of your bowel movements if you have loose stools. Products such as Metamucil employ this substance and it is safe in pregnancy.
  

• Exercise regularly. This helps stimulate circulation and intestinal function, causing your bowels to move properly - so, take a walk!

• Schedule bathroom time. Sometimes our busy lives make us postpone this important function and by so doing, we train our body to hold the stool and then, especially if we are not well-hydrated, constipation ensues. Plan time daily for this, even when you don't think you need to "go" and relax with a book, puzzle, etc. You can train yourself - your body will get the idea but it starts in your head.

• Drink plenty of water. If your body perceives dehydration (before you even feel thirsty), it will draw fluid from the colon, leaving the stool hard and dry. Ensuring adequate water intake will reduce this problem. Keep a water bottle handy and sip, sip, sip.

• Supplements? Some women who are enemic in pregnancy take iron supplements on the recommendation of their doctor. In some cases this may aggravate constipation. If this is the case with you, it is important that you increase your iron-rich foods as these sources of iron are more easily digested than supplemental iron taken as medicine. Check this list for food suggestions, and include red meats, egg yolk, whole grains such as oatmeal, spinach and beans in your diet. Many of the iron-rich foods also contain good amounts of fiber so this dietary measure can help in two ways.
  

If you still have problems after trying these things, discuss it with your health care provider. You may need a mild laxative such as Miralax or Milk of Magnesia but this should be with the approval of your doctor or midwife.

Common Pregnancy Complaints

Some of the most common pregnancy complaints are listed here:

Morning sickness is so common, nearly 80% of pregnant women experience it to some degree. It's a misnomer since it can occur any time of the day (or all day); not just morning. But, because an empty stomach seems to exaggerate it, mornings can be very rough. There seems to be a connection with blood sugar levels. Having some crackers at the bedside to eat immediately on rising may help a little. Keeping the levels even through the day is also helpful so frequent snacking may be better than "3 squares" but make your choices healthy ones because excess weight gain brings lots of complications.

Some women are bothered by odors or particular foods. The good news is this usually only lasts for the first trimester, except in a few unlucky cases.

Breast tenderness is a common early complaint by some, especially in first pregnancies. This is part of the body's normal function in preparing for milk production. You will also notice other breast changes such as darkening of the areola (skin around the nipple).

Fatigue and headaches are also very frequently reported. You ask yourself, "how can one microscopic baby cause this much havoc?" Hormones are doing all kinds of strange things to you right now and you feel exhausted. Treat yourself to naps as needed and get plenty of sleep at night! Your partying days are likely on hold for a while. If you have trouble sleeping, check out our March 9 blog entry Sleep, Glorious Sleep. Regular exercise can also help, believe it or not.

Breathless, winded, feeling faint? You're not alone here. Your body is making 1/3 to 1/2 more blood volume than pre-pregnancy. Even climbing a short flight of stairs can make you short of breath. This is normal as you breathe for two and pump that extra blood volume. Speaking of blood volume - your red blood cell ratio will change. Some women become anemic and almost all women do to some degree as volume increases but red blood cell production doesn't keep up. The best thing you can do is eat iron-rich foods (meats, spinach, cream of wheat, other whole grains, beans, dark colored fruits). Supplements are sometimes added later in pregnancy but your prenatal vitamin also contains iron and side effects are sometimes a problem when taken as pills, so dietary sources are preferred. For a good list, see HealthCastle.

Backache is very common. Usually this is related to overstretching of your abdominal muscles and hormonal changes that cause the relaxing of the ligaments throughout your body as well as your back. This is also one of the reasons we advise you to wear sturdy, low-heeled shoes. Your balance will be affected and the loosened ligaments that support your ankles can cause you to fall if you wear heels.

Always use good body mechanics and use caution when lifting (bend at the knees and use your legs rather than your back when picking up your toddler, etc.), change positions frequently and try to avoid long periods of either sitting or standing. Good sleep positions can also help. Tips

Heartburn is the result of hormonal changes that affect digestion (the same ones that sometimes result in constipation as the system is slowed). Again, small, frequent meals will help, avoid spicy or fried foods and include milk as your beverage. Antacids are considered safe in pregnancy but you should always discuss it with your midwife or doctor. Other options might be needed.

Constipation - the "C" word. High levels of progesterone cause slowing of the intestines. To help counteract this uncomfortable problem which can lead to hemorrhoids, drink lots of water, exercise daily, eat foods with high fiber content and give yourself plenty of bathroom time (good excuse to get some reading done). Additional supplements such as Metamucil and laxatives like Miralax or MofM are acceptable, but again - get the OK from your doctor whenever you take anything. The Pregnancy Risk line is another good resource for information about the safety of medications in pregnancy or while nursing. (See the number on the right in the hotline section.) Since many meds that have cautions are actually safe (it's a matter of the process for labeling, testing that is not done on pregnant women, etc.) these are the experts to advise you.

Hemorrhoids - the "H" word. This disorder is relatively common during pregnancy, partly because of the tendency to constipation and partly due to pressure on the anus by the baby's head. Some women get them for the first time while they're pregnant and in most cases they go away after delivery. They are aggravated when you strain to pass a bowel movement (see the "C" word above). If you develop these varicose veins of the rectum, ice packs and pain relief ointments can help, as well as stool softeners and sitz baths. For a good explanation about hemorrhoids, see Dr. Mercola's video here. However, this is not specific information for pregnancy so use of any supplements he recommends should only be with the approval of your own provider.

Pain - ouch! Some women experience a low, sharp pain from the stretching ligaments that support the uterus. This is usually experienced on either side of the lower abdomen and may occur especially with a change in position. Call your doctor for pain that doesn't quit, that is cramping, rhythmic in nature or is accompanied by other symptoms (fluid leaking, bleeding) which could be related to preterm labor. See MoD. As you grow, sometimes the help of a maternity support garment is needed. A doctor can order this in pregnancy and it is considered durable medical equipment by insurance plans.

Irritability - OK, kind of subjective, but it's a common occurrence so hopefully friends and family will realize this is temporary and hang in there until you are back to normal. I had left this one off and had someone point it out to me. I couldn't deny it was really a symptom!

Fortunately most of these annoying problems disappear with the birth of your baby and you will be so delighted this will be a dim, distant memory. For now, try these measures for relief and when in doubt call your provider.

For the net "surfers" out there, here are some good, general pregnancy sites you might enjoy.

Parents.com is a great resource for various pregnancy concerns. There's lots of commercial stuff here -they are home to American Baby, Family Circle, and Parents magazines. These are reliable sources and you can get a free subscription to American Baby there too.

Medscape has an extensive list of common symptoms in pregnancy with full explanation. If you want lots of detail and technical information check it out here: Medscape

eMedicine (WebMD) also shares some common pregnancy conditions here.