Abdominal Pain

The March of Dimes outlines the usual "normal" causes of abdominal pain in pregnancy here.  They also list times when you should be concerned and you should call your doctor as well as some ideas for relief.

All pregnant women can benefit from a few measures that also help relieve some of the symptoms and may even prevent some abdominal pain.

1. Exercise - get out and walk.  Besides helping with bowel health (reduce constipation, relieve gas), it's good for the vitamin D you get from the sun.  A daily 15 minute walk will give you what you need of that nutrient.  It's also good for emotional health, boosting seratonin in the brain (an important neurochemical that helps ward off depression) and women have been shown to have improved labor progress when they have regularly exercised in pregnancy.  
2. Drink water - staying hydrated is essential in pregnancy.  Dehydration can sometimes go unnoticed and yet can cause preterm labor.  Especially with warm weather coming it is important to sip, sip, sip.   Keep a refillable water bottle handy.  Some plastics are not recommended, especially when exposed to heat so try one of the new types such as stainless steel or aluminum.  If purchasing a plastic bottle be sure to look for a sticker or label that reads “BPA free."  (Click here to find out where and why plastic bottles have been banned.)  The thin plastic bottles are best if used as a "one time use only" drinking container. Check the recycling number on the bottom to determine which plastic bottles are safe: try to avoid numbers 3, 6 and 7 when possible. Go here for detailed information and useful pictures.  More info here.
3. Avoid abrupt and sudden movements - even jumping out of a chair can cause strain on ligaments.
4. Try a warm bath or "cozy" (bean, corn or rice bag warmed in microwave) or heating pad on low setting, wrapped in towel.

If you don't get relief from abdominal pain, call your health care provider.

Charley horse?

Photo from Babiesonline.com Used with permission

Cramps occur when a muscle contracts involuntarily and doesn’t relax. You may even see or feel your muscle twitching and even after the muscle relaxes, it may remain sore. Cramps can last anywhere from a few seconds to 25 minutes or more. While some people experience cramps during exercise, they can also happen while sitting or even sleeping - it may wake you suddenly with a severe pain. These most commonly occur in the leg, especially in the calf, hamstring and quadricep.

There are many reasons why cramps may occur. Inadequate stretching and overexertion might lead to a build up of lactic acid in your muscles. Muscle fatigue and dehydration may also contribute. Cramps are also more likely to happen in hot weather since you tend to lose more fluids. Not drinking enough is the most common cause of these cramps so keep sipping!
Leg cramps can be caused by low levels of potassium. When you have an insufficient amount of this mineral it upsets the electrolyte balance inside of your body which otherwise maintains normal healthy muscle functioning. You may only need to make simple dietary changes to reduce the likelihood of further cramps. Potassium is one of the main nutrients in a banana so eating more bananas could really help a lot. Orange juice, avocados,nuts, milk, potatoes and leafy greens are also good. Isn't it amazing how diet can fix what's wrong?
Other possible causes include sitting in one place for a long time as the muscle is not getting the chance to stretch a little to keep it supple. Drinking alcohol, changes associated with pregnancy, diabetes, Parkinson’s disease, some kinds of flu virus which seems to cause a temporary muscle spasm effect, and some types of medication can also contribute to the problem.

When cramps occur, try a few tricks to help the muscle relax. Start by gently stretching the area, but don’t reach too far; just lightly push the muscle until you feel a stretch or flex the foot upward. Usually it is not a good idea to point the toe, however. Learn specific stretches to use. Another way to reduce the pain is to gently massage the cramped muscle, but no hard rubbing! You might also try to ice the affected area for 15 minutes at a time. This will increase the circulation to the muscle. Some women benefit from a warm compress or bath.

Good advice from BabiesOnline.com

"If you experience persistent pain from these leg cramps see your doctor just in case you have something more serious going on. One of the most likely causes could be a blood clot in the leg. This can be deadly and should be treated as soon as possible." (Click the post title to read their full article).

Video about epidurals

One of my favorite resources, About.com has a good video on epidurals to prepare you in case this is something you want. Click the post title to be taken to the site.

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.