Common health problems in pregnancy

Cramps

Urinary frequency

Urinary stress incontinence

Heartburn and indigestion

Varicose veins

Varicose veins in the genital area

Constipation and haemorrhoids

Backache

Vaginal thrush

During your pregnancy you may have a number of annoying problems that are not dangerous but may need some attention. These problems include cramps, urinary frequency and incontinence, heartburn and indigestion, varicose veins, backache, constipation, haemorrhoids and thrush.

Fortunately some simple changes can often relieve your symptoms. Always contact your doctor or midwife if you have any concerns about these or any other health problems during your pregnancy.

Cramps

Leg and foot cramps are most common during the second half of your pregnancy and usually happen at night.

• If you get a cramp, keep your leg straight on the mattress and pull your toes back towards your knee. This will stretch your calf muscle and should help the pain. If this doesn’t work try standing up and stepping forward with the other foot to stretch the cramped muscle. Keeping the foot flat on the floor will increase the stretch.
• When the pain eases, you can massage the area or place a hot water bottle or heat pack on the area.

You may be able to prevent calf muscle cramp at night by stretching your calf muscles before you go to bed. You can get more information about these stretching exercises at your antenatal classes or from your doctor or midwife.

Urinary frequency

Urinary frequency is when you need to urinate (pass urine) more often than usual. This can be a problem in the first 12–14 weeks of pregnancy. After this, urinary frequency is not usually a problem until the last weeks of your pregnancy, when the baby’s head sinks lower into the pelvis ready for delivery.

• Urinary frequency is normal during pregnancy, and you can't really do anything to relieve it.
• It's really important not to limit the amount of water and other fluids you drink - you and your baby still need plenty of water.

Talk to your doctor or midwife if you have any feelings of burning, stinging or back pain when you pass urine. These could be signs of a urinary tract infection, which should be treated quickly to avoid any complications.

Urinary stress incontinence

When you are pregnant, you may leak a little bit of urine when you cough or laugh. This problem is called urinary stress incontinence, and it tends to become more of a problem later in pregnancy.

• Strengthening your pelvic floor muscles will help to prevent this problem now and after your baby is born.
• A physiotherapist usually teaches pelvic floor exercises during antenatal classes.
• Speak to your doctor if you have a continuing problem with urinary stress incontinence.
• See the topic 'Pelvic floor exercises'.

Heartburn and indigestion

Heartburn is a very common and uncomfortable problem during pregnancy.

• You can relieve heartburn with an antacid solution or tablets. Ask your pharmacist, doctor or midwife to recommend a product that is suitable to use in pregnancy.
• You can also try to avoid heartburn by eating small meals, and avoiding fatty and spicy foods.
• Heartburn can be worse if you lie down after a big meal.
• Raising the head of your bed by about 15 cm may help with heartburn at night.
• Sometimes, drinking a glass of milk or eating some yoghurt may help prevent and relieve heartburn.
• Talk to your doctor or midwife if heartburn becomes a continuing problem for you.

Varicose veins

Varicose veins usually appear as swollen, knotty, bluish veins that may develop on your legs during pregnancy. Pregnancy hormones are thought to make you more likely to develop these veins.

The following suggestions may help to prevent varicose veins from developing (or at least not as badly) and will help to relieve the aching that often accompanies these veins:

• Avoid standing for long periods
• Avoid crossing your legs
• Rest with your feet and legs higher than the rest of your body
• Do gentle, regular exercise such as walking or swimming
• Wear supportive stockings or pantyhose
• Tell your doctor or midwife if you develop any reddened, swollen or painful areas on your legs.

Varicose veins in the genital area

Some women may also develop varicose veins in the area around the opening to the vagina. These can become quite painful.

• Lying down and resting several times during the day may help to relieve the pressure and swelling of these veins.
• Sometimes pelvic floor exercise scan help.
• Talk to your doctor or midwife if it becomes a problem for you.

Constipation and haemorrhoids

When you are pregnant it is quite common to become constipated (this is when your bowel motions are hard and difficult to pass). If not treated, constipation can lead to haemorrhoids (piles), which are swollen veins around your anus (bottom).

Try to prevent or overcome constipation. This way, you will feel more comfortable and should be able to avoid haemorrhoids.

These ideas will help you to prevent and relieve constipation:

• Increase the fibre in your diet by eating plenty of wholegrain bread and cereals, fresh and dried fruit, vegetables, nuts and cooked dried beans and lentils - you should be aiming to eat 30 - 40 grams of fibre every day.
• Drink at least 6 - 8 glasses of water each day.
• Get plenty of gentle, regular exercise - walking is a great choice.
• Bulking - forming laxatives that contain psyllium (such as Metamucil**) can be used when you are pregnant, but if you need anything else, talk with your doctor or pharmacist.

If you do become constipated and develop haemorrhoids, try these ideas to help relieve the discomfort:

• Apply a cold pack or an ice cube wrapped in a tissue on your anus to reduce the swelling and irritation
• Keep your anal area very clean by gently washing with a product like Pinetarsol** (this helps to control the itching) after each bowel motion.

There are also haemorrhoid creams and wipes that can help to relieve your discomfort and are suitable to use during pregnancy. Please talk to your pharmacist, doctor or midwife before using any over-the-counter haemorrhoid product.

Backache

Many mothers get backache during pregnancy because of the combination of softened ligaments and the increasing weight of a growing baby which alters your posture.

• Maintaining a good posture, practising regular antenatal exercises and wearing comfortable flat- heeled shoes can all help to prevent problems and relieve symptoms.
• If your backache continues or is worrying you, please speak to your doctor or midwife, or make an appointment to see a physiotherapist.

Vaginal thrush

Many women notice that they have an increased vaginal discharge during pregnancy.

This is quite normal, unless the discharge becomes thick, is itchy, uncomfortable or has an unpleasant smell. If you have any of these symptoms, please speak to your doctor or midwife, as this may be a sign of a vaginal infection called thrush.

• Thrush is a yeast infection caused by the fungus Candida albicans. This fungus commonly lives in the vagina, but doesn't cause problems unless it starts growing too fast.
• When you are pregnant, there is lots of glycogen (a type of sugar) in your vagina that encourages the Candida fungus to grow. This means that you are 10 times more likely to get thrush when you are pregnant.
• If you think you may have an infection, talk with your doctor or midwife. Depending on your symptoms and the stage of your pregnancy, your doctor may prescribe some pessaries or cream to use. Not all of these products are safe to use at different stages of pregnancy, so it's really important to talk to your doctor before using any products.

These ideas may help to relieve your symptoms:

• apply a cold compress to the itchy, inflamed area
• eat natural yoghurt that contains cultures such as acidophilus and bifidus - these cultures help to restore the balance of 'good' bacteria in your vagina and stop the overgrowth of Candida
• wear cotton underwear.

**Any products referred to in our health topics are usually well-known brands readily available in Australia. The brand names are given as examples only, and do not necessarily represent the best products, nor the full range of effective products on the market.