Factors that may or may not be a Sign of Pregnancy

Nausea and Vomiting

Nausea and vomiting appear in most pregnancies during the first three months. The nausea subsides after the third missed period. Women should com­plain about this nausea to their physicians, who can assure them that it is related only to changes in the body associated with early pregnancy.

Eating dried fruits in small amounts and keeping the stomach slightly coated with food frequently helps to control nausea. Dried crackers, biscuits, or stale rye bread may be helpful early in the morning. Frequently, nausea is made worse by late rising and a rush to get to one’s job. Relaxation and unhurried movements in the morning tend to minimize the nausea.

If nausea is severe, mild sedation may be helpful. At times, various antinausea drugs may provide relief when taken either orally or rectally, as directed by a physician. If the patient is not able to eat or drink for 24 hours, the doctor should be notified immediately.
Heartburn

Heartburn or burning pain in the area just below the ribs is frequent in the middle and later months of pregnancy. It is probably due to changes in the position of the stomach, related to the enlargement of the uterus, and to changes in acidity of the stomach. A quarter of a glass of skim milk will reduce the heartburn. Various standard antacid products may prove to be helpful, but bicarbonate of soda should be avoided because, although it will relieve heartburn, it can produce swelling of the entire body.

Spells of shortness of breath frequently occur in the later months of pregnancy, from pressure of the enlarging womb upon the diaphragm. This is not related to any disease of the lungs. Propping up the patient on two or three pillows frequently helps.
Flatulence or Intestinal

Flatulence or intestinal gas commonly occurs in pregnancy; the intestines are merely slowing down due to effects of hormones produced by the pregnancy. Discomfort may be reduced somewhat during pregnancy, by not consuming gas-forming foods such as cabbage, baked beans, cauliflower and broccoli.
Muscle Cramps

Muscle cramps are frequent, particularly in the lower extremities, about the calves and thighs. These are associated with changes in the mineral content of the muscles during pregnancy. Limiting the consumption of milk to one glass a day for a week may reduce the cramps.
Back Pain

Back pain is a common disorder. Back pain commonly occurs from changes induced by pregnancy. All the ligaments attached to bones become softened. The protruding abdomen and weakened abdominal muscles affect the posture or “stance” of the pregnant woman. Also, there are various neuromuscular relationships that may be affected by the advancing pregnancy.

Generally, the disturbing back pain can be lessened by good standing posture and sitting on hard well-shaped chairs rather than soft cushioned couches or chairs. Standard simple exercises of abdomen and back muscles ease the discomfort. The bed should have a hard mattress, perhaps even a board placed under the mattress. Frequent car riding may produce back pain. Hard backrests are available to support the back muscles and improve driving posture. Driving may have to be curtailed if back pain is very severe and none of these measures help. A light, well-fitted supporting garment may be used to improve posture in walking and sitting.
Sleeping Habits

Sleeping habits of the pregnant woman may be upset. Emotional factors, such as worrying that something is wrong with the baby or that the baby is not moving, may keep her from falling asleep readily. Reassurance is important and worries should be talked out with doctor. Sleeping as well as breathing is easier in the last months of pregnancy if two or three pillows are used to prop the patient. In the last six weeks of pregnancy it is wise not to eat too late in the evening or to eat too large a meal. Mild sleep-inducing medications may be given safely if the sleeplessness is severe.

The beneficial effects of reasonable amounts of physical exercise in promoting conditions favorable to dropping to sleep at night should not be overlooked.
Faintness

The pregnant woman may get light-headed and possibly faint at least once during her pregnancy. If a fainting spell comes on, lie down or bend the head down between the legs and dizziness and faintness will subside quickly. Some women worry that they will “pass out” while driving a car. However, unless fainting spells occur with great frequency, driving is usually not forbidden. Premonitory sensations give a chance to pull over to the side of the road and lie down with the head at seat level. Carry a lump of sugar or piece of hard candy, chew on this, and dizziness and faintness will usually disappear. Fainting spells are at their maximum between the third and sixth months of pregnancy and rarely occur later.
Varicose Veins

Varicose veins often appear in pregnancy. The simplest way to prevent worsening of the varicosities is not to use constricting garters or rolled socks about the legs. When resting, elevate the legs on another chair or couch. If the veins are extensive, full-length elastic stockings may be worn, particularly when standing or walking for extended periods of time. Elastic stockings should fit tightly and are best put on by raising the leg far above the body and rolling them on from the foot. If a vein becomes tender, reddened and swollen it may be the early onset of phlebitis and the doctor should be consulted promptly for proper care. Surgery for removal of varicose veins is usually not recommended during pregnancy.
Hemorrhoids

Hemorrhoids are quite common during pregnancy. Hemorrhoids are large veins about the opening of the rectum. Increased pressure of the enlarging abdomen and uterus tends to over distend these veins. They may protrude outside the anus and be aggravated by hard or infrequent bowel movements. These are best treated by additional rest during the day and by cold compresses of diluted witch hazel. Discomfort may be relieved by anesthetic ointments prescribed by the doctor. Occasionally, a small hemorrhoid may become thrombosed (develop a blood clot in it) and be very painful. The doctor should be consulted and he will promptly relieve the discomfort. Surgery for hemorrhoids is not indicated during pregnancy.
Vaginal Discharge

Vaginal discharge is quite frequent during pregnancy. Moisture about the vaginal entrance tends to increase as pregnancy progresses toward the time of delivery. There are two common causes for abnormal vaginal discharge. A fungus called monilia causes a white flow. This is treated by specific drugs, either anti fungal agents or gentian violet preparations. The other infection causes a foamy, bubbly discharge produced by trichomonas parasites. A new antitrichomonal drug which may be taken either by mouth or vaginally, is datively specific for eradication of this condition.
Vaginal Bleeding

Vaginal bleeding is quite frequently encountered during pregnancy. At the time of the first missed period, some staining and slight bleeding may be related to implantation of the fertilized egg in the wall of the uterus. This bleeding usually subsides in several days. If bleeding progresses it may be due to a threatened abortion and the doctor should be informed. Occasionally, bleeding is due to a benign growth at the neck of the uterus called a polyp, or by a softening of cervical tissue, called an erosion. This area bleeds easily on pressure. The doctor can control it. Occasionally, bleeding is produced by intercourse.
Exercise

Exercise is important during pregnancy. Walking for a mile or so is fine for the average pregnant woman, but a long hike of four or five hours would be overdoing it. Dancing in its milder and less vigorous forms may be recommended. Sports such as tennis, golfing, or swimming, for short periods of time, are good relaxation for patients who are accustomed to them. This is too much activity for the final two months of pregnancy. More strenuous activities which are hazardous or fraught with tumbles, such as ice skating, skiing, horseback riding, diving, aqualunging and water­skiing are to be avoided during pregnancy. Even the exercises recommended are not advisable if the pregnancy is complicated by bleeding or cramps. Every patient is an individual and the type of exercise good for her should be discussed with the physician.
Traveling

Traveling is not hazardous for the normal pregnant woman. Airplane transport in pressurized cabins is the easiest form of travel. Rail travel is a little more difficult because of continuous pounding. Automobile travel for long distances is even more strenuous than train travel. Trips by car should be limited to two to three hundred miles a day, with frequent breaks to get out of the car, move around, and rest. Of course, some complication may make it unwise for a particular pregnant woman to travel; if so, the doctor will advise her.

It is not unusual for a woman in the first six months or so of pregnancy to make a long trip to a distant part of the country or even to go abroad. In such case she should have the name of an obstetrician who practices at her destination. She can also communicate with her own doctor by long distance telephone. In the final five or six weeks of pregnancy she should stay within 30 miles, or about an hour’s easy traveling time, of the hospital.

Seat belts should be used at all times when driving or as a passenger in a car. The safety belt must not be placed high on the abdomen, but lower down, snug about the hipbones which can take the shock of a sudden stop.
Clothing

Clothing should not fit tightly. Purchase lightweight undergarments that may be worn in both warm and cool weather. There is no reason why usual undergarments - a two-way stretch, for example can’t be worn in the early months of pregnancy, until they become too tight. When backache becomes troublesome, maternity girdles usually give considerable relief. High heels are an extra hazard when the abdomen enlarges and balance is precarious at best. However, a short woman married to a tall man may feel ill at ease in flats, and for morale reasons she may be permitted to wear moderately high heels if she is aware of the dangers involved.
Drugs

Drugs should be used only for absolutely necessary reasons during pregnancy, particularly in the first three months when the vital structures and organs of the baby are being organized. The various antibiotics should not be used during pregnancy except for reasons the doctor considers compelling. Not only does the use of these drugs sometimes produce an annoying vaginal discharge, but strains of germs resistant to the drugs’ actions may emerge. Such infections in a newborn infant are serious. Any drugs to which the patient is sensitive should be noted and used with caution if at all during pregnancy.
Smoking

Smoking during pregnancy has occasioned some furor. There is statistical evidence that infants tend to be smaller and the incidence of prematurity greater if the mother smokes excessively. It may be cruel, and frequently futile, to forbid cigarettes entirely to a woman who is accustomed to them, but nothing but good can come from cutting consumption from a pack or two a day to perhaps a half dozen cigarettes.