Common health issues during pregnancy
Pregnancy is certainly an exciting time, but it’s not without its fair share of uncomfortable symptoms. And while these may take a little getting used to, the fact is, they’re totally normal. The most important thing you can do is to be aware of the symptoms, know how to deal with them and where to seek help.
Most expecting mums experience some of the following health issues. They’re normal and are related to the rapidly changing hormones in your body. While knowing this may help you cope better, there’s no doubt they can still cause significant distress. Here’s a quick rundown of some of the most common issues:
Sickness or nausea – this happens to three out of four women during pregnancy, so you’re not alone. For some, it happens upon waking (morning sickness), while for others it can last all day. It usually disappears by the end of the first trimester, but can last until 20 weeks. Nausea can affect your general wellbeing and it may be difficult to work and/or to look after children. What causes it is not well understood and because every woman is different, it’s just a matter of finding out what treatment works for you.
Heartburn, acid reflux, indigestion and constipation – these gastrointestinal symptoms happen to three out of four women and are often related to symptoms of nausea. The good news is, there are dietary, lifestyle and medical treatments available.
Gestational Diabetes – this is a medical condition that may occur during pregnancy and is related to high blood glucose levels. All women in New Zealand should be offered screening for diabetes during their pregnancy. If you’re diagnosed, you’ll be provided with dietary and lifestyle advice, as well as ongoing professional care if you want it.
What methods of treatment are available?
For sickness or nausea
Importantly, it’s about acting early – so you shouldn’t wait until your symptoms get really severe. Your GP or midwife can prescribe medications that are safe and suitable for you. The most commonly prescribed is metoclopramide, while other first choices include prochlorperazine, promethazine, and diphenhydramine. Talk to your midwife or doctor about whether any of these medications would be suitable for you so you can quickly get back to feeling better. If you are prescribed one of these medications, the important thing is that you take them as directed.
You can also try ginger – in the form of ginger ale, ginger tea, ginger biscuits, or ginger supplements from the health food store. Vitamins such as B6 tablets (up to 200 mg per day) may also help, and are available without a prescription, while acupressure bands (pressing on the P6 point on the inner wrist) have shown to be useful to some women. These are all treatments that may help provide some assistance, but you should always consult with your healthcare practitioner.
Dietary changes may also help, such as eating smaller nutritious snacks more frequently (every 1-2 hours), staying well hydrated, separating solids from liquids (drinking fluids 20 minutes before or after you eat), and avoiding certain foods (fatty, spicy, or anything that triggers your nausea). Whatever you eat or drink, a simple rule is to make sure it stays down.
For heartburn, acid reflux, indigestion and constipation
When it comes to heartburn, you might find that the dietary and lifestyle changes listed for sickness or nausea may also help. Propping up your upper body on extra pillows while lying down may help reduce heartburn. Remaining upright after eating may also help reduce heartburn and reflux. It’s also a good idea to get some fresh air by going for short walks after a meal to help aid digestion.
Your GP or midwife can prescribe medications for heartburn that are also safe in pregnancy. One option is antacids which contain aluminium, calcium or magnesium. But be careful not to take too many in one day, or for too long – always read the directions and if you have any questions consult with your healthcare professional. Your second choice medications would be histamine (H2) blockers such as ranitidine.
When treating constipation, you should firstly drink lots of fluids, exercise regularly and add fibre to your diet (high fibre cereals, bread and snacks, lots of fruits and vegetables). While these lifestyle changes help most women, they don’t work for everyone. So if you’re having trouble with constipation, you should speak to your GP or midwife about trying some laxatives. Most are generally safe, especially if you’re only using them for a short time. Bulk-forming ones like psyllium or stool softeners like docusate sodium can both be used long-term and used as directed.
It’s also worth knowing that slowed gut movement due to rising progesterone levels is the cause of constipation in most women.
For gestational diabetes
The diagnosis of gestational diabetes is monitored during the early stages of pregnancy. Glycated haemoglobin, a measure of your average blood sugar levels over the past 3 months, is one of the key tests included in your blood work organised by your GP or midwife. If your glycated haemoglobin is considered high, you may have undiagnosed diabetes, or pre-diabetes and will be referred to secondary services in your area that specialise in diabetes during pregnancy.
The second point of testing for diabetes during pregnancy is between 24 to 28 weeks, where you will have a screening test in the form of a one-hour glucose challenge test (also called a “polycose”). If you’re considered by your midwife to be at high risk of gestational diabetes, then you’ll be advised to undertake a diagnostic test instead. This includes a fasting two-hour glucose tolerance test. If you are found to have gestational diabetes, don’t worry, there are ways to look after yourself. You’ll be given dietary and lifestyle advice and be offered ongoing care by health professionals who specialise in this area. For most women with gestational diabetes, it will usually resolve following the birth of the baby.
General ways you can stay healthy during pregnancy
Remember, a healthier you means a healthier baby. While there are specific treatments out there, there are also some simple ways you minimise the risks. Here’s a rundown of the strategies you can use:
Eat well – this means getting all of the nutrients you and your baby need. Have a read over our article, Healthy Eating During Pregnancy, or chat to your GP or health professional for advice.
Exercise regularly exercising moderately for 30 minutes per day, at least five days per week, is considered acceptable during pregnancy for maintaining healthy weight and wellbeing. Speak to your health care professional before embarking on a new exercise programme.
Get some sleep – it isn’t always easy, especially if you’ve experienced uncomfortable symptoms. But the more sleep you get, the better you’ll feel. Simple things like having a sleeping schedule, unplugging from technology, or making your bed extra comfortable, can really help you to relax and get the rest you need.
Say yes to support – pregnancy can be a stressful time, so make sure you call in favours from friends, family members and neighbours. They can easily make a meal, look after a child for a few hours, or hang a load of washing out – the more help the better.
Getting the right care early on
The most helpful thing you can do to ensure a safe and healthy pregnancy is to engage early with a lead maternity carer – usually a midwife. They’re an excellent source of information and advice. If you need a midwife, you can either contact your local maternity hospital services, or find a midwife in your area by going to www.findyourmidwife.co.nz
Deeper Reading
Pregnancy and Breastfeeding Resources
Gestational Diabetes in New Zealand: a clinical practice guideline (2014)
Healthy weight gain in pregnancy (2014)