Body change during pregnancy can take some women by surprise. For most women the desire to become pregnant is one of the strongest driving forces in life. Not surprisingly, therefore, pregnancy is a time of great fulfilment and happiness. It is, however, also a time of physical and mental change and it is important to understand these changes if unnecessary worry is not to mar the happiness. Fortunately, most women remain happy and healthy during pregnancy, but there are a few “do’s’ and ‘don’ts’ to heed if fitness and contentment are to remain at their peak.
Perhaps the best advice to any woman who is contemplating having a baby should be to ensure that she is fit and well before commencing pregnancy. Every gardener understands that it pays to prepare and nourish the soil carefully before planting the seed, and the same is true of pregnancy. The ideal that every woman should aim for before she becomes pregnant is to be in good health, to be the right weight, to eat the right diet, to take plenty of physical exercise and to stop smoking.
BODY CHANGE DURING PREGNANCY
Pregnancy involves the building of a baby in the uterus from the time that the fertilized egg enters, until the time that the fully formed baby leaves at the end of the labour. In order that all this may be achieved successfully, changes occur in the body to enable it to supply all a baby needs for healthy growth and development.
CHANGES IN THE BLOOD
Pregnant women have about 2 litres (4 pts) more blood than non-pregnant women, which is needed to supply the baby with the oxygen and nourishment that he requires. In order to make more blood the pregnant woman has to manufacture more haemoglobin-the essential component of red blood cells. Haemoglobin contains iron and in order to make the extra haemoglobin required for pregnancy, the mother-to-be draws upon iron which is usually stored in the body. If there is not enough iron in store, the woman cannot make enough haemoglobin, the blood becomes more diluted than it should be, and the woman is said to be anaemic. Anaemia in pregnancy, is, therefore, mainly due to a lack of enough iron to make the haemoglobin available for the essential extra blood cells.
Folic acid-a constituent of the Vitamin B complex which influences red blood cell formation also needed to build haemoglobin. Although less important than iron, lack of folic acid can also cause anaemia in pregnancy. Anaemia can be detected by checking the amount of haemoglobin in the blood and this is always done on several occasions during pregnancy. If anaemia is to be avoided it is obviously important for the pregnant woman to have adequate amounts of iron and folic acid in her diet. Most women, however, need to take a small dose of iron and folic acid every day from twelve weeks of pregnancy onwards.
CHANGES IN THE HEART AND LUNGS
Because of the increased amount of blood present in the body, the heart has to work a good deal harder in pregnancy, especially in the later stages. At the same time the lungs get pushed up by the uterus as it increases in size. As a result of these changes the pregnant woman gets out of breath more easily and is also more liable to feel faint from time to time.
These are normal happenings in pregnancy and should not be a cause for alarm. Also normal is a rapid heart beat which may be noticed from time to time during pregnancy. Such bursts of heart activity are due to the sudden need for the heart to work harder to keep up the increased output.
Heart failure is very rare in pregnant women and no woman with a normal heart need worry about its ability to meet the need of increased activity during pregnancy or labour. Pregnant women with heart disease do, of course, need special medical care to ensure that the heart is not put under too much strain.
CHANGES IN THE KIDNEYS AND URINARY SYSTEM
Pregnant women drink more fluid (water, tea, coffee, fruit juice, etc.). As a result, the kidneys produce more urine and the mother-to-be has to go to the lavatory to pass urine more often. This is particularly noticeable in early pregnancy when the enlarging uterus presses on the bladder; and in late pregnancy when the baby’s head does the same thing.
Unfortunately, pregnancy is also a time when infection of the urine is more likely to occur and it is sometimes difficult for a woman to distinguish between frequency of micturition (passing water) due to the pregnancy and frequency due to an infection involving the bladder (cystitis) or kidney (pyelonephritis) or both. When infection is present the urine seems to burn, or scald, or sting, as it passes and this helps to draw attention to the infection.
CHANGES IN STOMACH AND BOWELS
Feeling sick and being sick is common during early pregnancy, and this is due to the effect of increased hormone levels. As the pregnancy proceeds, the sickness wears off and most women are not troubled by it after about twelve to fourteen weeks. It does persist for longer than this in some women, but it is rarely very troublesome in middle or late pregnancy. Some women find that they can relieve the feeling of sickness by eating snacks between meals.
Apart from feeling sick, many women develop an increased appetite in pregnancy. The reason for this is not clear. Some foods are less attractive than others during pregnancy. Fried fatty foods are often avoided because they are more prone to cause indigestion or heartburn. Heartburn is a burning sensation behind the lower part of the breast bone and is caused by acid secretions from the stomach getting up to the lower part of the oesophagus (gullet).
This happens because the little mechanism that normally operates where the oesophagus and stomach join is less efficient in pregnancy. For this reason acid may splash up from the stomach, especially when the pregnant woman lies flat or bends over.
A craving for certain foods often occurs during pregnancy. Fruit usually features high on the list of cravings and highly flavoured or spicy foods, pickles, cheese or kippers are also popular. Cravings can also include unlikely items, such as coal, soap and toothpaste! The bowels are inclined to be sluggish during pregnancy and constipation is, therefore, very common. Unless the constipation causes discomfort it can be ignored.
CHANGES IN THE MOUTH
The gums may become a little swollen and spongy in pregnancy and they may bleed more easily than normal. Contrary to popular belief, the teeth do not lose calcium during pregnancy, not even when the pregnant woman’s diet is deficient in calcium. Pregnancy does not, therefore, damage the teeth directly. It does, however, seem to increase the risk of starting caries and of increasing the extent of existing caries. Dental check-ups are, therefore. especially important at this time.
Another widely held belief is that women make more saliva than usual when pregnant. However, measurement of the amount of saliva secreted does not support this idea. A possible explanation is that because some mothers-to-be feel sick they do not swallow the saliva and, therefore, have an excess of it in the mouth.
CHANGES IN BONES AND ]OINTS
Pregnancycause a softening of ligaments around the joints, especially in the back and pelvis. This looseness of back and pelvic joints, and the strain of walking about with an increasing weight of baby, often causes backache and pain in the sacro-iliac joints where the back joins the pelvis. Pain, low down in the back or pelvis, is often blamed on the baby ‘pressing on a nerve’, but it is more probable that the effect of the pregnancy on the bones and joints is responsible.
SKIN CHANGES DURING PREGNANCY
During pregnancy the blood vessels in the skin are more open than usual and this leads to the skin feeling warmer. This warmth is comforting in cold weather and may lead to disagreements between husband and wife about how wide the bedroom window should be kept open! In warm weather the feeling of heat is less welcome.
The skin all over the body shares in the change, including the skin lining of the nose. The increased blood flow here may lead to occasional nose bleeds or, if the skin lining is thickened by the change, to a tendency to snore. For this reason the poor husband may not only be cold at night, but kept awake!
Some women complain that they become more prone to skin blemishes andduring pregnancy, but for the most part the skin remains in good condition. Some pigmentation of parts of the skin, particularly on the face around the eyes and on the abdomen, has already been noted as a sign of pregnancy.
HAIR AND NAILS
The hair and nails grow more quickly in pregnancy, but this is not usually a problem. It does mean, however, that when the pregnancy is over the excess hair will fall out. Not surprisingly this can cause alarm, but it is a normal happening which never leads to baldness.
CHANGES IN BREASTS
A sensation of fullness and tenderness in the breasts is an early symptom of pregnancy and is followed by enlargement of the breasts as the pregnancy progresses. Enlargement is caused by an increase in the size and amount of the milk secreting glands and also by an increase in the amount of fat surrounding the breasts. Because of this increase in size it is advisable, throughout pregnancy, to wear a comfortable brassiere that gives good support to the breasts. The secretion of normal breast milk after the birth of the baby is dealt with in the breastfeeding post.
PSYCHOLOGICAL CHANGES IN PREGNANCY
Whole books have been written on the subject of psychological changes during pregnancy. But, in simple terms, there is no golden rule to apply to these. Many factors have to be taken into consideration, but the two most important are whether or not the baby is wanted and, later, on how much the mother-to-be is worried about the outcome of the pregnancy – i.e.,
- will my baby be normal?
- will I survive/endure/enjoy labour?
- will I be able to cope with looking after the baby?
- will my husband/partner still love me? etc.
As a general rule, it can be stated that attitudes to life tend to be exaggerated in pregnancy – the happy woman becomes happier, the anxious woman worries more and thewoman becomes even more depressed. The majority of women, the happy ones, will find, therefore, that is a time of increased happiness, but even they may occasionally become anxious and depressed for no very obvious reason. Provided the mother-to-be understands that the sudden changes of mood are normal, no harm results and a little sympathetic reassurance from an understanding husband is often the only treatment that she will require.