First of all, let’s go over some anatomy basics to give you a good idea of what happens during pregnancy, and why certain discomforts arise. The uterus is made of very strong and powerful muscles, three layers in the upper segment and two layers in the lower segment. The birth canal, also known as the vagina, leads to the cervix, which is the opening to the uterus. The cervix is three to four centimeters long, and it’s as hard as the tip of the nose. The cervix is closed when not in labor. Make a fist, and you’ll see that’s how small a non-pregnant uterus is. But it multiplies greatly in size during pregnancy, 15 or 20 times bigger, to the size of a large watermelon! It’s no wonder the body experiences stresses under that kind of change.
Inside the uterus is the placenta. The upper anterior part of the uterus is where the placenta should normally be. Coming out of the placenta is the umbilical cord — two arteries pumping blood to the baby containing oxygen and nutrients, and one vein returning the blood back to the mom with all the waste products and carbon dioxide. This is called the fetal maternal circulation. As for the baby itself, it is very comfortable in the womb. It’s very dark. It’s very warm. The baby is in amniotic fluid, floating and swimming all the time. This amniotic fluid provides cushioning and comfort, and the placenta is feeding the baby, and life is good inside.
But for the mother, a lot of changes are going on in order for the pregnancy to happen, in order to grow a baby. It’s a process that takes almost nine months, and drastic changes happen over those nine months. And the area around the uterus are not all the changes that happen in the body — the entire body changes. One mom mentioned that even the texture of her hair was changing throughout her pregnancy. So be prepared, moms…changes will occur all over your body, and not all of them will be welcome.
Common Discomforts in Pregnancy
When it comes to changes that lead to discomfort, let’s start with the breasts. What happens to the breasts in pregnancy? They get bigger. Why do they get bigger? They are the milk-producing factories, and they are gearing up for the impending birth. But when a breast gets bigger, sometimes it’s more tender or slightly uncomfortable. There are some various products you can use to deal with this discomfort. Wearing a special bra throughout the day, either a comfort bra or a sleep bra at night, helps with that tenderness.
And what happens to the mom’s lungs as baby gets bigger? They get pushed upwards, and it makes breathing slightly challenging. And the diaphragm, which separates the chest from the abdomen, is an important powerful muscle when we talk about bearing down and pushing, and now it needs to work harder, especially by the time you hit 37 weeks and later.
The liver, and closer to the midline the stomach, and the intestines, and the bladder will all be pushed and squished to the side and below and all around, and you can probably guess where a lot of your discomfort comes from. In particular, the bladder gets squeezed a lot, as there’s a baby sitting on it the whole time squishing it. That’s why pregnant women use the restroom frequently, because there’s a basically a bowling ball worth of weight sitting on their bladders.
When the Baby Drops
You probably hear that expression a lot, “The baby has dropped” or, “My baby has dropped.” Throughout the entire pregnancy, the baby is in the abdominal cavity, which takes up the space above the pelvis. The baby is expected to stay in the abdomen throughout most of the pregnancy. But anywhere between 36 to 38 weeks, in preparation for birth, they drop lower down and their head falls into the pelvis to prepare for vaginal birth.
You know what comes along with that dropping? More frequent urination because now the bladder is even more squeezed. But as a side benefit, maybe breathing becomes a little easier along with your ability to eat a little bit more than you’ve gotten used to, because there’s relief on the pressure up above, although now there’s more pressure down below.
Ligament and Pelvis Pain
The uterus is not just floating in the inside of the body, but it’s actually fixed to the three major pelvic bones by ligaments — two round ligaments on the sides and a thick ligament in the back. There can be a lot of pain at any of the ligaments, but especially a lot on the back area during the last few weeks of pregnancy, because the growing uterus is now applying a lot of tension on this very thick and important ligament.
There are three major primary fused bones in the pelvis by the time we are adults. And the joints formed by these pelvic bones can get tender and sore during pregnancy, due to the pressure and weight and tension and pulling. I’m sure that there are some pregnant moms right now rubbing the front, side or rear joints of their pelvis because they feel pain right there because of the inflammation in their pelvis joints.
Some Ways to Relieve the Discomfort
Let’s touch on some ways to relieve those discomforts. You’re going to discover all kinds of discomforts in pregnancy, so you should understand how you manage them and where they come from.
Loose joints happen because of the relaxin hormone. This hormone is responsible for relaxing the three major pelvic joints. Can you imagine when those three joints relax, what happens to the pelvis? That’s right, it becomes more roomy, there is more space, there is more room for the baby’s head to come out. Because in order for that baby to be born vaginally, the head and the entire body needs to travel down this bony pelvic cage. So relaxin creates extra space and extra room for the baby. But it also relaxes the rest of the joints, which can cause discomfort for you.
Where do you think your backache is coming from? Remember, it’s coming from the rear pelvis area, mainly due to the large ligament connected to the uterus. But not only that, not only the tension on that ligament, but can you imagine the impact of carrying an extra 25 to 35 pounds, and what that does to your lower back? It definitely hurts. Can you imagine the impact of the shift of the center of gravity forwards? Pregnant women always look like they are leaning back when walking, and it doesn’t make their spine happy. All of it adds up a lot of tension on their lower back.
Pregnant moms, please avoid wearing high heels, they’re going to hurt you a lot. Avoid standing a lot — that will also hurt. Make sure that you sit down frequently, and lay down and rest because standing a lot is going to add to your back pain.
Back Pain Relief
There are some effective ways to treat or alleviate the pain that you feel in your lower back. Husbands, partners and support people can do back massages that help a lot, by using their hands or fists and gently applying firm pressure on the back where it hurts, and moving them in small circles.
Another effective way to alleviate the back pain is alternating heat and cold. What’s the cheapest heat pack that you can make at home as a hot pack? You can put uncooked rice in a sock and microwave it for a couple of minutes. Place that on your lower back. Then ready a Ziploc bag with some ice in it, and put that onto your back after the hot pack. Ten minutes hot, ten minutes cold, ten minutes hot, ten minutes cold — alternating heat and cold will help a lot with the pain.
Pain along the side occurs because of the tension on the round ligaments. And for that we have the maternity support belt as a remedy. Pregnant moms who have used a maternity belt usually rave about it because it lifts the uterus and takes the pressure off of the round ligaments. For back pain, there’s a bigger belt that you can wrap around your entire belly, and it supports your back as well as the sides. Please start wearing these when you feel uncomfortable and it feels really heavy around your sides and back. That’s going to be the best time to start using these belts.
Other Discomforts of Pregnancy
All right, let’s go over some other discomforts. Heartburn can be horribly painful and uncomfortable, right? Why does that happen? The relaxin hormone relaxes the valve that is supposed to prevent the acid reflux at the bottom of your esophagus. So heartburn happens more easily. You want to avoid bending over right after meals, and you want to avoid spicy food and citrus foods that increase acidity.
You want to have an antacid readily available at all times. But if you discover that you’re taking a whole bottle of antacid every day, you may want to consider talking to your provider, and they will prescribe a different recommended antacid for you instead, because many OTC antacids have too much calcium which can lead to kidney stones. So watch out for that and don’t take a whole bottle of OTC antacids every day.
Shortness of breath is another common discomfort. And that feeling of not being able to breathe comfortably can be exacerbated after you eat heavy meals. It happens often in pregnancy because everything above the baby is squished upwards. One of the ways to cope is to not eat the entire plate every meal… just eat half your plate initially, and after three hours come back and finish the rest. That’s going to be a lot easier for your breathing.
Frequent urination is something we already touched on. It happens because of the weight on top of the bladder and because there are extra fluids in your body due to the retention that pregnancy hormones cause. Consequently, the kidneys get rid of the extra fluids, causing more urine.
Constipation is a common discomfort, because the relaxin slows down the wave-like motions of the intestines that move digesting food along. If you experience constipation, eat a high fiber diet, drink plenty of water, walk a lot — that’s all going to help. But if that’s not helping enough, prunes and prune juices can provide relief, or perhaps stool softeners under your provider’s supervision.
For some people with longstanding constipation, or even without constipation, hemorrhoids or piles can commonly occur with pregnancy. They’re basically congested veins around the anal opening. The good news is that they are usually reversible by the end of the pregnancy — they typically just go away on their own soon after birth.
Muscle cramps in your legs or other parts of the body are common with pregnancy, and we don’t really know why exactly. But we know that dehydration and exhaustion are the two major predisposing factors. If you exercise vigorously and go to bed, you’re probably going to get a lot of a lot of cramps. If you stand the entire day and forget to rest, you’re going to get cramps in the middle of the night. And if you’re not drinking enough water, you’re definitely going to get cramps a lot. So make sure that you avoid overexertion and dehydration.
What should you do if you get cramps in the middle of the night? When the cramp subsides, get out of bed and start walking around a bit. Have your partner massage the cramped muscles and stretch them out for you and relieve the painful knotted feeling.
When pregnant, you’ll notice that you are generally swollen, as there are lots of fluids retained in your body. And that swelling may be more obvious in your feet and legs because of gravity. So try to lift your feet if you’re sitting all day. If you’re sitting watching TV or on your laptop, try to place your feet higher than your heart so that the blood returns easily without causing swelling in your feet.
But you want to avoid sleeping on your back as much as possible, because when you lay on your back for hours, you’re compressing a major vein that brings blood from the lower half of the body back to the heart. You don’t want to do that. So sleeping on your sides is a better idea. Sleeping on your back won’t kill you… it’s just not the preference.
Stretch marks are another common discomfort; your skin is stretching and some of you will see some stretch marks, which are mostly reversible. And they’re not really a medical problem, they’re mostly cosmetic and nothing to truly be concerned about. Regularly massage moisturizers into your belly before you see stretch marks appear and you may be able to prevent them.
Forgetfulness and clumsiness happen to many pregnant moms, and it’s sometimes called “pregnancy brain” or “pregnancy fog.” Dads or support persons can get it too — it’s very common and happens to them out of empathy as well as love for the new mommy. Don’t worry, this is not a permanent memory impairment, just temporary during pregnancy.
Pregnancy is a beautiful time, but it can also be an uncomfortable one. Make sure you are ready in advance and prepare strategies for you to cope effectively. That way you can lower your overall discomfort and stress levels and be well prepared for the birth and delivery of your healthy baby.
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