Pregnancy is one of the most amazing times in your life, for SO many reasons. As a midwife and a mom of three, I can completely relate to this! Today, I just want to dive into some of the reasons WHY we feel the way we do during pregnancy. Growing that little human takes so much out of you physically, emotionally, and mentally. Let’s find out the, WHY, to some of those early pregnancy symptoms, how MOST of them are related to one another, and what you might try to help!
Why do I feel like I could sleep standing up on a flag pole?
Your body is working so hard growing this li’l life within you (think placenta AND tiny fetus). There are changes in a few hormones in your body which can wreak havoc! One of these hormones is called progesterone. Progesterone relaxes things, (which is not always a good thing). Your blood pressure and blood sugar are often lower making you feel tired. Sometimes, things like depression and anxiety can be heightened in pregnancy and thus, cause fatigue. Anemia (or low red blood cell count) can also cause you to feel run down and tired. Your red blood cells carry oxygen throughout your body. So, in this case, less is NOT more. Usually, your doctor or midwife will check this lab value around 10-12 weeks and treat you with iron supplements if need be. Any other medications you take during pregnancy may have fatigue as a side effect (and you may have only just begun to feel it during pregnancy). Finally, disrupted sleep during the night can also make you sleepy during the day (more on that below). These disruptions include things like: getting up to use the bathroom during the night, being uncomfortable, snoring/sleep apnea, and having restless legs.
Here is your FULL permission to nap when you can! It’s ok, folding laundry, cooking big meals, and cleaning up can wait. Also, it’s ok to ask for help (if a friend offers to watch the other kids, take them up on it and lie on the couch)! Please don’t kill me for saying this…but a gentle walk, some stretching, or yoga can often be beneficial. When your blood gets flowing, you release some endorphins which should help you feel better all-around and less tired. So, if you can stand it…try to move some too.
OMG, I am so nauseous/I am puking all day (NOT just in the morning), and NOTHING smells good or appeals to me…but I AM sort of hungry?
One big answer is one little pregnancy hormone called Human Chorionic Gonadotropin (HCG). Nausea and vomiting can happen at ANY time during the day or night. Usually, the extremes of the day are the culprits (early morning or from dinner to bedtime). Some folks will tell you “it’s good that you’re sick, makes for a strong baby!” Ask them to kindly trade places with you for a day and then see what they say! Yes, the fact your body is now pumping out this pregnancy hormone IS a good thing but WOW, it can be rough! Nobody really knows why some women are more sensitive than others but we do know nausea is often worse with multiples and also seems to be worse when carrying a girl baby! Crazy, right?! Another cause for nausea can be the changes in digestion. The slower emptying of our stomachs can make us feel sick and often lends itself to heartburn too, yay us…
So, what do you do? PLEASE know what works for one woman, may not work for another. Also, what may have tasted good in one pregnancy, may make the same woman heave in another pregnancy. Here are some basics I have found to be helpful and what I try to pass on to women I care for:
-Find your “good” time of day and try to eat then. It’s ok to just snack the rest of the time. It’s usually best to avoid a truly empty stomach
-Salty and sour are good. Lemon/sour candies, lemonade, or citrus. Also, plain carb-ish foods tend to stay down (noodles, fries, baked potato with butter, chips, or crackers/pretzels).
-Mint is another calming flavor (gum, candy, or lozenges)
-Sea Bands-these are acupressure bands (think 70s sweat bands) which help calm the nausea center and restore balance to your body (approx. $10.00 in drugstores or on Amazon)
-ReliefBand-motion sick band used by fisherman etc. Sends pulses from wrist to brain to control nausea center (approx. $100.00 on Amazon)
-Ginger in any form (chews, candy, supplements, tea)
-Vitamin B6/Unisom (this is the active ingredient in the medication Diclegis). Preggie Pops are also made with Vitamin B6.
-Carbonation makes you burp and can sometimes feel good. I tell patients all the new bubbly, flavored waters are great!
-Eat like a toddler, graze all day. Smaller meals and snacks not only help keep the nausea at bay but will help with fatigue too.
Vomiting which starts AFTER 10 weeks or is accompanied by pain, fever, dizziness, diarrhea, headache or upper belly pain needs to be evaluated by a doctor or midwife.
Something called hyperemesis gravidarum (HG) is also abnormal. HG is a condition of persistent vomiting with changes in your electrolytes, weight loss, and presence of ketones in your urine. If you feel you this might be you, call your provider. He or she may want to evaluate you for medication and/or check your thyroid.
Can we talk about my boobs right now?
Thank you again hormones (this time estrogen and progesterone) are helping you to establish that framework necessary for breastfeeding down the road…speaking of road, I thought my breasts looked like a dang road map of the United States when I was pregnant with my daughter! What the hell are all the veins? Well, they were always there! Now, they are just bigger and carrying more blood which increases their appearance. Your breasts and nipples can be extremely tender, even painful. Try and talk to your partner in order to be sensitive to this; it usually does get better as time moves you into the second trimester. Your breast (and bra) size typically increases and your nipples can also get bigger and darken in color (think targets for the baby to find their first meal). Best just to go with the flow on this one! Support those breasts with comfy camis at bedtime and a supportive bra during the day.
Uh, where’s the bathroom and why did I have to get up 5x to pee last night?
Your newly growing uterus begins putting more pressure on the bladder therefore, it feels fuller quicker. HCG and other hormones also cause more blood flow to your pelvis. At night, all the fluid which collects in your arms and legs during the day gets processed by your kidneys as well! All these changes mean you have to pee, A LOT more than you did before pregnancy!
If you have pain when you urinate, blood in your urine, fever, or constant pain/ache in your lower back, you need to seek care with your doctor or midwife.
Pee; no let’s discuss poop…or lack thereof (and the gas…)
Because you are so tired, you probably are moving a lot less than you normally do, right? You are probably eating a low fiber/high carb diet (you know you aren’t craving all the good rabbit food right now). Dehydration and that lovely friend of ours, progesterone also combine to make bowel movements more firm and harder to pass in early pregnancy. All this combined can lead to more gas in our bellies and sometimes that means pain, ouch! It can also mean hemorrhoids. Try out some of the remedies for dehydration and fatigue, this can help here too! Hopefully, once your body gets used to all the hormonal changes, this will right itself. If not, try to increase your fiber. Miralax or stool softeners (Colace) can also help as a last resort (please ask your provider before using these).
If I am so tired, why CAN’T I SLEEP?
Sleep is the one place ALL of these symptoms seem related and come together. Insomnia (can’t sleep, can’t stay asleep, or can’t go back to sleep) can happen BECAUSE you have heartburn, your mind is racing in anticipation of so many changes, your nose is stuffy, your back or belly is hurting, you have to pee, you have to vomit, your legs are restless, or you are dreaming REALLY weird stuff. Caffeine and medication may also affect your sleep. Anxiety or depression…these are also associated with fatigue and insomnia.
I try to guide women down the natural route first. Try to establish a routine for bedtime. No screens for an hour or two before you go to bed. Turn lights down in your house after dinner. Warm bath before bed is also very relaxing. I am a huge fan of essential oils for this too-lavender on the feet or in the diffuser are great. Limit caffeine (1-2 cups/day and none after 4pm). If you cannot sleep in bed, GET UP. Go get a small snack or drink and lie on the couch. If you are sleeping well on couch, tell family to leave you there, surely you will wake up and come to bed the first time you have to pee, right?! I know apps exist which play calming sounds or even tell stories to lull you to sleep, don’t discount these. Several medications are proven safe in pregnancy but please ask your provider on those prior to use.
This is the middle of August, not allergy season…my nose is so stuffy and my head is pounding! GRRRR
Hormones, these hormones I say!!! Progesterone and estrogen increase blood flow to SO many places in pregnancy. Your nose has mucous membranes with all these tiny little blood vessels. They are fuller now and can be swollen, making you feel stuffy…ALL THE TIME! You can also have a runny nose because of these changes to the mucous membranes. Your response to the changes in hormone levels can cause headaches as well. If you are a woman who feels headaches normally around your cycle, you are familiar with how changes in hormone levels make your body feel. Finally, dehydration is yet another cause of headaches.
You do NOT want to take decongestants while pregnant. Steer clear of those. A Neti Pot, Navage, or regular/plain allergy medication are usually OK for headaches. Tylenol is usually OK as well. I advise women to be as hydrated as possible then take some Tylenol with a serving of caffeine to help alleviate headaches. Ibuprofen (Advil, Motrin) and aspirin should not be used for headaches in pregnancy. Heat or cold applied to the head can feel good. Stretching or a gentle walk can help too. Again, always go with the advice of YOUR provider, these are just some guidelines.
All I did was walk up the stairs, why is my heart thumping and I feel like I just ran a marathon?
You have some big things happening to your heart and blood vessels during pregnancy. You are basically doubling your blood volume during this time. Your heart beats faster and has to do a lot more with each of those beats. So, when you think about it…your heart and lungs have to work in excess to give your blood oxygen and then carry it to all the needed places in your body and to the baby! Gravity also makes it harder to circulate blood if you are standing upright too! Jeez, there’s a lot going on we don’t even control but we sure do feel the effects!
So, just slow down and be easy on yourself! Although some changes in breathing can be normal, it is always necessary to seek care if you have a cough, wheezing, fever, palpitations (heart skipping a beat or continual pounding), or increase in your heart rate which is consistently above 120bpm
Damn, I feel so lightheaded, am I gonna pass out?
Remember, our bodies are working so hard and sometimes they tell us to slow it down and let things work. Do you recall Victorian-era times, at the end of the beds, typically there sat a small couch? These were actually “fainting couches!” Many women would pass out being dressed in their corsets, a sure sign they might be early pregnant (and so common they prepared for it)! Dehydration can also be reason for this feeling. I get it, can be very hard to stay properly hydrated when you feel nauseous, are throwing up, or nothing tastes good. Some ways to get hydrated without having to chug a bunch of water: popsicles, coconut water, soft ice to chew on, fruit, watery veggies, watered down juice, and smoothies. If you need to just water down Gatorade or Sprite with a bunch of ice, that’s better than nothing in my book. Just know, a lot of sugar is not good long-term. Water is always best! The light headed feeling should improve if you lie down. If you feel like you are still struggling, even with adequate hydration and lying down on your side for a time, please seek out your care provider
If my period has stopped, why am I crampy and feel like my period is about to start at any second?
Your uterus is growing about 1cm per week once you become pregnant. Remember, it is a muscle and we sense that growth/expansion/contraction as cramping. This can be totally normal. If this is so painful you cannot do what you normally do on a daily basis or start to bleed, you need to contact your OB care provider. You also have ligaments which hold the uterus stable. As your uterus grows, these pull and stretch (this is called round ligament pain). This pain is usually worse when you first get up, roll over in bed, step up, or do a lot of moving. If it comes and goes, usually that is a good sign-something dangerous tends to NOT go away! Yet another hormone called relaxin can be felt here too. Relaxin does what it sounds like it does; it relaxes your joints and ligaments (especially in the pelvis). Therefore, your low back and hips may hurt as well!
You can soothe this with warm packs, abdominal support band (pregnancy band), resting, and stretching, or a warm bath.
Most women feel some or all of these pregnancy signs by 5-8 weeks after they miss their cycle. I try to reassure my patients this is all for the greater good (meaning your new lil human) but MAN does it feel like near-death at times! AND…with each pregnancy, typically women feel things sooner and often, more pronounced. The good news is, most of this significantly improves for MOST women by about 14 weeks.
Some symptoms to be concerned about:
- Vaginal bleeding which is more than spotting (especially if painful)
- Abdominal/pelvic pain which does not subside or it worsens over time
- Fever
- Shortness of breath that does not improve with rest/any chest pain
- Persistent vomiting
As always, things discussed here should not replace YOUR doctor or midwife’s advisement. I just want you to feel supported and not alone in this journey called pregnancy!