Nausea and Vomiting

The most common problem encountered during pregnancy is nausea and vomiting. Many causes have been suggested for nausea and vomiting in early pregnancy, such as hormones secreted by the placenta, vitamin B6 deficiency, pregnancy-related changes in the gastrointestinal system, and excessive activity of the thyroid gland. During pregnancy, the stomach and intestines empty more slowly under the influence of pregnancy hormones. Accordingly, complaints such as indigestion, bloating, and gas may occur.

Although nausea and vomiting are more common in the morning, they may occur at any time of the day. They are generally more severe in first pregnancies, young women, and twin pregnancies. Nausea usually starts in the 6th-7th week of pregnancy and decreases by the 12th week of pregnancy.

Eating more frequent and smaller meals throughout the day reduces nausea. Taking small amounts of fluid during meals also helps recovery. As a dietary approach, prefer solid, dry, low-fat, and salty foods. Avoid unpleasant smells and foods. Especially stay away from kitchen odors and heavy perfumes.

Frequent Urination

Changes in kidney functions and enlargement of the uterus during pregnancy make you feel the need to urinate frequently. You may even leak urine while sneezing, coughing, or laughing. The reason for this is the pressure of the growing uterus on the bladder. Reducing fluid intake throughout pregnancy is definitely not recommended. Because drinking plenty of water has many positive effects on pregnancy. Urinate whenever you feel the need. Holding your urine may prevent your bladder from emptying completely and may lead to urinary tract infection. If frequent urination (pollakiuria) is accompanied by burning and stinging while urinating (dysuria) and groin pain, this may be due to a “urinary tract infection”; consult your physician.

Breast Tenderness

The increase in the secretion of hormones called estrogen, prolactin, and progesterone is the main cause of changes in the breasts of pregnant women. In this case, avoiding tight underwear while sleeping and avoiding contact with the nipples to prevent breast stimulation will reduce such complaints to some extent.

Weight Gain

The generally recommended weight gain during pregnancy is approximately 12-15 kilograms. This amount may vary according to the mother’s pre-pregnancy weight. If you started pregnancy overweight, it is recommended that you gain 7-8 kilograms. If you are expecting twins, a weight gain of 17-22 kilograms is normal. If we consider the ideal weight gain to be approximately 12 kg, 4 kilos of this should be in the first half of pregnancy (first 20 weeks), and the remaining 8 kilos should be in the second half of pregnancy. In the first three months, your weight usually remains stable. In fact, in cases where nausea and vomiting are severe, some weight loss may even be seen. In this case, there is no need to panic. When nausea ends, weight gain begins. Do not worry that the baby will be undernourished during this period.

Abdominal and Groin Pain
 

When you first become pregnant, you may experience pain in your groin, hips, and lower back similar to menstrual pain. As the uterus grows, the connective tissues that hold it also stretch. This stretching is the cause of the pain. The female uterus is the only organ in our body that can grow this much beyond its own size and return to its previous state after birth. The main cause of the pain and burning sensations seen during this period is the increase in the weight and size of the uterus, along with pregnancy hormones.

Although this pain in the groin may be uncomfortable, there is no need to worry. If your pain is more severe than intense menstrual cramps, consult your doctor.

Lower Back and Back Pain


During pregnancy, the joints between the bones in your hip area soften and loosen. These are preparations that allow the baby to pass through this area during birth. During this period, the weight of your uterus increases and the location of your center of gravity changes. As a result, over time and perhaps without even noticing, your body shape and walking pattern change. Changes in the center of gravity cause back pain. To minimize your complaints, do not strain yourself too much, avoid lifting heavy loads, and rest by lying down when your pain increases. Also avoid wearing high-heeled shoes, which negatively affect lower back and back health. Always prefer flat shoes, preferably with orthopedic soles. Exercises that work the muscles in your abdominal area will help reduce lower back and back pain.

Leg Cramps

Leg cramps are generally common after the 3rd month. They occur especially at night and can sometimes be severe enough to wake you from sleep. Although the exact cause of leg cramps is unknown, calcium and magnesium deficiency are generally blamed. If leg cramps bother you a lot, first do stretching exercises for your hip muscles. Avoid sitting for long periods or walking for long periods. Massage and warm applications to that area may be relaxing. Calcium, magnesium, or vitamin B6 may be prescribed to patients with cramp complaints.

Heartburn

The most common cause of heartburn is the backflow of stomach contents into the esophagus, known as “reflux”. As a result, stomach acids irritate the esophagus. There are several reasons why reflux occurs more frequently than normal during pregnancy. The most important reason is that the growing uterus pushes the stomach upward. Another reason is that the functioning of the digestive system slows down under the influence of hormones (especially the progesterone hormone), and the movement of food through the esophagus by wave-like motions slows during pregnancy. Emptying of your stomach is delayed and food empties more slowly from the digestive system. As a result, complaints such as indigestion, bloating, and nausea may also occur.

To prevent nausea and vomiting, eat small and frequent meals. Avoid highly acidic foods and excessively spicy and fatty foods. Do not consume excessive amounts of tea, coffee, and chocolate.

Prefer boiled-type pot dishes instead of fried foods. Drinking soda may sometimes reduce your complaints. Also avoid movements and positions that increase your heartburn, such as sudden bending forward. You may even place another pillow under your head at night and raise your head a little more.

Constipation

Constipation is a common problem during pregnancy, and its most common cause is the general slowing of the digestive system and the pressure of the growing uterus on the final part of the intestines.
In addition, constipation increases the development of hemorrhoids and anal fissures in the later stages of pregnancy. The most important treatment and prevention method for constipation is a fiber-rich diet and plenty of fluid consumption. You can also drink plenty of apricot, plum, and fig compotes and natural fruit juices to help the intestines work comfortably. Drink a glass of warm water on an empty stomach before breakfast in the morning. In addition to all these, increasing your exercise may also help reduce this problem.

Anemia

During pregnancy, blood volume increases by 50 percent, and accordingly a relative anemia picture appears. In addition, the baby’s increasing needs during pregnancy increase your body’s iron requirement. While your daily iron requirement before pregnancy is about 15 mg, twice this amount is needed during pregnancy. Anemia in pregnant women may cause problems such as fatigue, weakness, palpitations, chills, shortness of breath, dizziness, and decreased body resistance. The only treatment for anemia is taking iron. A daily intake of 60 mg of elemental iron is recommended. Therefore, pregnant women who need it should take additional iron from the 16th-18th week of pregnancy onward. It is also beneficial to consume foods rich in iron.

Edema in the Legs

Edema seen especially in the later stages of pregnancy as a result of the growing uterus pressing on the blood vessels returning from the legs generally does not cause a serious problem. To reduce edema in the later stages, it is recommended not to stand still for long periods, not to consume excessive salt, and to elevate the feet by placing a pillow under them while resting.

 Op Dr İsmail KÜÇÜK / Obstetrics and Gynecology Specialist / İRENBE