Navigating Pregnancy Pitfalls

If you’re dealing with some of the unpleasant side effects of pregnancy, we’ve got expert advice on how to make it through.

Illustration by Marco Goran Romano

Varicose Veins
Most pregnancy problems are the result of hormones, says Caitlin McCarthy, M.D., at Seven Hills Women’s Health Center. “Specifically, progesterone is the bad guy.” It relaxes the smooth muscles that form the supportive tissue of internal organs and blood vessels, causing veins to dilate and blood to pool. The result? Two-thirds of women will experience those unsightly, bulging, painful leg veins during their reproductive years. Ugh.

What to do: McCarthy says prevention is key. Buy compression hose, avoid prolonged standing, and elevate your legs whenever you can. “Activity is good!” she adds. “Anytime you get your legs moving, it helps pump the blood back to your body and heart.”

tummy trouble
Hormones strike again (that pesky progesterone). This time, it’s uncomfortable—and unflattering—GI issues. The progesterone relaxes the muscles around the digestive tract. That can cause gas and constipation, which will likely lead to hemorrhoids. “Hemmies” (for those with intimate familiarity) are basically varicose veins in the rectal area, typically the size of peas—and horribly achy.

What to do: Again, it’s all about prevention. Exercise regularly and do Kegel exercises, increasing circulation to the area. Increase dietary fiber; fiber powder and stool softeners can help, but be sure to drink lots of water, McCarthy says. Avoid straining during bowel movements.

If you develop hemmies, soak your bottom in a sitz bath basin filled with warm water. A cool compress soaked with witch hazel feels delightful. “Usually hemorrhoids improve after delivery,” McCarthy says.

For flatulence, try to avoid trigger foods. Gas relief capsules and digestive enzymes, which help break down food, can be effective and safe. Discuss all supplements with your medical provider.

Urinary Leaking
Baby presses on your bladder, progesterone loosens the sphincter muscles, and without warning a laugh or sneeze causes a gush of pee.

What to do: Again, Kegel exercises. Always pack extra underwear, and wear incontinence panty liners if leaking is frequent. Don’t cut back on water and don’t hold urine too long, as that predisposes you to infection, McCarthy warns. Bladder infections can appear without typical symptoms, she adds, which is why your OB asks for a urine sample at every visit.

should you get a first-trimester screening?

What: The First-Trimester Screening (FTS) is optional for all pregnant women and assesses your baby’s risk of abnormalities. It consists of a maternal blood test and fetal ultrasound, combined with maternal factors (like age) to determine the risk factor.

Who: A family history of genetic disease may warrant an FTS. Also, women over age 35 might be interested, says Susan Emmerling, an obstetrician with Lifestages Centers for Women, Premier Physician Network, as there is age-related risk of a fetus with genetic problems.

Why: FTS can detect possible abnormalities like a heart defect but not neural-tube defects. It also indicates the risk for chromosomal abnormalities like Down syndrome (as well as Edwards and Patau syndromes, which are typically fatal before birth or within the first year). FTS is offered at 11–15 weeks and is the most accurate noninvasive genetic test. A positive FTS result does not necessarily mean a defect; it is an indication of risk, prompting your practitioner to offer further testing, cautions Emmerling.

How: Insurers typically cover FTS. It provides an opportunity to mentally prepare for a pregnancy that may require interventions, and for coordinating exceptional care and resources for a newborn with special needs.

Learn about prenatal screenings at American

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