Standing, Sitting and Lying Down Comfortably

• Standing – “Think Tall and Proud” Tilt the pelvis back to prevent your heavy uterus from angling forward and putting excess stretch on the abdominal muscles as well as compressing the lumbar region in an exaggerated curvature. Tighten your belly and tuck in your buttocks. Think of carrying your baby in the pelvis and not in front of you.
• Sitting – Try to sit with your back straight and your pelvis square with your shoulders. When arising, slide to the edge of the chair, lean forward and lift yourself to a standing position using your legs. Taylor sitting allows the uterus to lean away from the spine and can relieve pressure on the back.
• Lying Down – Option include 3 primary positions.
• Supine (flat on your back) – place a pillow under the knees to flatten your back and try to raise your feet above the level of your heart to increase circulation and prevent varicose veins and swelling.
• Semi-reclining – Use pillows to raise your head and shoulders to about a 30 degree angle. Place pillows under your knees/thighs for comfort.
• Side-lying – Support you head with a pillow that keeps your neck in line with the rest of your spine. Slightly bend your knees and keep them together with a pillow between them. Use a pillow under your belly to prevent forward rotation of the pelvis and a strain on your back.

Backache (lower)

This is most often contributed to by an increase in the lower back curvature (lordosis) and or the action of a hormone called relaxin which contributes to the softening of the ligaments. The spinal joints can become compressed by these two mechanisms.

Prevention

· Remain in top physical condition prior to pregnancy.

· Observe healthy posture.

· Avoid excessive strain and fatigue.

Relief

· Maintain good posture.

· Observe good mechanics while lifting.

· Avoid high heeled shoes.

· Chiropractic care and Massage therapy

· Try hot packs to promote circulation to sore muscles.

· Exercises – pelvic rock, squatting, abdominal strengthening

· Natural Remedies – Arnica or other homeopathic remedies (Topricin)

Backache (upper)

Upper backache usually results from the muscular strain of your increased breast size. Your body soon adjusts to the change and the problem usually resolves on its own by the second trimester.

Prevention

· Maintain good upright sitting posture. Avoid allowing your shoulders to sag forward.

Relief

· Wear a bra with good support to minimize breast movement.

· Exercises – shoulder rotations and arm circles.

· Natural Remedies – Arnica or other homeopathic remedies (Topricin).

Bleeding and Tender Gums

Bleeding gums result from the increased blood volume of pregnancy and the effect of increased estrogen; softening of the gum tissue. This condition is usually self-limiting and resolves a month or two after delivery.

Prevention

· Brush your teeth 3-4 times daily with a soft bristled brush.

· Floss your teeth daily.

· Be sure your diet is high in vitamin C and calcium.

Relief

· Follow the above prevention steps.

· Consume a diet high in fresh and raw fruits and vegetables.

· Gently massage your gums with clean fingers.

Breast Soreness

Breast sensitivity during pregnancy results from the development of milk-producing tissue and your 30 to 40% increased blood supply. The increased size and development of your milk-producing and milk-bearing glands are orchestrated by the hormones of pregnancy and, alas, is not preventable. However, avoid using drying soaps on your nipples.

Relief

· Wear a well fitting supportive bra to alleviate discomfort from added breast weight.

· Avoid soaps or alcohol containing preparations which may remove protective skin oils and predispose the nipples to soreness and cracking.

Breathing Problems

Most often occurring in the third trimester, breathlessness is a purely mechanical problem caused by the uterus taking up so much space. There is less room in the abdomen and chest cavity to breath as deeply as you do when you are not pregnant. Third trimester breathlessness is not preventable.

Relief

· Sit straight. Slumping further closes up the space for full lung expansion.

· Stretch your hands over your head.

Constipation

Especially common during the second and third trimesters, this condition results from multiple pregnancy induced factors. Progesterone causes smooth muscle relaxation which slows gastric motility predisposing to constipation. The growing uterus also displaces and compresses the intestine, impeding circulation. Some pre-natal vitamins high in iron can also contribute to the condition.

Prevention

· Drink plenty of fluids. A general rule of thumb is to drink half your body weight in ounces of water every day. Avoid caffeine products and sodas.

· Include lots of high fiber foods in your diet. Whole grains, seeds and nuts, dried or fresh fruits and raw and cooked vegetables.

· If you are taking an iron supplement with or in your pre-natal, make sure it is an organic form of iron such as iron fumarate, iron peptonate or iron picolinate versus the less expensive and more commonly found ferrous sulfate.

Relief

· Eat prunes or drink natural prune juice.

· Avoid straining during bowel movements.

· Exercise – walk daily and exercise regularly.

· Natural Remedies – Acidophilus or herbal formulas safe for pregnancy. Avoid cascara sagrada, a natural laxative that may cause birth defects. Promote regularity with an herbal bulk colon cleanser such as psyllium husks. Avoid mineral oil which can interfere with mineral absorption.

Dizziness or Faintness

Especially after an abrupt change in position, this condition occurs as a result of a drop in blood pressure associated with the stress of gravity.

Prevention

· Change positions slowly.

· Observe good body mechanics as described earlier.

· Exercise regularly.

Fatigue

Fatigue is common during the first trimester and the third. Each timeframe has its own reasons for the development of the condition. In the first trimester the condition is the result of hormonal changes, altered metabolism and the physical and emotional changes you experience during pregnancy. Third trimester fatigue usually results from the physical stress of the increasing weight of the baby as well the physical and emotional changes that take place before giving birth. Pregnant women require more sleep than those who are not pregnant.

Prevention

· Try to get a full night sleep every night.

· Rest for half an hour once or twice during the day as you feel the need. If this is inconvenient, a few minutes here and there will help.

Relief

· Be sure to eat a well balance, high protein diet to avoid anemia.

· Have your health care provider check your blood iron level.

Flatulence

Particularly in the third trimester, flatulence can be common in pregnancy. You may also feel bloated and overfilled. As with the condition of constipation, the enlarging uterus causing pressure on the intestinal tract is the most common cause.

Prevention

· Avoid junk foods and carbonated drinks.

· Avoid gas producing foods such as beans, corn, cabbage, broccoli, fried foods and dairy products.

Relief

· Establish regular daily bowel movements.

· Exercise – Daily walking may help minor GI problems such as this.

· Natural Remedies – fennel, peppermint or ginger tea; homeopathic remedies labeled for flatulence, acidophilus supplement, herbal bulk colon cleansers or probably the best; digestive enzymes.

Finger Tingling and Numbness (Carpal Tunnel Syndrome)

From mildly annoying to severe and quite painful, this condition is caused by pressure on the median nerve which passes through the front of the wrist in a tight space known as the carpal tunnel. The median nerve carries both sensory and motor signals to the hand and when compressed can cause the mild tingling or in severe cases, a loss of motor skills and grip strength. During pregnancy, the most common cause is edema combined with a B-6 deficiency. The extra blood volume and resulting extracellular fluid is more likely to collect and put pressure on the nerve. Another cause is the posture of the shoulders in the pulled back position, a typical late pregnancy posture. As your chiropractor will say, the mechanics of the neck, shoulder, elbow, wrist and hand can be affected as well and contribute to nerve pressure and edema.

Prevention

· Maintain good wrist posture while typing or using your fingers for prolonged periods.

· Observe good posture especially while standing paying particular attention to the shoulders.

· At the first sign of tingling while typing take a break and perform specific stretches as prescribed by your chiropractor.

Relief

· See your chiropractor.

· Supplement with vitamin B-6.

· Identify aggravating activities and minimize them.

· Exercise – Shoulder rotations, specific hand and wrist stretching and strengthening.

Food Cravings

Pica is the term for the sometimes bizarre cravings women get during pregnancy. The most common form is the “pickle pica”, but these strange cravings can commonly include sweets, sours and dairy foods and less frequently but more unusual laundry starch, dirt, clay and even inner tubes! Pica is a transitory phenomenon and is of no serious concern unless the mother eats dangerous substances.

The cause of pica is uncertain, but many believe that a craving can be an indication of a deficiency or what you need in your diet. Why someone would need inner tubes, I have no idea!

Prevention

· Be sure you are eating a well balance diet and taking a readily assimilated prenatal vitamin. However, this is no guarantee that you will not experience food cravings.

Relief

· Satisfy the craving if you are also eating a nutritious, well balanced diet and the substance is not inherently dangerous.

Groin Pain

Discomfort in the groin area is a common problem especially in the latter months of pregnancy. This may range from a sudden sharp pain to a vague discomfort. When noted during transitions or position changes, this pain is often related to the round ligaments which are ligaments that hold the uterus in place.

Prevention

· Rise form a lying position slowly and gently. To get out of bed, roll to one side first and then ease up to a sitting position.

· When resting, lie on one side with a pillow under your abdomen to support the uterus and another pillow between your knees

Relief

· See your chiropractor.

· Take a warm bath to ease the tension on the tissues.

Headaches

Headaches can be common any time during pregnancy. They have a variety of causes from emotional tension to sinus congestion, both also common during pregnancy. Headaches can also be related to the stresses on the structure of your body as you adapt to the pregnancy posture. Chocolate, hard cheese or red wine are common headache triggers.

Warning: A severe continuous headache may be an indication of preeclampsia (a pregnancy disease characterized by high blood pressure, severe continuous headache and excessive swelling). If a headache persists or becomes severe, consult your healthcare provider.

Prevention

· Get adequate rest and plenty of fresh air each day.

· Avoid long periods without eating to maintain blood sugar levels and avoid sweets.

· Drink plenty of water. Avoid caffeine.

Relief

· See your chiropractor.

· Relax in a quiet place with a cold compress.

· Exercise – head and neck rolling, gentle stretching

· Natural Remedies – homeopathic remedies labeled for headaches, white willow bark tincture or relaxation exercises.

Heartburn

This aggravating discomfort is a burning sensation in the lower chest or upper abdomen. It results when stomach acids are regurgitated into the esophagus. The lining of the esophagus is not protected against the acidic contents of the stomach. Several reasons account for the increased incidence of heartburn during pregnancy. Firstly, there is less physical room for the gastrointestinal organs. Also the hormone progesterone relaxes the smooth muscle of the cardiac sphincter (the valve at the top of the stomach) and makes it easier for the contents to come back up. The progesterone also slows gastric motility and delays the stomach emptying.

Prevention

· Observe good posture to make more room for digestion.

· Eat small frequent meals, keeping the stomach from getting too full.

· Avoid rich, greasy or highly spiced foods.

· Avoid coffee.

· Do not lie down after eating.

Relief

· See your chiropractor to ensure good nerve conduction to the stomach and the cardiac valve. They may also perform organ manipulation to reduce tension on the stomach and valves.

· Natural Remedies – Drink chamomile, fennel or peppermint tea after meals. Acidophilus supplements may be helpful. Slippery elm throat lozenges may ease severe heartburn.

Hemorrhoids

Hemorrhoids result when the uterus is the heaviest and exerts pressure on the veins in the rectum. Constipation and straining at bowel movements are often the indirect causes and can aggravate an already existing problem.

Prevention

· Avoid constipation as previously discussed.

· Avoid constrictive clothing that may impede circulation. Avoid inorganic iron supplements that can lead to constipation.

Relief

· Use a sitz bath in very warm or hot water.

· Use ice packs to numb the area and help hemorrhoids to recede.

· Rest with hips and legs elevated on cushions to reduce blood pressure.

· Exercise – pelvic floor strengthening and pelvic rocking.

· Natural Remedies – homeopathic hemorrhoid creams, homeopathic tablets labeled for hemorrhoids, witch hazel pads. Bioflavinoids can strengthen the exterior blood vessel walls.

Insomnia

Especially common during the last weeks, your body is preparing you for life with a baby. Other factors can include the inability to get comfortable, waking multiple times to urinate or Braxton-Hicks contractions.

Prevention

· Try to keep a regular sleeping schedule.

· Avoid large meals two or less hours before bed.

· Find the most comfortable position as discussed earlier.

Relief

· Take a warm relaxing bath before bed.

· Drink chamomile tea before bed.

· Try different sleeping positions.

· Get daily exercise.

· Natural Remedies – homeopathic remedies labeled for relaxation. Teas from chamomile or passion flower, lemon balm or marjoram.

Leg Cramps

Usually in the calf region, leg cramps can result from increased pressure of the uterus on the nerves, decreasing circulation in the legs. An imbalance of calcium and phosphorus is the most common cause. This can result from drinking too much milk which disturbs the balance of the minerals.

Prevention

· Be sure your diet has enough calcium, but avoid excessive milk. Calcium can also be depleted when consuming too many phosphorus rich foods and drinks such as sodas and meats.

· Take a well balanced, natural prenatal vitamin.

Relief

· See your chiropractor to ensure proper nerve conduction to the muscles.

· Stretch regularly.

· Massage.

· Elevate your legs while resting.

· Take a warm bath before bed.

· Exercise – pelvic rocking, squatting, tailor sitting, ankle rotations and daily walking.

· Natural Remedies – nutritional supplements with the proper balance of calcium to magnesium (2:1). Herbal remedies include nettle tea or red raspberry leaf tea.

Morning Sickness

Perhaps the most common and most unpleasant problem for over 50% of expectant mothers in the first trimester, morning sickness may be caused by increasing levels of the hormones progesterone or human chorionic gonadotropin. The degree of nausea varies from mother to mother and often from one pregnancy to another. In some mothers the smell of certain foods can trigger nausea. Strong aversions to even formerly favorite foods are common.

As the first trimester ends, the dropping levels of HCG may be responsible fro the reductions in morning sickness. Severe morning sickness can lead to malnourishment if it continues past the first trimester and should be evaluated by your health care provider.

Prevention

· Take a well balanced prenatal vitamin.

· Eat a healthy, well balanced diet.

· Avoid junk foods or deep fried foods that are difficult to digest.

· Exercise regularly.

Relief

· Eat crackers, dry cereal, or toast slowly first thing in the morning. This absorbs stomach acid and begins the digestive process. Then relax a few minutes in bed before getting up.

· Eat five or six small meals rather than three larger ones.

· Drink fluid between meals rather than with.

· Avoid greasy, fried and spicy foods.

· Air out rooms when cooking.

· Natural Remedies – vitamin B-6 (usually 10-20mg per day) is the most effective remedy. Additionally zinc (25mg per day) and magnesium (up to 500mg per day) can be helpful. Your prenatal vitamin should have adequate nutrients. Herbal remedies include peppermint, spearmint, chamomile or raspberry leaf tea and ginger, raw or in capsules. Homeopathic remedies labeled for nausea can be helpful.

Sciatica

The sciatic nerve is a large nerve that starts as smaller individual nerves that first leave your spinal cord in between each of the vertebrae in your lower back and pelvis. These smaller individual nerves come together to form the sacral plexus, a large bundle of nerves low in the pelvis. The sciatic nerve courses through the gluteal area to the hip and then down the back of the leg where it begins to divide back down to smaller nerves in the back of the thigh. Pain from sciatica may be felt all the way down to the foot. The pain of sciatica can come from several different reasons. One of the smaller nerve roots can be irritated as it leaves the spinal cord by the pressure of a bulging disc or joint inflammation. The heavy uterus can put pressure on the sacral plexus. Tight muscles can put pressure on the sciatic nerve in the hip or gluteal region. Proper diagnosis is essential to obtain the correct treatment.

Prevention

· Observe good posture sitting, standing and walking.

· Maintain proper spinal biomechanics and alignment.

· Exercise regularly.

Relief

· See your chiropractor for proper diagnosis and treatment.

· Try up to 50mg of vitamin B-6 to keep your nerves healthy.

· Exercise – Walking daily is the simplest and most effective form of exercise to maintain proper pelvic position and motion. Strengthen the pelvic floor with leg raises and hip/buttocks lifts.

· Natural Remedies – spinal/pelvic manipulation, soft tissue work, homeopathic remedies (Topricin), alternate ice and moist heat.

Stress Incontinence

The loss of a few drops of urine when sneezing, coughing, laughing and putting other forms of pressure on the pelvic floor area can be an embarrassing condition for the expectant mother. The most common cause is weak pelvic floor musculature.

Prevention

· Strengthen the pelvic floor musculature. Kegel exercises can be especially helpful.

Relief

· If the exercises don’t help, you may need to wear a sanitary pad.

Swelling (Edema)

Some swelling especially of the ankles, feet and occasionally the hands is considered normal during the third trimester. This results from a combination of fluid retention and impaired circulation. Prolonged sitting or standing always aggravates the condition. Therefore you notice swelling late in the day after being on your feet all day. Swelling is more prevalent in warmer weather.

Prevention

· Wear non-restrictive clothing.

· Change positions frequently, avoid prolonged sitting or standing.

· Drink lots of water.

Relief

· Rest with your legs and hips elevated above the level of your heart.

· Exercise – foot bending and circling.

· Natural Remedies – increase parsley in the diet or try dandelion root tea or tincture (both are natural diuretics). Vitamin B-6 and magnesium may also help relieve fluid build up.

Urinary Frequency

In early pregnancy the need to urinate frequently is caused by increased bladder sensitivity and pressure on the bladder from the growing uterus. There is simply not enough room for the bladder to fill. This is relieved a bit as the uterus grows out of the pelvis and into the abdomen during the second trimester. During the third trimester the increasing weight of the baby once again applies pressure on the bladder increasing the frequent need to void.

Warning: Painful or burning urination may suggest a urinary tract infection and may need to be treated by your health care provider.

Vaginal Discharge

The vagina is usually comfortably moist from cervical and vaginal wall secretions. Increased vaginal secretion occurs during puberty, ovulation, pregnancy and, for some women, during the pre-menstrual period. Vaginal secretions may be especially profuse during the first trimester. Providing there is no foul odor or itching, this condition is quite normal and nothing to be concerned about. The increased discharge during pregnancy is due tot the increased activity of the cervical glands.

Prevention

· Since this condition is normal during pregnancy, there is nothing you should do to try to prevent it. Avoid douching for normal secretions as this is unnecessary and can disturb the balance of the normal vaginal flora.

Relief

· Wear soft underpants with a cotton crotch or a mini pad.

If there is itching or an unpleasant odor…

This may suggest any of a group of vaginal infections called vaginitis. Consult your health care provider to diagnose and treat the particular form of vaginitis. Yeast infections are the most common variety and can be treated without prescription medications.

· Natural Remedies – Many natural suppositories are made. Acidophilus suppositories can be very helpful in controlling the yeast overgrowth as it establishes a competing population of the beneficial flora.

Varicose Veins

Varicose veins are enlarged swollen veins. During pregnancy they may develop in the legs and less often in the vulva. Varicosities of the anal region are called hemorrhoids. If varicose veins develop, you may first notice a dull ache in the legs and see a network of fine purplish veins near the surface of the skin. As the veins enlarge, they may appear knotty here and there along their course.

Several factors may contribute to the development of varicose veins during pregnancy. Your blood supple increases 30 -40% to meet the needs of your growing baby. At the same time, the vein walls and surrounding muscles are more relaxed due to the action of progesterone. Pressure on the pelvic veins from the flowing uterus interferes with blood return from the lower part of the body.

Varicosities often run in the family. You are more likely to develop varicosities during second or subsequent pregnancies than during the first. However, if you take relief measures now during pregnancy, you may avoid developing varicose veins entirely. Even if you do develop varicosities, they may disappear or at least diminish after your baby is born.

Prevention

· Avoid prolonged standing.

· Avoid high heeled shoes that contribute to poor posture and poor circulation.

· Avoid sitting with your legs crossed.

· Lie down with your legs elevated for short interval during the day.

Relief

· Wear elastic stocking or support hose to give support to the weakened veins if the varicosities develop. Put on stocking before rising in the morning before veins have a chance to swell or elevate hips and legs for a while before putting them on if putting them on later in the day.

· Exercise – pelvic rocking, tailor sitting, foot bending and circling. Walk regularly!

· Natural Remedies – your chance of both varicose veins and hemorrhoids may be reduced by sufficient vitamin C, vitamin E, calcium, magnesium, phosphorus and Bioflavinoids. At the first sign of varicosities, try European bilberry extract, an herb that has been shown to strengthen the blood vessel walls.

This material is mostly reprinted from the booklet by Carl Jones of the same title. It is published as part of the Keats Good Health Guide, The Women’s Self-Care Library.