A Primer on the Not-So-Pretty Side-effects of Pregnancy

myOptumHealth, March 2012


Being pregnant may be beautiful–but it’s not always pretty. Even women who seem to be basking in “the glow” of pregnancy can also be experiencing a host of odd and often embarrassing complaints, from nosebleeds and bloating, to heartburn and hemorrhoids.

“There’s just so much happening in a woman’s body during pregnancy,” explains Dr. Suja Roberts, an obstetrician/gynecologist at Clinic Sofia in Minneapolis, MN. “Hormone levels are changing, blood volume is rising, your metabolism is running high, and your bowels can get very lazy. For many women, it can be a rather uncomfortable time.”  Here, how to handle some of the less-than-lovely side effects of pregnancy.

Flatulence, bloating, and constipation

Why it happens: As the hormones relaxin and progesterone relax the smooth muscle of the uterus during pregnancy, they also go to work on the gastrointestinal tract, slowing down digestion. “When you’re pregnant, the gastric emptying time is prolonged to nearly six hours, which is why gas and constipation are very common in pregnancy,” says Roberts. If you’ve got morning sickness, decreased exercise and disrupted eating patterns can add to the problem.

What to do: Eating whole foods, walking every day, and drinking plenty of water can help get your bowel back on regular time. Talk to your provider about taking an over-the-counter stool softener or a home remedy such as ginger to help prevent hemorrhoids later in your pregnancy.

Pimples and dark patches

Why it happens: The skin’s sebaceous glands amp up production during pregnancy, which may lead to more acne outbreaks. Hormones also boost the production of skin pigments that can darken existing moles and freckles, or cause chloasma, patches of brown or yellow skin on the face sometimes called “the mask of pregnancy.”

What to do: Make sure your make-up and skin care products are non-comedogenic, and aren’t adding to the extra oil content of your skin. Since you’re more sensitive to the sun during pregnancy, avoid direct sunlight and wear sunscreen every day.


Why it happens: Waking up with a wet pillow is a common side effect of pregnancy, as the body produces more saliva than usual. Nausea can also be a contributing factor, as some women may try not to swallow to keep vomiting at bay.

What to do: “Don’t suck on lemon drops or hard candies,” says Roberts. “It will only make the problem worse.” If you’re experiencing excessive salivation along with intense morning sickness, be sure to share this with your doctor. These symptoms can be a sign of a rare pregnancy complication called hyperemesis gravidarum.

Yeast infections

Why it happens: “Increased estrogen levels cause an increase in the glycogen content in the cells that line the vaginal walls, which is a perfect environment for the production of yeast,” Roberts explains. Though some pregnant women can have active yeast infections with no symptoms, others are made miserable by itchiness, burning, or even pain during intercourse.

What to do: Don’t treat with an over-the-counter medication—instead, get your doctor to confirm that it’s a yeast infection and not something more serious. Once your body’s pH balance has been restored, try these tips to prevent a recurrence: change out of wet workout clothes as soon as you can, wear breathable cotton underwear, cut back on sugary foods, and try eating yogurt with the active bacteria acidophilus to keep your body’s natural bacteria in balance.



Why it happens: Your blood volume can rise by nearly 40 percent during the course of pregnancy, putting extra pressure on blood vessels and making you more prone to headaches. Lack of sleep, low blood sugar, stress, and caffeine withdrawal can all add to the ache.

What to do: Aspirin and ibuprofen aren’t recommended during pregnancy; consult your own doctor about whether you should take acetaminophen. Janis Keil-Day, a certified nurse midwife at Fairview Riverside Women’s Clinic in Minneapolis, recommends trying simpler self care remedies such as laying down in a dark room, applying a cool cloth to your forehead, and eating smaller and more frequent meals to keep your blood sugars in balance.

Urinary incontinence

Why it happens: Muscle-relaxing hormones combined with the baby’s growing pressure on your bladder causes urine to leak when you laugh, cough, or sneeze.

What to do: “It’s never too late for Kegels,” says Roberts. Start by contracting the pelvic muscles as if you were trying to stop urinating, hold the contraction for 10 seconds, and then rest. “Whether you are pregnant or not pregnant, do your Kegels every day religiously, three times a day, to prevent future problems with your pelvic floor.”


Why it happens: “Hemorrhoids are the blood vessels of the rectal area and they can become swollen during the last trimester of your pregnancy,” says Roberts. “As the baby grows bigger, there’s more pressure on the veins and the bowels, and the hemorrhoids may prolapse out” causing itchiness, discomfort, or even rectal bleeding.

What to do: Women who have had hemorrhoids prior to pregnancy are more likely to get them again, but there are some tips for prevention: Eat high fiber foods and drink plenty of water to avoid constipation. Move your bowels when you need to and try not to strain. Lie on your left side when you’re sleeping to increase blood flow and take the pressure off of rectal veins.


Why it happens: Progesterone is the culprit again, relaxing the valve that keeps gastric acids from rising back up the esophagus, and causing an often painful burning sensation just under your breast bone.

What to do: Stay upright for at least an hour after eating, and don’t eat or drink anything (including water) at least two hours before bedtime. “Another good solution is gravity,” says Keil-Day, who recommends sleeping with plenty of pillows to keep your shoulders propped up above your stomach, or putting blocks under your bed to elevate your head during the final stretch of pregnancy.

Nose bleeds

Why it happens: Increased pressure on the blood vessels during pregnancy can create tiny ruptures in the delicate membranes in your sinus.

What to do: Tip your head back and put pressure on the bleeding nostril for up to ten minutes. To prevent nosebleeds in the future, keep your nasal membranes moist by drinking water, humidifying your bedroom during the winter, and avoiding drying nasal sprays and decongestants.


Why it happens: Like the other organs of the body, your skin is struggling to make way for baby, too, causing tissue around the breasts and belly to become itchy and unusually sensitive.

What to do: Avoid hot showers and scented lotions, which can add to skin irritation. If you have a hive-like rash on your belly, it could be a sign of “polymorphic eruption of pregnancy” or PUPPPS, a skin condition that disappears after delivery. If the itching is concentrated on the palms of the hands or soles of the feet, call your doctor right away—these can be the symptoms of a more serious liver problem called “cholestasis of pregnancy.”


Why it happens: “The blood vessels can get a little leaky during the last stages of pregnancy ,filling up the surrounding tissue,” say Keil-Day. Though swelling (edema) was once considered a warning sign of preeclampsia, puffy ankles and swollen feet are so common in pregnancy that physicians no longer consider it a reliable predictor of high blood pressure or other problems.

What to do: Curb your intake of salt and processed foods to cut water retention. If swelling comes on suddenly, or is concentrated on one side of your body, call your doctor–it may be the sign of a blood clot.

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