The Center for Women




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Physical Changes in Pregnancy & Basic Care Guide

Body Changes
As the pregnancy progresses, you will experience body changes and discomforts. Backaches are common and are usually caused by the growth of the uterus. A heating pad can be used to relieve some of this discomfort.

Breast Changes
Your breasts will grow and become firm and tender. Wear a bra that fits and supports. Your nipples may stick out and become darker.

Breathing Problems
Breathing problems occur as the uterus grows and the lungs do not have as much room to expand causing you to become short of breath. At the end of the pregnancy, the baby will drop and press against the cervix at approximately 36-38 weeks. This will make it easier for you to breathe.

Constipation is very common during pregnancy. Drink lots of fluids and fruit juices. Eat more fiber; raw vegetables, fruits and bran cereal. Exercise will help too. Metamucil, Citrucel, Benefiber and Colace may be used occasionally.

Daily Dietary Guidelines and Serving Size

  • 6-11 servings of bread, rice, cereal and pasta
  • 2-3 servings of vegetables
  • 2-3 servings of fruit
  • 4 servings of milk, yogurt and cheese (Increase to 5 servings in under 18, and increase to 6 servings for multiple gestations)
  • 3 servings of meat, fish, dry beans, eggs, nuts and peanut butter

Vegetarian Diet - You can continue your diet, but make sure you are getting enough nutrients for you and the baby. Make sure you are getting enough protein. You may want to take Vitamin B12 and Vitamin D.

Lactose Intolerant - Dairy products are an important source of calcium. However, some people cannot tolerate the diarrhea, gas or bloating. Try lactose-free products, or Extra Strength Tums to add calcium to your diet.

Fish - Fish should be a part of your healthy diet. Some fish contain high levels of mercury. Avoid shark, swordfish, king mackerel or tilefish. You can eat 12 oz. of seafood a week. Albacore tuna is higher in mercury than regular tuna. Therefore, we suggest onlyl 6 oz. weekly. Shellfish, smaller ocean fish and farm-raised fish are all safe during pregnancy. No raw fish (that means sushi)!!

Meats - Meat high in nitrates have been linked to growth restriction of your fetus in pregnancy. Recommendations are that you avoid these meats: Hot dogs, Bologna, Salami, Pepperoni and Bacon. Also, when eating cold cut meats, we recommend that you heat the meat in the microwave for 30-60 seconds prior to eating it.

Diet and Weight Gain
Everything you eat is passed to the fetus through the placenta. The growth of the fetus could be affected by not following a good diet. When you are pregnant, you need approximately 2500 calories a day.

Recommended weight gain for women of normal weight is 25-35 pounds, 15-25 pounds for overweight women and 15 pounds for obese women.

Obesity is a difficult thing to discuss with patients. It is however, becoming an epidemic and makes everthing we do in the practice of obstetrics much more difficult. Obesity is risk factor for miscarriage, elevated blood pressure, preeclampsia, gestational diabetes and the need for cesarean section for delivery.

Obesity also increases the risk of complications during and after cesarean, such as, increased blood loss, prolonged operative time, wound infection and difficulty with anesthesia.

Babies that are born to obese women have an elevated risk of stillbirth, prematurity, being excessively large at birth, neural tube defects and higher rates of childhood obesity.

Pregnancy can bring on emotional changes. Your hormone changes can cause mood swings. Fatigue may make you more irritable or depressed. Rest and exercise may help you feel better.

Exercise and Pregnancy
Exercise is safe in pregnancy and can help to strengthen muscles that you will use during labor. If you exercised before pregnancy, you may continue as long as you are not getting your heart rate above 140. If you were not exercising before, brisk walking, swimming and prenatal yoga are fine in moderation.


  • Get dehydrated
  • Get exhausted
  • Go above optimal heart rate (140)

Fetal Movement
Generally, you should feel regular fetal movement after 28 weeks. There are times when the babies are more active than others and babies do nap in the uterus, just like after they are born. Fetal movement should not slow down or decrease in frequency the closer you get to term. Call your doctor right away with any concerns about decreased fetal movement.

Frequent Urination
This will occur during the entire pregnancy and may get very frequent toward the end. If you experience painful urination, fever or change in odor or color, you may have an infection - contact your practitioner.

Gestational Diabetes
Testing is done at approximately 26-28 weeks. Gestational diabetics have too much sugar in their blood, which is caused by the way the body makes or uses insulin. This can happen without any symptoms. Most patients with gestational diabetes are controlled with diet. Some patients may have to be controlled with insulin if the diet fails. This usually goes away after delivery.

Hemorrhoids are varicose or swollen veins in the rectum and can be very painful. Constipation and straining may make them worse. Preparation H, Anusol and Tucks can be used to ease the discomfort.

High Blood Pressure
High blood pressure may occur during pregnancy. If not treated, this can be serious.

Some women have no symptoms while others may have some or all of these symptoms:

  • Headaches
  • Swelling in hands & feet
  • Dizziness
  • Blurred vision or seeing spots in front of eyes
  • Sudden weight gain
  • Stomach pain
  • Protein in urine

In some cases, patients are put on bed rest at home or admitted to the hospital. Sometimes it is necessary to deliver the baby early.

Home Life
Although you are pregnant, taking care of your home and family still needs to be done. Some of the work may need to be shared with your partner or others. You should not be moving heavy things without help. Household cleaners and latex paint are safe to use as long as the area is well ventilated. Do not exceed more than 20 pounds of lifting after 20 weeks of gestation.

Inability to Sleep
It may be difficult to get comfortable.

  • Try a warm bath at bed time
  • Relaxation exercises
  • Lie on your side with a pillow under your abdomen and one between your legs
  • Benadryl or Tylenol PM can be used occasionally

Also called heartburn, indigestion is the burning feeling in the stomach that rises up into your throat.

  • Eat 6 small meals a day
  • Avoid foods that contain a lot of acid or can cause gas
  • Mylanta, Maalox, Tums and Zantac can be taken to ease your heartburn

During pregnancy, you still get illnesses such as colds, the flu, upset stomach, bladder infections, fever and STD's. Do not take over-the-counter medications unless it's on the list. Contact your doctor before taking any medications not on the recommended list. The common cold has no effect on the fetus. Some viral infections such as hepatitis can cause miscarriage, stillbirth and preterm labor.

Leg Cramps
Leg cramps usually come at the end of the pregnancy. Stretching your legs or soaking in warm water may relax your legs before bed.

Morning Sickness
Nausea and vomiting are common early in the pregnancy and can happen any time of the day.

  • Try to always keep something in your stomach
  • Dry toast or crackers before getting out of bed
  • Smaller meals, more frequent meals
  • Avoid unpleasant smells
  • Avoid spicy and fatty foods
  • Contact your doctor if it becomes severe. There are medications that are safe in pregnancy to help with the nausea and vomiting
  • Acupressure, wristbands (sea-bands) - You can find them at a pharmacy

Call if you have been unable to keep any food or fluids down for more than 12 hours.

Numbness and Tingling
As the uterus grows and your body retains water, some of the nerves may be constricted causing numbness. This may affect legs, feet and arms. It will stop after the baby is born.

Preterm Labor
Any labor that starts before 37 weeks is considered preterm. If the fetus is not full grown, every effort will be made to stop labor as long as possible. Your doctor may try bed rest or special medications that will stop the contractions.

Signs of preterm labor:

  • Vaginal discharge (change in type - watery, mucousy or bloody)
  • Pelvic or lower abdominal pressure
  • Low backache
  • Abdominal cramping, possible diarrhea
  • Regular contractions

Round Ligament Pain
As the fetus grows, the muscles that support the uterus are stretched. You may occasionally feel sharp pains and dull aches. Changing position and resting may help this.

How do I know it is round ligament pain?

  • It is usually low in the belly and in the groin area - it may be on one side only or on both sides
  • The pain tends to be cramping or pulling pain
  • The pain usually occurs with activity such as walking
  • It also occurs with position changes such as turning in bed or going from sitting to standing
  • It may linger if you have been especially active, but it usually gets better with rest
  • There should not be any bleeding associated with the pain

What can I do for the pain?

  • Stopping what you are doing can often relieve the pain
  • Avoid quick position changes
  • If you can't sit or lie down when it is happening, try bending at the waist by leaning forward to lessen some of the stretch
  • Avoid prolonged walking or activity if it has been a problem
  • Use pillows under your belly and between your knees while sleeping
  • Consider a maternity belt if it is a persistent problem

Sex is safe during pregnancy. The fetus is well cushioned. Your doctor may advise you to avoid sex if there are signs of complications with your pregnancy.

Smoking, Alcohol and Recreational Drugs
Women who smoke during pregnancy are at a higher risk of having small birth weight babies, preterm births and other complications. Smoking decreases the oxygen and nutrients to the fetus. If you are smoking, try to quit now. It is better for both you and your baby. Drugs such as crack, cocaine, heroin and tranquilizers are harmful to the fetus. Use of these drugs during the pregnancy can cause the baby to become addicted, have learning problems, cause the placenta to detach from the uterus (abruption) or fetal death.

Swelling in pregnancy is normal. It happens to the legs and hands in the last few months. It may appear worse in the summer when it is hot and humid. Let your doctor know if it becomes severe.

To reduce some of the swelling:

  • Elevate your feet above your heart whenever you can
  • Rest on your left side
  • Eliminate salty foods
  • Wear support hose

Most pregant women can travel out of town up to 36 weeks pregnant.

When you travel:

  • Use a seat belt and place it under your hips
  • Walk around every 1 1/2 hours
  • Have snacks to prevent nausea
  • Drink plenty of fluids
  • Take a copy of your medical records in case you have an emergency and need medical attention out of town
  • Always check with your doctor if traveling late in pregnancy

Varicose Veins
Varicose veins are swollen veins caused by pressure from the uterus. They appear on the legs but can be in the vaginal area also. They are not serious, however, they can be very painful at times. Wear support stockings or a girdle and rest to alleviate discomfort.

Most women can work until they are due or until late in their pregnancy.

  • Work may become more challenging because of the physical changes you experience throughout your pregnancy.
  • We may be able to suggest simple measures to take in order to deal with these changes and challenges.

Special circumstances may require earlier disability leave from your job.

  • Ethically, it could only be recommended when medically indicated to prevent or reduce danger to your health or your baby's health. This is rarely required.
  • If disability from work is required or you plan to utilize the FMLA (Family Medical Leave Act), completion of forms is usually required.

    To expedite the process, you will be asked to:
    – Provide the papers as soon as possible
    – Complete a questionnaire
    – Allow 7-10 business days for completion
    – Attach a self-addressed, stamped envelope for the return of the forms, or pick them up at your next visit
    – There is a $10 charge for completion of these forms

Let us know if you have specific concerns about your work environment and safety with the pregnancy.

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