DISCOMFORTS DURING PREGNANCY
A. EARLY PREGNANCY
DISCOMFORT
1. Breast tenderness
2. Palmar erythema
Due to increase estrogen
3. Constipation
4. Nausea and vomiting
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SOLUTION/MANAGEMENT
 Wear bra with a wide shoulder strap for
support
 Dress calmly to avoid cold drafts if cold
increases symptoms.
 Calamine lotion
 Encourage her toe evacuate her bowels
regularly
 Increase fiber in her diet by eating raw fruits,
bran and vegetables
 Increase fluid intake at least 8nox glasses of
water daily
 Encourage daily exercise such as walking
 Should not use mineral oil ( absorb fat soluble
vitamins ADEK= vitamins necessary for fetal
and maternal health)
 Avoid enema = can initiate labor
 Avoid over the counter laxatives
 Use stool softener = docusate sodium (Colace),
evacuation suppositories like glycerin
 Avoid gas forming foods ( cabbage, beans)
 Eat a few dry crackers, toast or a sourball
before getting out of bed in the morning to
increase carbohydrate intake.
 Eat small but frequent meals rather than large
infrequent ones.
 Avoid greasy or highly seasoned food
 Delay breakfast until nausea passes
 Make up missed meals at some other time of
the day to maintain nutrition
 Avoid sudden movements and fatigue because
these may increase or cause nausea.
 Eat a snack before bedtime so delaying
breakfast will not cause you to go a long time
between meals.
 Purchase a wrist acupressure band= for
motion sickness.
 Teach the woman the importance of nutrition
for herself and fetus
  7 servings of CHON rich food, 1 serving
of vegetable protein
 3 servings of dairy products or other
calcium rich foods.
 7 servings of grain products
 2 or more servings of vit C rich
vegetables or fruit.
 3 servings of other fruits and
vegetables
 3 servings of unsaturated fats
 2 or more servings of other fruits and
vegetables

If nausea is present:
 Try sipping a carbonated beverage, water or an
herbal noncaffeinated or ginger tea.
 Try a walk outside in the fresh air or take deep
breaths through an open window.

Notify your health care provider if:

 You are losing weight rather than gaining
weight
About 2-5lb gain in early pregnancy (.9 – 2.3
kg) and about 1 lb ( .5 kg)/ week for the
remainder of the gestation.
 You are unable to make up for lost meals some
time of the day.
 Ve signs of dehydration such as little urine
output.
 Nausea has lasted past 12 weeks of pregnancy
 Vomit more than once daily
Heartburn (pyrosis)  Eat small meals frequently rather than large
meals
 Sleep on left side with 2 pillows to elevate the
upper torso.
 Do not lie down immediately after eating; try
and wait at least 2 hours.
 Avoid fatty and fried foods, coffee, carbonated
beverages, tomato products, and citrus juices.
 Aluminum hydroxide (Amphogel, Alternagel) or
Maalox can be prescribe.
 Cimetidine (Tagamet) and ranitidine ( Zantac)
histamine antagonist
 Chest pain should be due to
gastrointestinal tract reflux not related
to the heart.
5. Muscle cramps  Lies on her back momentarily and extends her
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  Due to decreased serum calcium and
increased phosphorus
6. Hypotension
 Occurs when a woman lies on her back
and the uterus presses the vena cava
impairing blood return to the heart..
 Irregular heart beat
 Feeling of apprehension
7. Varicosities
 Or tortuous leg
Common during pregnancy because of the
weight of the distended uterus putting
pressure on the veins returning blood from the
lower estremities.= pooling of blood and
distended veins = veins engorges, inflamed and
painful.
8. Hemorrhoids ( varicosities of the rectal veins)
 Because of the pressure on the veins from the
bulk of the growing uterus
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involved leg while keeping her knee straight
and dorsiflexing the foot until pain disappears.
If with frequent leg cramps
 Take magnesium citrate or aluminum
hydroxide gel ( Amphogel) = binds
phosphorus in the intestinal tract and
lowers its circulating level.
 Lower milk intake to only 1 pint daily and
supplement it with calcium lactate to
reduce phosphorus level.
 Elevate lower extremities frequently during
the day to improve circulation.
 Avoid full leg extension .
 Rest or sleep on their side not on their back
 Rise slowly
 Avoid extended periods of standing
 If feeling to faint = sitting with her head
lowered.
 Rest in Sim’s position or on back with the legs
raised against the wall ( small firm pillow
placed under her right hip).
 Elevate legs using a footstool 15 to 20 minutes
2x a day.
 Instruct women to avoid crossing their legs or
knees bent
 avoid constrictive knee-high hose or garters
with varicosities:
 may need to use elastic support stockings
before rising in the morning= should reach
the point of distention.
 Exercise
 Break during long periods /.walk break at
least 2x a day
 Vitamin C helpful in reducing the size of
varicosities because it is helpful for the
formation of blood vessel collagen and
endothelium.
 Include fresh fruit or juice everyday.
 Daily bowel evacuation
 Modified sim’s position daily
 Knee chest position for 10-15 minutes to
reduce the pressure on rectal veins.
 Stool softener ( colace)
 Apply hazel or cold compress to external
hemorrhoids

9. Heart palpitatations
 Due to sudden turning over in bed,
movement
 Because of circulatory adjustments
necessary to accommodate her
increased blood supply during her
pregnancy
10. Frequent urination
 Bec of the pressure of the growing
uterus on the anterior bladder.
 Last for 3 months,
 disappear in the midpregnancy when
the uterus rises above the bladder
 return in late pregnancy= as the fetal
head presses against the bladder
11. abdominal discomfort
 experience by woman with multiple
pregnancy
12. Leukorrhea
 Whitish viscous vaginal discharges
 Increase in the amount of normal
vaginal secretions
 Occurs in response to high estrogen
levels and the increased blood supply
to the vaginal epithelium and cervix in
pregnancy.
B. MIDDLE TO LATE PREGNANCY
Discomforts
1. Backache
 Due to posture changes
 Can be a sign of a bladder or a kidney
infection
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 Gentle pressure to the hemorrhoids
 Slow movements
 If occur frequently accompanied with pain –
report it to a physician
 reduce caffeine
 kegel exercise for 3 sec 10x a day
 may take 6 weeks for the
pubococcygeal muscles to be
strengthened
 should not restrict fluid intake
 rise slowly from lying to a sitting or from a
sitting to a standing position.
 Daily bath or shower
 Wearing cotton underpants
 Sleeping without underwear
 Wear perineal pad
 Avoid tampons= because this would lead to
stasis of secretions and subsequent infection.
 Instruct woman to contact physician if there is
a change in color, odor, character.
 Avoid tight pants and pantyhose
Management
 Wear low heeled shoes
 Encourage woman to walk with her pelvis
tilted forward
 Apply local heat
 Squat rather than bend over to pick up
objects
 Lift objects close to the body
 Firm mattress should be used
 Pelvic rocking or tilting
 Acetaminophen (Tylenol)
 Acupuncture
 Caution women not to take herbal medicines,
muscle relaxants or analgesics without
consultation.
 2. Headache
 Due to expanding blood volume
which puts pressure on cerebral
arteries
3. Dyspnea
 Bec of the expanding uterus places
pressure on the diaphragm, lung
compression.
 Notices during night when she lies
flat
4. Ankle edema
 During late pregnancy
 Observe when the woman can’t
already wear their shoes
 Caused by fluid retention and
reduced blood circulation in the
lower extremities bec of uterine
pressure.
5. Braxton hicks contractions
 In early 8th-12th weeks of
pregnancy
 Middle or late= contractions
become stronger, pain like to a
menstrual cramp.
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 Place cold towels on the forehead
 Take usual doses of acetaminophen
 If headache is more intense=report to a
physician= sign of PIH
 Sleep with head and chest elevated
 Use or more 2 pillows
 Limit her activities to prevent exertional
dyspnea.
 Resting in a left side lying position= bec this
increases the kidney’s glomerular filtration
rate and allows good venous return.
 Sitting for half an hour in the afternoon and in
the evening
 Avoid wearing constricting clothing such as
panty girdles or knee high stockings= can
impeded lower extremity circulation and
venous return.
