Common Health concerns in Pregnancy: A Guide by Dr. Anu Vij

1) Constipation in pregnancy:

Constipation means that the bowels move less than three times in a week OR the stool is hard and it takes a lot of pushing effort to pass OR there is bleeding after the stool is passed OR feeling of incomplete evacuation after passing stools OR any combination of these.

During pregnancy there is a rise of the hormone Progesterone, which is responsible for continuation of pregnancy by keeping the uterus relaxed. Unfortunately it also relaxes the bowel and increases the bowel emptying time. This leads to constipation Other causes of constipation are :

• • Not eating enough fibre, which is found in fruits, vegetables and cereals
• • Not drinking enough fluids
• • Not moving enough and spending long periods sitting or lying down
• • Being less active and not exercising
• • Often ignoring the urge to go to the toilet
• • Changing your diet or daily routine
• • A side effect of medicine
• • Stress, anxiety or depression


To help prevent constipation, one can:
• • Eat foods that are high in fibre, such as wholemeal breads and cereals, fruit and vegetables, and pulses such as beans
• • Exercise regularly to keep one’s muscles
• • Drink plenty of water
• • Avoid iron supplements, which increase constipation

2) Cramps in pregnancy:

Cramp is a sudden, sharp pain, usually in your calf muscles or feet. It's most common during second and third trimesters esp at night. While there is no specific cause, they can be due to:

• • Changes in blood and circulation
• • Tired leg muscles
• • Weight gain
• • Pressure from the growing uterus and blood vessels
• • Dehydration
• • Vitamin Deficiency
• • Electrolyte imbalance
• • Too much or too little exercise
• • Mineral deficiencies
• • Hypothyroidism


Regular gentle exercise in pregnancy, particularly ankle and leg movements, will improve your circulation and may help prevent cramp.
Try these foot exercises:
• • Bend and stretch your foot vigorously up and down 30 times
• • Rotate your foot 8 times one way and 8 times the other way
• • Repeat with the other foot

• • Calf Stretches: Before bed stretch your calves with your heels flexed. Try foot and ankle pumps to move excess fluid away from your ankle and calves.
• • Massage: Gently massage your calf muscle to relax it . Also try rubbing ice.
• • Movement: Walk around on your heels OR try walking and then sitting and raising your legs. Avoid sitting or standing in one position for a long time and don’t cross your legs
• • Hydration: drink lots of liquids throughout the day to keep the muscles well hydrated.
• • Exercise: regular gentle exercise under the supervision of a physio will help reduce cramps.
• • Supplements: Vit E, magnesium, Na and K may help.
• • Bath: A warm bath just before bed may help reduce cramps.

3) Feeling faint in pregnancy

You may feel faint or dizzy while pregnant. This is usually due to hormonal changes, low blood sugar, low blood pressure, low iron levels, over heating or getting up too quickly from a sitting position to a standing position. Fainting happens if your brain is not getting enough blood and, therefore, not enough oxygen.

Here are some tips to help avoid feeling faint:

• • Try to get up slowly after sitting or lying down
• • If you feel faint when standing still, find a seat quickly and the faintness should pass – if it does not, lie down on your side
• • If you feel faint while lying on your back, turn onto your side
• • It's better not to lie flat on your back in later pregnancy or during labour. You should avoid going to sleep on your back after 28 weeks as it has been linked to a higher risk of growth restriction of the fetus.
• • Try drinking glucose water

4) Feeling hot in pregnancy

It is normal to feel warmer than usual during pregnancy. This is due to hormonal changes and an increase in blood supply to the skin. The blood vessels dilate slightly to handle the extra blood, bringing blood closer to the skin. You're also likely to sweat more to compensate for this warm feeling and to help cool down.

It can help if you:

• • Wear loose clothing made of natural fibres, as these are more absorbent and breathable than synthetic fibres
• • Keep your room cool – you could use an electric fan or ac
• • Wash frequently to help you feel fresh
• • Consuming more of citrus fruits eg oranges, lemons, grapes, …..rich in in vit c and anti- oxidants can provide effective cooling effect besides strengthening immunity

5) Urinary problems in Pregnancy

During pregnancy, due to increased blood volume and pressure of the growing fetus, a pregnant lady can experience quite a few urinary problems. Most common of these is an increased frequency of passing urine.

It starts in early pregnancy and sometimes continues until the baby is born. In later pregnancy, it's caused by the baby's head pressing on your bladder.

If you find you need to get up in the night to pee, try cutting out drinks in the late evening. However, make sure you drink plenty of non-alcoholic, caffeine-free drinks during the day to stay hydrated.

Later in pregnancy, you may find it helps to rock backwards and forwards while you’re on the toilet. This lessens the pressure of the womb on the bladder so you can empty it properly.

If you have any pain while peeing or you pass any blood in your pee, you may have a urine infection, which will need treatment.

Another common problem is incontinence of urine. It is a common problem during and after pregnancy. You might be unable to prevent a sudden spurt of pee when you cough, laugh, sneeze, move suddenly or just get up from a sitting position.

This may be temporary, because the pelvic floor muscles (the muscles around the bladder) relax slightly to prepare for the baby's delivery. There are exercises you can do to strengthen your pelvic floor muscles.

6) Skin changes in Pregnancy

Pregnancy can cause a variety of skin changes , including:

• Dark Spots: Melanin Levels Increase In Pregnancy, Which Can Cause Darkened Skin, Esp On The Face
• Stretch Marks: These can occur anywhere there is rapid growth and stretching of the skin, such as on the abdomen, buttocks, thighs, breasts and hips.
• Spider Veins: These appear as tiny red veins on the face neck and arms. Thought to be due to high oestrogen levels.
• Acne: The skin’s sebaceous glands produce more oil during pregnancy which can cause acne.
• Moles or freckles: They may get bigger and darker.
• Melasma:Also known as Mask of Pregnancy, this is a common condition that some women experience during pregnancy. It is characterised by patches of discoloration on the cheeks, forehead and upper lip.
• LineaNigra: This is hyperpigmented straight line that extends from the pubis to umbilicus. It typically appears during the second trimester.

7) Varicose veins in pregnancy

Varicose veins are veins that have become swollen. They occur when the gravid uterus puts pressure on the great vein of the abdomen that carries blood from the legs and feet to the heart. Varicose veins can cause pain, discomfort and itchiness. They can appear on the legs, vulva or rectum, and can be blue, red or purple. They usually get better after the birth.

The risk factors include:

• • Increased blood volume during pregnancy
• • Weight of the growing baby pressing on the pelvic blood vessels
• • Older mothers

• • Avoid standing for long periods of time
• • Try not to sit with your legs crossed
• • Try not to put on too much weight, as this increases the incidence of varicose veins
• • Sit with your legs up as often as you can to ease the discomfort
• • Try compression stockings, which you can buy at most pharmacies – they won't prevent varicose veins but can ease the symptoms
• • Try sleeping with your legs higher than the rest of your body – use pillows under your ankles or put books under the foot of your bed
• • Do foot and other antenatal exercises, such as walking and swimming, which will help your circulation
• • Reduce salt intake to minimise swelling of veins
• • Avoid wearing high heels; wear flat shoes instead as it exercises the calf muscles , aiding in better circulation.
• • Healthy balanced diet with plenty of foods rich in Vitamin C


Try these foot exercises:


• • Bend and stretch your foot up and down 30 times
• • Rotate your foot 8 times one way and 8 times the other
• • Repeat with the other foot