Many pregnant women experience nausea and sometimes vomiting in the first trimester (first 3 months) of pregnancy. It is often referred to as morning sickness because many women say that they feel worse in the morning, but some women do feel sick at other times during the day too, and others may continue to have nausea and vomiting after the first trimester. Some women also experience symptoms during the whole of their pregnancies which can be very distressing.

Further information on morning sickness and ways to manage this is provided here

If vomiting becomes severe this may be a sign of hyperemesis which is a more serious condition and can result in dehydration and electrolyte imbalance. Talk to your midwife if you are having persistent or severe nausea and vomiting. The link above has further information.

It is not unusual to suddenly dislike some foods that you have previously enjoyed. Sometimes this is because of the smell, sight or taste of the food. Women who experience nausea may find that their diet can change to avoid foods that they associate with the nausea or they just can’t tolerate. This isn’t usually a permanent change.

Food cravings are related to a strong desire to eat a certain food (and sometimes eating something not usually viewed as food). This craving is known as pica and sometimes causes women to crave substances such as coal or chalk. Generally if the cravings are for usual foods then eating them will not be harmful. Do consider the nutritional value as too much sugar and fat is not advised during pregnancy.

Hormonal changes in pregnancy can affect the stomach muscle and this muscle relaxation can allow acid to reflux out of the stomach into the oesophagus. This can cause a burning sensation at the back of the throat and/or a sour taste in the mouth. Heartburn, reflux and indigestion later in pregnancy is commonly caused by pressure on the intestines and stomach from the growing baby although these can happen at any time. Some things that may help are;

• Eating smaller meals more often
• Avoid eating spicy or fatty foods, drinking coffee, smoking cigarettes or drinking alcohol as all of them can irritate the stomach
• Use pillows to raise head and shoulders when lying down or sleeping
• There are some foods that can reduce or calm stomach acid.  These include milk and bland foods
• There are some antacids that may be helpful but talk to your midwife first before taking these as they are not all the same

In early pregnancy women often feel very tired and this is in response to the rapidly developing baby. This can be challenging but it is important to rest when you can. Extreme tiredness usually improves after the first 12-16 weeks.

In some situations low blood iron levels (anaemia) can be an underlying cause of tiredness. Blood tests during pregnancy will help identify whether this is an issue and whether nutritional changes and/or medication is needed. Your midwife will discuss this with you.

Sometimes pregnant women have problems sleeping; they may find it difficult to get to sleep, or they wake up after a short time and cannot get back to sleep. This can be caused by being uncomfortable or restless and it may help to use pillows or padding to support your back and legs in bed. Having a massage or a relaxing bath before settling into bed can also be helpful.

Some women experience quite vivid dreams. If these are concerning for you ask your midwife who you can talk to about them.

Haemorrhoids are common, particularly in late pregnancy and this is due to hormonal effects and increased abdominal pressure as the baby grows. Haemorrhoids are swollen veins around the anus. They can burn, hurt or itch and can sometimes bleed. Avoiding constipation may help to prevent or reduce haemorrhoids. Hormonal changes can make the bowel sluggish and if pregnant women are taking iron supplements this can also cause constipation. Simple actions may help avoid constipation such as;

• Drink plenty of fluids but avoid tea, coffee and alcohol
• Eat high fibre foods – lots of fruit, vegetables, and wholegrain breads
• Keep active with regular exercise

If haemorrhoids appear, the same three actions can still help. Topical medications with analgesics and anti-inflammatory effects can provide short-term relief from discomfort, pain, itching and bleeding but please talk with your midwife about treatment.

Varicose veins are common in the legs during pregnancy, and some women also get them around the vagina (vulval varicose veins) later in pregnancy due to increased pressure and increased blood volume. There is no immediate treatment during pregnancy for these varicose veins but taking time to rest and put your feet and legs up can give some relief as well as regular gentle exercise to assist blood circulation. The use of compression stockings may help to relieve symptoms for some women.

This is a normal part of pregnancy caused by the extra fluid in your system. Swelling in the feet and ankles can be more noticeable later in the day after being on your feet for long periods or in hot weather.

• Avoid standing for long periods
• Rest with your feet elevated to the level of your heart
• Wear comfortable shoes
• Wear support tights
• Drink water to help flush the body and reduce water retention

Contact your midwife if the swelling suddenly gets worse.

Many women experience pain in the lower abdomen as the baby grows. This typically starts at around 14 weeks and goes on into late pregnancy. It is due to the growing womb (uterus) pulling on the structures (round ligaments and the broad ligament) which hold it in place. This usually causes a stabbing pain down one or both sides of the tummy and sometimes down into the hips and genital area. The pain can be quite marked.

Some women feel it particularly when they turn over in bed. It can be so sharp that some worry it may be appendicitis. The ligaments stretch and pull as your womb grows bigger. This causes pain, particularly on sudden large movement.

The following may help:

• Warmth, such as a wheat bag or a warm bath may relieve pain
• Lying on the opposite side may help
• Taking care when moving around, keeping movements gentle, to try to avoid triggering spasms

This will usually settle in late pregnancy.

Further information on pregnancy related pelvic and back pain

Backache is another common experience for pregnant women and it is again linked to pregnancy hormones and increased pressure in the abdomen. Most pregnancy backache is caused by strains and pulls of the muscles and ligaments of your back. It is caused by a combination of:

• The extra weight you are carrying
• Your altered way of standing and walking (your posture)
• The softening of the ligaments around your back which can allow things to move slightly more freely than usual

The following may help:

• Light exercise – walking and exercises such as yoga
• Avoiding sitting or standing for long periods of time
• Avoiding heavy lifting including, if you can help it, toddlers wanting to be carried!
• If you have to sit, supporting your lower back with a cushion
• Trying exercising in water

If these do not help or symptoms are worsening discuss other options and options for referral with your midwife.

Further information on pregnancy related pelvic and back pain

For some women the increasing weight of their baby and the hormonal relaxation effects on their body including joints, ligaments and muscles, will cause their pelvic joints to begin to separate, resulting in a painful condition called Symphysis Pubis Dysfunction (SPD) or sometimes called pelvic girdle pain as it isn’t always only the symphysis pubis at the front of the pelvis that is affected.

It is a painful condition and is often worse on walking and on turning over in bed at night. It can be helpful to sleep with a pillow between the knees, which supports the shape of the pelvis. Women can experience clicking or grinding in the pelvis and lower back pain. However pain is commonly at the front of the pelvis over the pubic bone, although pain can spread to the hips and tummy (abdomen). If you are experiencing any of these symptoms discuss with your midwife ways to manage this and what referral options are available e.g physiotherapy services.

Try to

• Avoid wearing high heels. Limiting heel height to no more than 3-4 cm is ideal. This helps to reduce the strain on the lower back
• Avoiding sitting with your legs crossed, even when on the floor or instructed to do so during yoga
• Avoid doing exercises which require a lot of bouncing, standing on one foot or jarring
• Avoiding bike riding which can create further problems with opening the already unstable joint

The following may help;

Using a support belt, a thin strap which fits underneath your abdomen and around your hips and helps to support your pelvis and ease and ease the weight of the baby

Keeping knees/legs together when getting out of chairs or cars and when turning over in bed or rising from the bed

Using a tubigrip support stocking, a tubular piece of stretchy stocking worn around either your abdomen, or the lower half of your abdomen, to help support your pelvis and support the weight of the baby

Dizziness during pregnancy is a common symptom, which again can be related to pregnancy hormones. It can also be due to low blood pressure, low iron levels and low blood sugar levels so it’s important to let your midwife know if you are feeling faint or dizzy. Taking care to move slowly from a sitting position to a standing position can help avoid normal dizziness.

Headaches during pregnancy can also be due to hormonal changes. Taking some regular time out to rest and staying hydrated with water can help. Let your midwife know if you are experiencing headaches as sometimes a headache can be a sign of more serious problems such as high blood pressure or pre-eclampsia. Your midwife will be checking your blood pressure routinely and regularly. Talk to your midwife before taking medication.

This is very common during pregnancy, particularly early and late pregnancy, and caused by pressure on the bladder. Getting up to the toilet frequently at night is to be expected and is normal. If other symptoms such as burning pain during passing urine occur, or if fever, chills, headache, or you experience lower abdominal pain these may be signs of a urinary tract infection. Talk to your midwife if you have any of these symptoms.