Maternal stores of fat, protein, and other                                                          7 lbs.

nutrients (for both pregnancy and lactation)

Increased body fluid                                                                                             4 lbs.

Increased blood                                                                                                    4 lbs.

Breast growth                                                                                                        2 lbs.

Enlarged uterus                                                                                                    2 lbs.

Amniotic fluid                                                                                                       2 lbs.

Placenta                                                                                                             1,5 lbs.

Baby                                                                                                                   7,5 lbs.

Total                                                                                                                    30 lbs.

IMT ( kg / m² )

Total increase recommended

During trimester 2 & 3

Thin ( IMT , 185 )

12.7-18.1 kg

0.5 kg /week

Normal ( IMT 18.5-23.3 )

11.3-15.9 kg

0.4 kg /week

Fat ( IMT 23.3-3.29 )

6.8-11.3 kg

0.3 kg /week

Obesity ( IMT>29 )

0.2 kg / week

0.2 kg /week

Twins

15.9-20.4 kg

0.7 kg /week

Month Of Pregnancy

Symptom

1

2

3

4

5

6

7

8

9

Abdominal muscle separation

v

v

v

v

v

v

Backache

v

v

v

Belly button soreness

v

Bleeding gums

v

v

v

v

v

v

v

v

v

Bleeding or spotting

v

v

v

Braxton Hicks  contractions

v

v

v

v

Breast enlargement

v

v

v

v

v

v

v

v

v

Breast tenderness

v

v

v

Breathlessness

v

v

v

v

v

v

v

v

v

Carpal tunnel syndrome

v

v

v

v

v

v

Constipation

v

v

v

v

v

v

v

v

v

Cramping (abdominal)

v

Cravings

v

v

v

Edema (fluid retention) and

swelling

v

v

v

Eye changes  (dryness and

vision changes)

v

v

v

v

v

v

v

v

v

Faintness and dizziness

v

v

v

v

v

v

v

v

v

Fatigue

v

v

v

v

v

v

Food aversions

v

v

v

v

v

v

v

v

v

Gas and bloating

v

v

v

v

v

v

v

v

v

Headaches

v

v

v

v

v

v

v

v

v

Heartburn

v

v

v

Hemorrhoids

v

v

v

v

v

v

Hip soreness

v

v

v

v

v

v

Insomnia

v

v

v

v

v

v

v

v

v

Itchiness

v

v

v

v

Leg cramps

v

v

v

Linea nigra (vertical line down center of abdomen)

v

v

v

v

v

v

Mask of pregnancy (chloasma)

v

v

v

v

v

v

Morning sickness

v

v

v

Nasal  congestion (rhinitis)

v

v

v

v

v

v

v

v

v

Nosebleeds

v

v

v

v

v

v

v

v

v

Perineal aching

v

Pubic bone pain

v

v

v

v

v

v

Rashes

v

v

v

Round ligament pain

v

v

Sciatica

v

v

v

Skin changes

v

v

v

v

v

v

v

v

v

Smell heightened sense of

v

v

v

Stretch marks

v

v

v

Sweating, increased

v

v

v

v

v

v

Swelling and edema (fluid retention)

v

v

v

Thirstiness

v

v

v

v

v

v

v

v

v

Urinary incontinence (leaking of urine)

v

v

v

Urination,

Increased frequency of

v

v

v

v

v

v

Vaginal discharge, increased

v

v

v

v

v

v

v

v

v

Varicose veins

v

v

v

Weepy

v

v

v

v

v

v

v

v

v

Yeast infections

v

v

v

v

v

v

v

v

v

Morning sickness

For some women, the nausea that can strike during the first trimester is worse in the mornings, maybe because the stomach is empty at that time of day. But ask anyone who’s had morning sickness, and she’ll tell you: It can hit any time it wants. It often starts during the fifth or sixth week (that is, three to four weeks after you miss your period ) and goes away, or at least becomes much less severe, by the end of the 11th or 12th week. It can last longer, though, particularly in women who are expecting twins or more.

If you’re experiencing nausea, we sympathize. Even when nausea doesn’t actually cause you to vomit, it can be extremely uncomfortable and truly debilitating.. If your queasiness gets out of control — if you experience weight loss, if you find that you can’t keep down food or liquids, or if you feel dizzy or faint — call your doctor. If you’re really bothered by the nausea, talk to your doctor about over-the counter or prescription medications. Your doctor may suggest or prescribe :

• Vitamin B6: Some evidence suggests that 50 milligrams of vitamin B6 three times a day can reduce nausea.  Take time to talk to your doctor about trying vitamin B6.
• Ondansetron (Zofran): Some women find relief for extreme nausea with or without vomiting from this prescription medication. Although ondansetron hasn’t been extensively studied in pregnancy, we know of no reports of an increase in birth defects associated with this medication.
• Metoclopramide (Reglan): Your doctor can actually administer this drug by continuous infusion under the skin through a device known as a subcutaneous pump. The advantage of this method is that for those women who really can’t even swallow a pill because they’re so nauseous, they don’t have to.

Occasionally, the nausea and vomiting are so severe that you develop a condition called hyperemesis gravidarum. The symptoms include dehydration and weight loss. If you develop hyperemesis gravidarum, you may need to be given fluids and medications intravenously. If you’re less than six weeks pregnant, you can take folic acid alone instead of your prenatal vitamin. Folic acid is the main supplement that you need early in your pregnancy, and it’s much less likely to upset your stomach than the multivitamin you normally take during pregnancy. Check with your doctor for the correct dose for you.

You may hear some women say that morning sickness is a sign that you’re experiencing a “normal” pregnancy, but that claim is a myth — and so is the reverse. If you’re not having morning sickness, or if it suddenly disappears, don’t worry that your pregnancy isn’t normal; just enjoy your good fortune. Similarly, you may hear that the severity of your queasiness indicates whether you’re having a girl or a boy. But that’s also a myth, so don’t buy those pink or blue outfits just yet, Above all, don’t compound the problem by worrying about it.

The nausea is harmless — to you and the baby. Your optimal weight gain for the first three months is only 2 pounds. Even losing weight probably isn’t a big problem. This is the most talked about discomfort of early pregnancy. It is actually a misnomer since it can occur at any time of the day. Many women describe it as feeling like the beginnings of a stomach flu. You feel nauseous—as if you’re going to throw up. You may also be actually vomiting at times. Some researchers believe this symptom of early pregnancy is researchers believe it’s caused by the way your body breaks down and utilizes carbohydrates. You can’t really do anything about the hormones—they’re needed to maintain the pregnancy. But you can provide your body with a more constant supply of carbohydrates. Many women with morning sickness experience it upon waking perhaps because their bodies have been without carbohydrates during an 8 to 10 hour period of sleep. The answer to the problem, whenever it occurs, may be to give the body more carbohydrates. Unfortunately, the last thing you’ll want to do when you feel like this is to eat

Tips for dealing with morning sickness :

• Make sure you get something light to eat just before bedtime.
• Throughout the day, try to notice when you have the most intense symptoms of “morning sickness,” then, in the following days, try to eat something prior to this time period even if you’re not hungry. Remind yourself that there may be unpleasant consequences if you don’t follow the schedule.
• Try eating six small meals a day instead of the usual three, or include nutritious snacks in your daily eating.
• Avoid fried or greasy foods. They may exacerbate morning sickness and they aren’t good for a pregnancy diet anyway. Spicy food may also not be tolerated well in early pregnancy.
• Always carry some crackers, protein bars, or dry cereal with you. You should keep snacks in the car, at work, and in your purse. When you start to feel queasy, eat these carbohydrates slowly and try to get some fresh air.
• If you feel nauseous, put a cold cloth on your face and take slow, deep breaths to calm yourself. Realize that the anxiety of knowing you may be getting “sick to your stomach” may make the problem worse.
• Some women learn how to use acupressure. This Chinese method of applying pressure to various points in the body may be helpful in alleviating your pregnancy nausea.
• Others say that eating foods containing ginger or drinking ginger tea or ginger ale decreases their morning sickness. If you feel that your morning sickness is unbearable, or if you’re vomiting more than once per day, let your doctor or midwife know. Other symptoms to report include producing only small amounts of dark urine, feeling light-headed, and a rapid heartbeat. These may be signs of dehydration. Your OB provider may provide nausea medication to alleviate your distress. A severe case of morning sickness is called hyperemesis gravidarum. If you find you cannot tolerate any solid food and most liquids, you will need to be closely monitored by your OB provider.

TRY THIS

Have the following items in your car and at work to help with morning sickness:

• Crackers, dry cereal, and dried fruit in small plastic bags or containers
• A large plastic bag—if you need to get sick while in the car
• Some moist wipes to refresh you
• A bottle of water

Unusual Food Cravings

You may not have problems with morning sickness but crave unhealthy foods, nonfood items, or may have no appetite during this first trimester. These responses to early pregnancy are all normal

Tip :

• If you find you’re wanting to eat excessive amounts of foods high in fat or sugar, choose healthy eating menus or meal plans that describe specific meals to prepare and eat. Enroll your husband and around. Give yourself a tiny reward once in a while.
• While some cravings are normal, wanting to eat things such as clay, dirt, chalk, or starch, is called “pica craving” and may be caused by a lack of certain minerals and vitamins in your body. Tell your doctor or midwife about any pica cravings. Some women crave ice in early pregnancy. This is not necessarily harmful but may be a sign of anemia and should also be reported to your obstetrical provider.
• If you have little or no appetite in the first trimester, try to eat small portions frequently during the day, ignoring your lack of hunger. Learn which foods contain the nutrients your baby needs, and plan to include them in your diet. You may want to make a schedule that establishes when you’ll have regular snacks. Healthy snack foods include yogurt, pretzels, trail mix, nut butters, fruit, and raw vegetables

Bloating

Well before the baby is big enough to stretch out your stomach, your belt may begin to feel uncomfortable and your belly may look bloated and distended. This side effect of the hormone shift starts happening as soon as you conceive. Progesterone, one of the two key pregnancy hormones, causes you to retain water. Plus, it slows down the bowels, causing them to enlarge and thus increase the size of the abdomen. Estrogen, the other key pregnancy hormone, causes your uterus to enlarge, which also makes your abdomen feel bigger. This effect is often more pronounced in second or third pregnancies because the first pregnancy causes your abdominal muscles to relax to a greater degree.

Aches, Pains, and Backaches

As your uterus expands, pains in the back, abdomen, groin area, and thighs often appear. Many women also have backaches and aching near the pelvic bone due the pressure of the baby’s head, increased weight, and loosening joints. Backaches are pretty common in pregnancy. They are caused by the stress and strain on the muscles that support the lower back and pelvic region.

There are also mechanical issues involved. As your center of gravity moves forward, you’ll lean backwards to compensate from flailing forward. Naturally, this creates an increased amount of strain on the back muscles.

In addition, there are hormonal changes, specifically a hormone called relaxin, which is produced by the body and helps to loosen the ligaments and attachments in the pelvic region in order to accommodate the baby. All of these things, plus poor posture and possibly poor physical conditioning, can increase a person’s risk for back pain. The basic physiological change that is occurring is an inflammatory response to the strain-induced muscle and back injury.

Tips to try :

• lying down;
• resting; and
• applying heat
• try some gentle stretching exercises in the morning and evening
• work on having good posture during the day and use a support pillow propped behind your lower back in an ergonomic chair if you are working at a desk.
• take more frequent breaks to walk around and stretch—at least once an hour. If you have to lift something, make sure that you lift properly so you don’t aggravate the back problem.
• Don’t bend over; rather, squat down and lift with your legs and not your back.
• Your partner or significant other can be a big help here. Have him apply a warm
• compress or heating pad (or warm towel) to the back and massage it through the back towel.
• You can also take a warm bath—anything that soothes the area
• If you are worried or the pains do not get better, call your doctor.

Breast Changes

A woman’s breasts increase in size and fullness during pregnancy. As the due date approaches, hormone changes will cause your breasts to get even bigger in preparation for breastfeeding. Your breasts may feel full and heavy, and they might be tender or uncomfortable. The nipples and  areolae (the circular areas around the nipples) also grow bigger and may begin to darken. Breast changes are caused by the large amounts of estrogen and progesterone your body produces during pregnancy. These hormones cause the glands inside your breasts to grow and branch out for milk production and breastfeeding after the baby is born. Blood supply to the breasts also increases markedly. You may notice large, bluish blood vessels coursing along your breasts.

Breast discomfort is pretty common among pregnant women as the breast stretches and enlarges in order to accommodate future lactation. In fact, some women will suspect they are pregnant because their breasts hurt. Other women experience more discomfort closer to delivery. For many women, the pain varies from the beginning of the pregnancy until the end.

In the third trimester, some pregnant women begin to leak colostrums from their breasts. Colostrum is the first milk that your breasts produce for the baby. It is a thick, yellowish fluid containing antibodies that protect newborns from infection. If leaking becomes embarrassing, put nursing pads inside your bra.

Tips to stay comfortable :

• Wear a soft, comfortable maternity or nursing bra with extra support. Adjust your bra size if needed. Get a comfortable bra with good support. Good support helps reduce stretching and sagging later on.
• Wash your nipples with water instead of soap. Soap can dry and irritate nipples. If you have cracked nipples, use a heavy moisturizing cream that contains lanolin.
• Always tell your doctor if you are worried or the pain is out of the ordinary or unbearable

Frequent Urination.

Your uterus expands enough to rise up into your abdominal cavity. Your enlarging uterus may compress your bladder, which both decreases its capacity and increases the feeling that you need to urinate. Having to urinate more frequently is common in early and late pregnancy. Your changing hormone levels cause the smooth muscles of the uterus and bladder to relax, increasing the sensation of the need to urinate. In addition, your body is beginning to get rid of waste for two people.

Tip :

• Plan for more frequent trips to the bathroom, especially when you’re involved in activities such as a long car trip, a meeting, or going to a movie. Do not wait to go to the bathroom. Holding off will only cause you mental and physical stress. If you experience a burning sensation or pain of any kind when you urinate, or feel that the need to go is urgent but you produce little urine, you may have a bladder infection. Report these symptoms to your doctor or midwife.
• You can’t do much about your need to urinate frequently, except use common sense. Before going out for long (or even short) trips, empty your bladder so that you don’t find yourself needing facilities when none are available.
• Drink plenty of fluids during pregnancy to avoid dehydration, but try to drink more during the day and less in the evening so that you aren’t up all night going to the restroom. Coffee and tea contain caffeine (a diuretic, which increases the flow of urine) and may aggravate the situation, so try decreasing the amount of caffeine you consume.
• If you find yourself urinating even more than your pregnancy norm or if you feel any discomfort or burning or notice blood during urination, talk to your practitioner. When you’re pregnant, bacteria in your urine are more likely than usual to cause a urinary tract infection.

Fatigue

During the first trimester, you’re likely to feel over whelming fatigue. You may feel very tired throughout the day or at times feel you have never experienced such fatigue before. You may crave a nap each day This fatigue may be a side effect of all the physical changes your body is experiencing, including the dramatic rise in hormone levels. The fatigue is caused by the rapid growth of your uterus and your baby, both demanding energy from your body.

Rest assured that your exhaustion will probably go away somewhere around the 12th to 14^th week of your pregnancy. As your fatigue lessens, you’ll probably feel more energetic and almost normal, until about 30 to 34 weeks into your pregnancy, when you may tire out again. In the meantime, remember that fatigue is nature’s way of telling you to get more rest. If you can, try to catch a short nap during the day and go to bed earlier than usual at night.

Tip :

• Plan for this rest time. Don’t fight the urge for a nap. Schedule time in your day just to rest. Even if you don’t sleep, just put your feet up and drink some water. You’ll feel better, less tired, and perhaps less moody.

Dizziness

Many pregnant women complain of dizziness and light headache throughout their pregnancies. Fainting is rare but does happen even in some healthy pregnant women. There are many reasons for these symptoms. The growth of more blood vessels in early pregnancy, the pressure of the expanding uterus on blood vessels, and the body’s increased need for food all can make a pregnant woman feel lightheaded and dizzy.

Tips :

• Stand up slowly. Be careful about standing up too suddenly or making sudden changes in positions (from lying down to getting up too quickly)
• When you’re feeling lightheaded, lay down on your left side.
• Avoid sitting or standing in one position for a long time.
• Eat healthy snacks or small meals frequently. Food and rest can usually cure headaches that are caused by nausea, fatigue or hunger. So try eating and getting some extra sleep.
• Drinking plenty of fluids to offset this condition. Women who aren’t properly hydrated are more sensitive to this blood pressure drop.
• Don’t get overheated.
• Call your doctor as soon as possible if you faint. Dizziness or lightheadedness can be discussed at regular prenatal visits.
• If your headaches are chronic or recurrent, you may need to take medications, despite their effects on your fetus. As always, consult with your doctor before taking these medications.

Anemia

There is a physiologic anemia that begins early in pregnancy and is considered normal. While it’s not really a true anemia in the classic sense—but rather a physiologic anemia, meaning that it only occurs in pregnancy—it still needs to be treated. What happens is that there is a 50% increase in an expectant mother’s plasma volume, but only about a 20–40% increase in her red blood cells. This discrepancy leads to a dilutional effect. The body thinks it is anemic because of this dilutional effect, and the result is that the woman does actually feel tired. Because of this relative anemia, most doctor give pregnant women prenatal vitamin supplements that contain the necessary iron that she might lack. However, rarely will a woman require more iron than can be found in the normal prenatal vitamin. Her anemic status will be checked again in the third trimester, and additional iron supplements may be added at that time as needed.

Hemorrhoids

Up to 50% of pregnant women get hemorrhoids. Hemorrhoids are swollen and bulging veins in the rectum. They can cause itching, pain, and bleeding.

Hemorrhoids are more common during pregnancy for many reasons. During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The expanding uterus also puts pressure on the veins in the rectum. Plus, constipation can make hemorrhoids worse. Hemorrhoids usually improve after delivery.

Tips to help prevent and relieve hemorrhoids :

• Drink lots of fluids.
• Eat plenty of fiber-rich foods like whole grains, raw or cooked leafy green vegetables, and fruits.
• Try not to strain for bowel movements.
• Talk with your doctor before taking any laxative.
• Talk to your doctor about using witch hazel or ice packs to soothe hemorrhoids.

Leg Cramps

At different times during your pregnancy, you might have cramps in your legs or feet. They usually happen at night. The cramping is probably related to the uterus growing and enlarging. This is a very common symptom, so don’t worry. This is due to a change in the way your body processes, or metabolizes, calcium.

Tips to prevent and ease leg cramps :

• Eat lots of low-fat calcium-rich foods.
• Get regular mild exercise, like walking.
• Ask your doctor if you should be taking a prenatal vitamin containing calcium.
• Gently stretch the muscle to relieve leg and foot cramps. If you have a sudden leg cramp, flex your foot toward your body.
• Use heating pads or warm, moist towels to help relax the muscles and ease leg and foot cramps. You may feel a vague, menstrual-like cramping sensation during the first

Nasal Problems

Nosebleeds and nasal stuffiness are common during pregnancy. They are caused by the increased amount of blood in your body and hormones acting on the tissues of your nose. To ease nosebleeds blow gently when you blow your nose. Stop nosebleeds by squeezing your nose between your thumb and finger for a few minutes. If you have nosebleeds that do not stop in a few minutes or happen often, see your doctor.

Drinking extra water and using a cool mist humidifier in your bedroom may help relieve nasal stuffiness. Talk with your doctor before taking any over-the counter or prescription medicines for colds or nasal stuffiness.

Shortness of Breath

As the baby grows, your expanding uterus will put pressure on all of your organs, including your lungs. You may notice that you are short of breath or might not be able to catch your breath. Some women complain about shortness of breath during the first trimester. This condition could be caused either by hormonal changes or by the diaphragm being elevated due to the growing pregnancy so that it restricts the downward movement that allows a woman to expand her lungs.

Sometimes, women may have a perception that they are having trouble breathing, but in fact, they are fine, and there is usually nothing about which to be concerned. If a shortness of breath occurs, the remedy is to stay calm and not panic. Take a few deep breaths and relax. Generally, that anxious feeling will pass, and your breathing will resume normally.

However, if you have a pre pregnancy pulmonary condition like asthma before becoming pregnant or develop it while you’re pregnant (which does happen), this condition could possibly be exacerbated with pregnancy, and you should consult your doctor immediately

Tips to ease breathing include :

• Take deep, long breaths.
• Maintain good posture so your lungs have room to expand.
• Use an extra pillow and try sleeping on your side to breathe easier at night.
• Get help quickly if you are an asthmatic. Check with your doctor to see which medicines you can use while pregnant.

Swelling

Most women develop mild swelling in the face, hands, or ankles at some point in their pregnancies. As the due date approaches, swelling gain or your hands or feet suddenly get very puffy, call your doctor as soon as possible. It could be a sign of high blood pressure called preeclampsia or toxemia.

Tips to keep swelling to a minimum :

• Drink 8 to 10 eight-ounce glasses of fluids (water is best) daily.
• Avoid caffeine.
• Try to avoid very salty foods.
• Rest when you can with your feet elevated.
• Ask your doctor about using support hose.

Teeth and Gum Problems

A pregnant woman’s teeth and gums need special care. Pregnant women with gum disease are much more likely to have premature babies with low birth weight. This may result from the transfer of bacteria in the mother’s mouth to the baby during pregnancy. The microbes can reach the baby through the placenta (a temporary organ joining the mother and fetus which supplies the fetus with blood and nutrients), through the amniotic fluid (fluid around the fetus), and through the layer of tissues in the mother’s stomach.

Every expectant mother should have a complete oral exam prior to or very early in pregnancy. All needed dental work should be managed early, because having urgent treatment during pregnancy can present risks. Interventions can be started to control risks for gum inflammation and disease. This also is the best time to change habits that may affect the health of teeth and gums, and the health of the baby.

Remember to tell your dentist that you are pregnant! You can ease bleeding gums by brushing with a soft-bristled toothbrush and flossing at least twice a day. Get more details on taking care of your teeth and gums during pregnancy.

Varicose Veins

During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. Plus, pressure on the large veins behind the uterus causes the blood to slow in its return to the heart. For these reasons, varicose veins in the legs and anus (hemorrhoids) are more common in pregnancy. They can be twisted or bulging and are dark purple or blue in color. They are found most often on the backs of the calves or on the inside of the leg.

Tips to reduce the chances of varicose veins :

• Avoid tight knee-highs or garters.
• Sit with your legs and feet raised when possible.
• Consult your doctor if either condition becomes unbearable.

Digestive Difficulties

Constipation

Many pregnant women complain of constipation. High levels of hormones in your pregnant body slow down digestion and relax muscles in the bowels leaving many women constipated. Plus, the pressure of the expanding uterus on the bowels boosts the chances for constipation. What this means is that the intestines are not pushing the fecal matter through the bowel as efficiently as before the pregnancy. Therefore, the stools become drier as the water in them is reabsorbed by the intestines, which leads to firmer and drier stools, and the unpleasant feeling associated with constipation

Tips to stay more regular :

• Eat plenty of high-fiber foods. Bran cereals, fruits, and vegetables all are good sources of fiber. Some women find it helpful to eat some popcorn, but choose the low-fat kind, without all the butter and added oil. Check the fiber content on package labels and choose foods with higher fiber content.
• Drink plenty of water. Drink eight to 10 glasses of water everyday. Staying well hydrated helps keep food and waste moving through the digestive tract. Some juices (especially prune juice) may help, while others (such as apple juice) may only exacerbate the problem.
• Take stool softeners. A stool softener, such as Colace (docusate sodium), isn’t a laxative — it just keeps the stool soft. Stool softeners are safe during pregnancy, and you may take them two to three times a day. Avoid laxatives because they can cause abdominal cramping and, occasionally, uterine contractions. For any person, pregnant or not, chronic laxative use should be avoided. If you’re extremely constipated, though, and aren’t at risk for preterm labor, you may want to talk to your practitioner about the short-term use of a very mild laxative, like a glycerin suppository or milk of magnesia.
• Exercise as regularly as you can. Exercise helps constipation, so enjoy some safe exercise (even if it’s only walking).

Heartburn and Indigestion

Almost every pregnant woman experiences indigestion and heartburn. Hormones and the pressure of the growing uterus cause this discomfort. Pregnancy hormones slow down the muscles of the digestive tract. So food tends to move more slowly and digestion is sluggish. This causes many pregnant women to feel bloated. Hormones also relax the valve that separates the esophagus from the stomach. This allows food and acids to come back up from the stomach to the esophagus. The food and acid causes the burning feeling of heartburn. As your baby gets bigger, the uterus pushes on the stomach making heartburn more common in later pregnancy. Before rushing to the doctor for medication, try to sort through the condition on your own.

Tips :

• Avoid greasy and fried foods.
• Eat six to eight small meals instead of three large meals.
• Don’t gain more than the recommended amount of weight.
• Take small sips of milk or eat small pieces of chipped ice to soothe burning.
• Eat slowly.
• Ask your doctor if you can take an antacid medicine.

Stretch Marks and Other Skin Changes

Stretch Marks

Worried about the dreaded stretch marks of pregnancy? Just about all pregnant women are. The good news is that only about half of pregnant women get stretch marks. Stretch marks are red, pink, or purple streaks in the skin. Most often they appear on the thighs, buttocks, abdomen, and breasts. These scars are caused by the stretching of the skin, and usually appear in the second half of pregnancy.

The color of stretch marks depends on a woman’s skin color. They can be pink, reddish brown, or dark brown streaks. While creams and lotions can keep your skin well moisturized, they do not prevent stretch marks from forming. Most stretch marks fade after delivery to very light lines.

Other Skin Changes

Some women notice other skin changes during pregnancy. For many women, the nipples become darker and browner during pregnancy. Many pregnant women also develop a dark line (called the linea nigra) on the skin that runs from the belly button down to the pubic hairline. Blotchy brown pigmentations on the forehead, nose, and cheeks are also common. These spots are called melasma or chloasma and are more common in darker-skinned women. Most of these skin changes are caused by pregnancy hormones and will fade or disappear after delivery.

Spotting.

You may notice a little spotting—a tiny amount of red or brownish blood—during the first trimester. Sometimes spotting happens because tiny blood vessels on the cervix break after sex. Spotting can also be caused by a minor vaginal infection. Or it may occur when the fertilized egg implants in the uterus. Most of the causes of spotting are nothing to worry about, but it’s important to report all incidences to your doctor/midwife. She or he will determine if any action is necessary.

If you have spotting accompanied by pain in the pelvic area, back, or shoulder, report these symptoms immediately to your OB provider. He or she will want to see you to be sure you’re not having an ectopic pregnancy. With ectopic pregnancy, a fertilized egg does not descend into the uterus for implantation. Instead it remains in the fallopian tube and starts to develop there. If the embryo is allowed to remain there, it will rupture the fallopian tube. Once this problem is diagnosed, the treatment is usually successful. If you’re diagnosed with an ectopic pregnancy, for the sake of your health, your pregnancy cannot be allowed to continue. Prompt action on the part of your OB provider will ensure that you’re able to try and become pregnant again as soon as you desire.

Tingling and Itching

Tingling and numbness of the fingers and a feeling of swelling in the hands are common during pregnancy. These symptoms are due should disappear after delivery.

About 20 percent of pregnant women feel itchy during pregnancy. Usually women feel itchy in the abdomen. But red, itchy palms and soles of the feet are also common complaints. Pregnancy hormones and stretching skin are probably to blame for most of your discomfort. Usually the itchy feeling goes away after delivery. In the meantime,

Tips to feel better :

• Use thick moisturizing creams instead of lotions on your skin.
• Use gentle soaps.
• Avoid hot showers or baths that can dry your skin.
• Avoid itchy fabrics and clothes.
• Try not to get overheated. Heat can make the itching worse.

Sleeping Troubles

During your pregnancy, you might feel tired even after you’ve had a lot of sleep. Many women find they’re particularly exhausted in the first trimester. Don’t worry, this is normal! This is your body’s way of telling you that you need more rest.

In the second trimester, tiredness is usually replaced with a feeling of well being and energy. But in the third trimester, exhaustion often sets in again. As you get larger, sleeping may become more difficult. The baby’s movements, bathroom runs, and an increase in the body’s metabolism might interrupt or disturb your sleep. Leg cramping can also interfere with a good night’s sleep.

By the third trimester, your large belly will make it impossible to sleep on your front, and sleeping on your back is not recommended since this position may restrict blood flow to your uterus.

Tips to feel and sleep better :

• When you’re tired, get some rest.
• Try to get about 8 hours of sleep every night, and a short nap during the day.
• If you feel stressed, try to find ways to relax.
• Sleep on your left side. This will relieve pressure on blood vessels that supply oxygen and nutrients to the fetus.
• If you have high blood pressure during pregnancy, always lay on your left side when you’re lying down.
• Avoid eating large meals 3 hours before going to bed.
• Get some mild exercise like walking.
• Avoid long naps during the day.

Weight Gain

The amount of weight you need to gain during pregnancy depends upon how much you weighed before you became pregnant. According to the American College of Obstetricians and Gynecologists (ACOG) women who have a normal weight before getting pregnant should gain 25 to 35 pounds. Women who are underweight before pregnancy should gain 28 to 40 pounds. And women who are overweight should gain 15 to 25 pounds.

Research shows that women who gain more than the recommended amount during pregnancy have a higher chance of being obese 10 years later. Ask your doctor how much weight gain during pregnancy is healthy for you. Some weight gain, particularly around the waist, is normal. However, if you’re gaining an inordinate amount of weight in the first trimester, consult with your doctor.

First, make sure you are not pregnant with multiple gestations (i.e., twins). Next, try to rule out any physiological reason for the weight gain, such as any pre-existing medical condition or hormonal disorder (possibly thyroid disease, diabetes, or Cushing’s disease or syndrome). Make sure you’re eating a healthful diet with the requisite amounts of fruits, vegetables, proteins, and complex carbohydrates. Try to cut out excess sugar and calories, such as fried foods and fast foods. The first trimester is not the time to gain weight. An ideal weight gain for this period would likely be based on your body mass index (BMI), which can be calculated using your pre pregnancy height and weight