Think pregnancy is cute? All the things it can actually do to your body

Monday, May 20, 2019

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PREGNANCY, in general, is a beautiful experience. And while the journey for most women is filled with glowing skin and lush, bouncy hair, for other women it's less than magical.

There are plenty of not-so-cute and even ugly changes that the woman's body experiences during pregnancy and even after birth. Fortunately, said obstetrician-gynaecologist Dr Anna-Kay Taylor Christmas, these changes are mostly temporary.

Below, she shares some of the symptoms as well as what, if anything, can be done to minimise the effects of these unpleasant body changes:

 

Constipation

The high iron content of prenatal vitamins can cause constipation (as well as a darkening of the stool, which is not serious). The increased strain to pass stool, combined with the generalised swelling that can accompany pregnancy, also increases the chances of haemorrhoids (piles) developing. These can be quite painful or even bleed.

“To counteract this effect, obstetricians often prescribe a prenatal supplement that may also contain a stool softener. However, if haemorrhoids are severe, additional stool softeners and pain relievers (oral tablets and/or rectal suppositories) are also prescribed. We also recommend dietary changes that help with constipation, such as increased fibre and water in the diet, as well as moderate exercise,” Dr Taylor Christmas advised.

She said, too, that most of these symptoms resolve during the weeks to months following delivery.

 

Gum/oral disease

Pregnant women are at increased risk of gingivitis (red, inflamed, bleeding gums) due to the increased blood flow and hormonal changes associated with pregnancy.

If severe and untreated, it can result in periodontitis, which, in addition to the symptoms of gingivitis, can cause receding gums, bad breath, loose teeth, and tenderness when biting.

“Periodontitis disease is associated with a significant increased risk of pre-term birth and low birth weight, and should be treated urgently. All dental associations recommend routine dental assessment at the beginning of pregnancy and treatment of any underlying gum disease to prevent progression and complications,” Dr Taylor Christmas explained.

There is also the risk of pregnancy tumours in the mouth, caused by an enhanced inflammatory response to irritants (food and plaque), and these may develop on the gums, tongue, palate or cheeks, but usually resolve after childbirth.

Pregnancy tumours are typically left alone and observed; unless they bleed, interfere with chewing or do not resolve after delivery.

“Increased levels of oestrogen and progesterone can also affect ligaments and bones that support the teeth, occasionally causing teeth to loosen or fall out during pregnancy, even without gum disease,” Dr Taylor Christmas underscored.

 

Increased shoe size

“The generalised swelling and weight gain of pregnancy can also affect the feet and many women experience an increase in shoe size during pregnancy,” Dr Taylor Christmas said.

She explained that this is a result of pregnancy hormones, which causes relaxation of the ligaments between bones (aimed primarily at the pelvis); they also affect the ligaments elsewhere, including the feet. The effect may be greater in one foot over the other and, unfortunately for some women, can be permanent after the pregnancy is complete.

 

Change in vaginal discharge

The colour and consistency of vaginal discharge is guided by varying hormonal levels (primarily oestrogen and progesterone). As the levels of these hormones change during pregnancy, so does the vaginal discharge.

“Many patients notice a heavier, thicker discharge than normal, which we often reassure them about. If there is any associated itching, burning or a bad odour, this is a potential sign of infection and should always be investigated further,” Dr Taylor Christmas said.

 

Increased hair growth

A potentially wonderful side effect of the changing hormone levels in pregnancy that many women look forward to is increased hair growth. Women often report thicker, longer hair as their hair is stimulated to remain in the growth phase for a longer time period.

“Some women, however, also experience an increase in hair growth in other areas such as the chest, around the nipples, and the upper thigh, which may be considered an unwanted inconvenience but is simply a normal variation due to pregnancy,” Dr Taylor Christmas highlighted.

 

Hair loss

On the flip side of extra hair growth during pregnancy is the heavy shedding of hair that can occur after delivery when there is a sudden dip in hormone levels, putting the hair out of the growth phase.

“New mothers may experience hair thinning and loss of clumps of hair during routine hair care and grooming activities that may be quite distressing. We often reassure them that hair growth and thickness will return to normal once the hormone levels settle down in the months following delivery,” Dr Taylor Christmas said.

 

Facial discolouration

“While many women anticipate the 'pregnancy glow' caused by increased blood flow to the face, some are affected by a condition called melasma. It causes patchy dark areas to form on the face, usually on the cheeks, nose, forehead, chin, and upper lip,” Dr Taylor Christmas pointed out.

She said that the condition usually self-corrects after pregnancy, and women should adopt a wait-and-see approach with no active intervention during pregnancy. In addition, she said that sunscreen use helps to prevent and slow the progression of this condition.

 

Skin rashes

Pregnancy can cause an aggravation of any pre-existing skin conditions, including acne, eczema, psoriasis, skin tags, and spider veins. These flare-ups are usually treated with topical solutions for symptomatic relief and are expected to improve after pregnancy is finished.

“Pregnancy can also cause new skin rashes due solely to pregnancy, primarily the condition pruritic urticarial papules and plaques of pregnancy, which causes small, red, itchy bumps that may form into larger patches. They usually start on the abdomen and spread to the thighs, buttocks, breasts, and arms,” Dr Taylor Christmas outlined.

She said that severe itching may less commonly be due to a much more serious condition caused by dysfunction of the liver called obstetric cholestasis, but this does not have an associated skin rash.

 

Varicose veins

“In addition to spider veins, the increased swelling and blood flow of pregnancy can lead to the formation or worsening of varicose veins on the legs and thighs. In severe cases, it may extend all the way up to the vulva or vagina. At this point, the risk of bleeding from a tear or rupture of one of these swollen vessels is weighed to decide on vaginal versus caesarean delivery,” Dr Taylor-Christmas shared.

She said to limit the severity of varicose veins and swelling on the legs, doctors encourage pregnant patients to wear compression stockings, especially when working, and to elevate the legs on chairs or pillows whenever possible.

“Sudden, severe swelling, especially if it involves the hands or face, may make us suspicious for the complication of pre-eclampsia, which is accompanied by high blood pressure and excess protein in the urine. If the swelling is accompanied by bleeding from the vagina, pain in the abdomen, decreased movement of the baby, headache, or difficulty seeing properly, medical attention should be sought immediately, as this can cause severe illness in mother and baby,” Dr Taylor Christmas advised.

 

Loss of abdominal muscle tone

“The stretching of the abdominal wall muscles associated with pregnancy can lead to a condition known as diastasis recti, which in simple terms means a separation of the rectus (six-pack) muscles,” Dr Taylor Christmas explained.

She pointed out that the degree or severity can range from mild to severe and, unfortunately, may be permanent after pregnancy and delivery. It may also cause pain or discomfort in the abdominal region and a noticeable 'pooch' or protrusion of the belly.

“Milder cases can usually be improved with targeted exercises and physiotherapy. More severe cases may require more intensive and specialised physiotherapy or even surgery to repair the damage,” Dr Taylor Christmas advised.

 

Pelvic floor/vaginal damage

Pressure from the weight of the baby's head and body, and vaginal tearing during delivery, can damage the muscles and nerves in the pelvic floor. These muscles are responsible for keeping the pelvic organs (uterus and cervix, bladder and rectum) in the correct position. If they become weakened or damaged, it can result in prolapse of these organs where they push down into the vagina.

“In the most severe cases, they may push all the way out of the vagina. It can also cause dysfunction with passing stool and incontinence of urine. Urinary incontinence is one of the most common complaints after a vaginal delivery and should always be checked for at the post-natal check-up,” Dr Taylor Christmas said.

Vaginal tears, another common result of vaginal delivery, she said, are usually easy to repair, but severe tears that extend into the rectum require more extensive reconstruction to prevent incontinence of stool.

“Mild to moderate cases of prolapse can be treated with Kegel exercises or specialised pelvic physiotherapy. More severe cases may require support devices such as pessaries or surgery. Elective caesarean sections may help lessen the severity, but do not necessarily prevent these conditions,” Dr Taylor Christmas advised.


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