FEET AND ANKLES | Known as ‘oedema’, this is essentially excess blood and water ‘pooling’ in your extremities. Don’t be alarmed. It’s common and normal and will go away after you give birth. But it can be incredibly uncomfortable and inconvenient. Your shoes may not fit anymore, and you may feel ungainly and bizarrely trapped in this new, inflatable body. What to do Elevate your feet when possible (also keep a stool or pile of books under your desk); lie on your left side when possible; put on waist-high support tights before you get out of bed in the morning so blood has no chance to pool around your ankles; drink plenty of water (surprisingly, keeping hydrated helps your body retain less water); exercise regularly; avoid salty foods. Word of warning Sudden severe swelling in your hands and face can be a sign of pre-eclampsia, a condition that is very serious. Call your midwife or doctor if this happens.
VARICOSE VEINS | Yes, sometimes we get these glamorous things in pregnancy, because of our increased blood volume. They are enlarged veins (blood vessels) close to your skin’s surface and usually found in your legs and feet. They can ache, itch or throb, and they can look a bit grim. What to do Talk to your midwife if you have them/think you’re getting them. She’ll suggest keeping your feet elevated, wearing support tights, moving around a lot, avoiding certain sitting positions (crossed legs, thighs pressing on edge of chair), avoiding standing for long periods.
GROUP B STREP | This is a common bacteria, harmless to you and found in your vagina. If you have it, your baby can pick up an infection on its way out and can be damaged by it. You may be screened for this in pregnancy. There is more about this in Chapter 5: Your Options, page.
VAGINAL YEAST INFECTIONS (OR THRUSH) | This is very common in pregnancy because of hormonal shifts and appears as a frothy, yeasty discharge accompanied by intense vaginal itching. What to do Avoiding sugar may help and ask your GP or midwife about over-the-counter creams that are safe to use in pregnancy.
More serious health worries
There are, of course, endless rare, technical problems to do with pregnancy that we just can’t cover in this book. We cover a few of the most common serious health worries below. If anything else crops up during your pregnancy, talk to your doctor, midwife or specialist: the basic advice is to become as informed about your particular issue as possible and get help from any support group you can find. The internet is always a good place to start, but ask at your hospital for recommendations too.
BED REST | If, for example, the baby looks likely to be born prematurely, you may be put on bed rest. This can range from literally not moving from the bed until the baby is born, to a low-key, temporary rest. How to cope Make sure you completely understand the reasons for your bed rest, and the extent of your limitations. Get specific information, such as how long can you stand in the shower everyday? Does this time include dressing? If allowed, sofa-rest may be more manageable (you’ll feel more normal, less ill). Ask your doctor.
TIPS FOR BED REST SURVIVAL
Create your own space: have the TV remote control, books, books on tape, drinks, wet wipes, toothbrush, chapstick, phone, pen and paper etc. all within reach.
Have something to look at that will encourage you: the baby’s scan picture, for instance.
Accept help (laundry, food, with other children).
Network: one of the best defences against depression is support from others in your circumstance (if you have a laptop it could be your cyberlifeline). Try http://fpb.cwru.edu/Bedrest.
Put on real clothes if allowed to move. You aren’t ill, so try and do the little things that will help you remember this.
Practise relaxation techniques and do any doctor-approved stretches to keep your blood flowing.
This would be a great time to learn to knit (yes, really: bizarre as this may seem to the non-knitter), or to address baby announcements, read War and Peace or do your Christmas cards (even in July). If you fancy having a go at knitting try: www.ethknits.co.uk, www.bust.com/knithappens
Bed rest may affect your finances. Let your mortgage/loan officers and credit card companies know. Arrange new payment schedules if necessary that will keep you from lying there worrying.
BLEEDING IN PREGNANCY | Twenty per cent of us have early pregnancy ‘blood spotting’ or light bleeding. Dark red bleeding with tummy cramps can mean the start of a miscarriage, though not always. Call your GP/midwife if you experience bleeding – even if just for reassurance.
DIABETES | If you are a diabetic you need special care in pregnancy as you need to control your blood sugar carefully (there is an increased risk of miscarriage or complications with the pregnancy if it is poorly controlled). Discuss this with your doctor/midwife early in pregnancy.
GESTATIONAL DIABETES | About three to five per cent of pregnant women develop this kind of diabetes during pregnancy and it can usually be controlled by diet. It goes away afterwards. There may be no symptoms except sugar in your urine. There is an increased risk that you will have a big baby if you develop the condition. Policies on screening for gestational diabetes vary across the country. In many hospitals, your pee will be tested for sugar at your antenatal check-ups. Or you may be screened in your second trimester. Do talk to your midwife/doctor about screening, if you have any of the risk factors, or are worried about this. Risk factors include previous gestational diabetes, family history, a previous big baby, a previous stillbirth, obesity and certain medical conditions.
HIV | All health authorities in the UK have to offer you an HIV screening at your booking-in blood test. Treatment is available if you are HIV positive and there are important steps you can take to minimise the chances of passing on HIV to your baby (during pregnancy, birth and afterwards). Your doctor or midwife will give you more information and help. Or try the support organisation Positively Women: 020 7713 0444 (www.positivelywomen.org.uk).
INFECTIONS | Colds, flu and general tummy bugs will not harm the baby. Catching rubella or chickenpox, however, might. An early blood test at your booking in should assess your rubella immunity. For chickenpox, there are drugs that can reduce the effect of the virus so see your GP immediately if you think you’re at risk (i.e. you have never had it, and have been exposed to someone with active chickenpox).
PRE-ECLAMPSIA | This is high blood pressure in the mother than can harm the baby. Mild pre-eclampsia affects about 10 per cent of pregnancies, but only 2 per cent of pregnancies severely (about three to five mothers in the UK die of it each year). There are no overt symptoms in the early stages but it can be detected by regular antenatal checks on your blood pressure and urine. It is curable only by having the baby, so some babies may have to be delivered – by caesarean – prematurely. You are more at risk if: you have had it before, are pregnant for the first time by a new partner, are over 40, overweight (BMI of 35 or more), suffering from other chronic medical problems, including hypertension, kidney problems, diabetes or are carrying twins or multiples. If you have a family history of preeclampsia, have had it before or have waited ten years or more since your last baby you are also at a slightly higher risk. For more information, ask your doctor/midwife or try Action on Pre-Eclampsia (APEC): Helpline: 020 8427 4217 www.apec.org.uk.
Busy woman’s look at pregnancy stages
First trimester (1–12 weeks)
YOUR BODY | You may feel tired, nauseated, constipated, bloated, achy (pelvis and breasts). You may notice more vaginal discharge, more prominent veins, crave odd foods and have an acute sense of smell. Sickness usually peaks about Week 8. You may have fainting spells and headaches. Your waistband may feel tight as early as Week 4 (especially if this is not