While morning sickness tends to
strike at the beginning of pregnancy, heartburn is more likely to be a
problem in the last three months. The main symptom is a burning
sensation in the chest, caused by acids going back up the oesophagus
(food pipe) from the stomach. A muscle valve usually prevents this from
happening, but during pregnancy hormonal changes cause muscle
relaxation and the valve becomes less effective.
Heartburn can be particularly bad
after a large meal or during activities that involve bending down, such
as cleaning the floor or even just picking something up. The pressure
of the growing baby on the stomach can make heartburn worse as
pregnancy progresses. This is particularly true for those
expecting twins, as the uterus is inevitably larger and therefore
presses more on the stomach. In the last weeks of pregnancy, your
baby’s head may move down into your pelvis in preparation for the
birth. The head is then said to be ‘engaged’. This usually reduces the
pressure on the mother’s stomach and the symptoms of heartburn are
often reduced. The good news is that when the baby is delivered,
heartburn generally disappears almost instantly.
There are several things you can do to ease the symptoms of heartburn:
- Wear loose-fitting clothes to reduce extra pressure on your stomach.
- Avoid becoming too full, by eating little and often
instead of having large meals. Also, don’t drink too much at mealtimes
so that your stomach doesn’t become so full.
- Try to identify trigger foods and avoid them, especially
in the evening. Common culprits include spicy food, citrus fruits, rich
and fatty foods, tea and coffee, and bananas.
- When you eat, sit upright instead of slouching, and try not to rush.
- Try staying upright for a while after meals and avoid eating for a couple of hours before going to bed.
- When you go to bed, prop yourself up with several pillows.
- Milk is good for neutralising the stomach acid and
easing symptoms, so try drinking a small glass before bed or have some
ready to sip during the night.
- Homeopathy, aromatherapy and yoga may all help.
If you suffer from severe
heartburn then talk to your doctor or midwife. They will be able to
prescribe a suitable antacid or anti-reflux medicine. Not all
treatments are suitable for pregnancy, so before taking anything it is
best to check with your doctor, your midwife or a pharmacist.
Many women feel more thirsty than
usual during pregnancy. This is quite normal, as extra fluids are
needed to allow your blood volume to increase and to produce and
constantly replace the amniotic fluid your baby is swimming in. Some
women also feel warmer than usual and lose water due to hot sweats,
which further increases fluid needs. If your wee is dark yellow, this
is a sign of dehydration and means you need to drink more. It may be
due to severe morning sickness or it may be something simple, such as
giving up coffee and not replacing it with other fluids. It’s important
to make sure you have at least eight glasses of fluid a day.
A small number of women
experience such a raging thirst that they end up having to carry around
litre bottles of water at all times. Generally this is nothing to worry
about, although it is worth talking to your doctor or midwife about it.
If you are weeing more than usual as well as feeling very thirsty, it
can be a sign of gestational diabetes and your doctor or midwife can
check if this is the case.
Constipation isn’t as common among
vegetarians as among meat-eaters, and vegans tend to have less of a
problem than lacto-ovo-vegetarians, as they usually have a higher fibre
intake. However, constipation is more common for everyone during
pregnancy because of hormonal changes. Increasing progesterone levels
cause all the muscles in your body, including intestinal muscles, to
relax, so food moves through your intestines more slowly. This helps
your body absorb more nutrients from the food, but it can also lead to
constipation. In addition, the pressure of your baby on your bowels can
make going to the toilet more difficult. Iron supplements can
also make matters worse. However, making a few adjustments to your diet
and being as active as possible can go a long way towards easing the
To treat constipation, try the following:
- Eat plenty of fibre-rich foods such as wholemeal bread, wholegrain breakfast cereal, pulses and lots of fruit and vegetables.
- Have some prunes or prune juice. This is an age-old
remedy that really works. The laxative effect cannot be explained just
by fibre – prunes contain similar amounts to other dried fruit, and
prune juice has none at all, as it is filtered before bottling. It is
more likely to be down to the high levels of sorbitol in prunes. This
is a type of sugar that is absorbed very slowly and passes into the
large intestine like fibre. Prunes also contain large amounts of
phenolic compounds, which also have a natural laxative effect.
- Drink plenty of water and other fluids. Along with
dietary fibre, water helps to make stools softer and bulkier, which
means they are easier to pass.
- Take some gentle exercise, such as walking, swimming or yoga.
- When you go to the toilet, relax and take your time.
- Switch iron supplements if necessary .
Sprinkling bran onto
cereal or other foods may help relieve constipation but it isn’t a good
idea. Bran comes from the outer layer of cereal grains, such as wheat
or rice, and it contains lots of fibre. The problem is that it reduces
the absorption of important vitamins and minerals, including iron and
zinc. It is much better to eat fibre-rich foods such as wholemeal
bread, pulses, vegetables and fruit, as these contain higher levels of
still have constipation, talk to your midwife or doctor; they may
prescribe laxatives that are safe to take during pregnancy. Not all
laxatives are suitable.