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BY MONIQUE MAITLAND | Registered Midwife & Nurse

Pregnancy Mysteries Unraveled. We asked Clinical midwife Monique Maitland your burning questions about Body Changes Beyond the Bump - Aches, Pains, Glowing Skin, and More!


Q6: What's the reason behind heartburn and indigestion during pregnancy, and how can I manage these symptoms?

Heartburn and indigestion during pregnancy are common, affecting up to 80% of expecting Mums.

Heartburn, commonly known as ‘reflux’ is characterised as an uncomfortable, burning sensation in your chest or stomach that moves towards your throat. This discomfort occurs when stomach acid flows back into the oesophagus (the tube connecting your mouth to your stomach). Which results in gastric acid irritating the lining of your oesophagus.

Indigestion, also known as dyspepsia, refers to discomfort experienced in your upper abdominals. This includes various symptoms such as abdominal pain and a sense of fullness shortly after commencing a meal.

So why does this occur?
The main cause of heartburn & indigestion is due to pregnancy hormones acting on the esophageal sphincter. These hormones encourage the muscle that usually holds your esophageal sphincter closed to relax allowing food and acid from your stomach to move back up your esophagus. In combination with this, your growing baby can place additional pressure on your stomach contributing to these symptoms.

To manage these symptoms, you can make several lifestyle and dietary adjustments:

Eat Smaller & Frequent Meals: Avoid large meals, instead opt for smaller and more frequent meals throughout the day. This will prevent overloading your stomach and reduce the likelihood of acid reflux. 

Avoid Trigger Foods: Certain foods and beverages, such as rich or spicy meals, chocolate, citrus foods, and coffee, can trigger heartburn and indigestion. Avoiding these can help alleviate symptoms.

Stay Upright After Eating: Avoid lying down or reclining immediately after meals. Remaining upright allows gravity to help keep stomach acid in your stomach, reducing the risk of it flowing back into your oesophagus.

Eat Early Where Possible: Try not to eat big meals close to sleeping. Eating several hours before lying down can give your body enough time to digest the food.

Elevate Your Head:  If you’re experiencing heartburn overnight try elevating your head and upper body. This elevation with a pillow can help prevent stomach acid from flowing into the oesophagus.

Medication To Consider: Antacids neutralise stomach acid which can provide temporary relief from heartburn. Other medications like ranitidine can help reduce stomach acid production. For individualised advice consult your healthcare provider or pharmacist before taking any medication during pregnancy.


Q7: Could you explain why haemorrhoids occur during pregnancy and provide some recommendations for dealing with them?

Although often not spoken about, haemorrhoids are very normal throughout pregnancy and postpartum. They can vary in size and discomfort from woman to woman.

What are they?
Haemorrhoids are varicose veins of the anus, or rectal canal.

What causes them?
The weight of the baby and the uterus apply pressure to the rectal area. Blood flows to this area and the pregnancy hormone progesterone & Relaxin causes blood vessels to relax making them less efficient at pumping the blood back. Blood then pools in the veins of the rectum and swells them. After birth, haemorrhoids can be made worse by a prolonged pushing phase of labour, being constipated, or forcing bowel motions in the days or weeks after the birth.

How can you look after your haemorrhoids?
Prevention of haemorrhoids is key:

  • Wearing compression wear in pregnancy and postpartum is so important to optimise your blood flow, preventing a buildup of blood in vessels
  • Avoiding constipation to prevent straining when doing a number two. Drinking plenty of fluids and eating a fiber rich diet is recommended.

 
Managing haemorrhoids:

Compression wear: promotes blood flow which can prevent pooling of blood within vessels.

Pain management: Using simple analgesia to relieve discomfort as well as anorectal products such as ointments or suppositories can help manage haemorrhoids.  For individualised advice consult your healthcare provider or pharmacist before taking any medication.

Rest: Rest the area. Avoid sitting directly on your bottom and rather lay on your side or where possible elevate that area. If you are postpartum, try a side lying feeding position rather than sitting upright to relieve discomfort.

Diet: Ensure you are drinking adequate amounts of fluids & consuming a high fibre diet to reduce constipation. If having troubles with constipation consult your healthcare provider or pharmacist to discuss stool softeners.

Most importantly be reassured that your haemorrhoids will heal naturally but if you are ever concerned, please consult your own healthcare provider.


Q8. What hair changes can I expect during pregnancy and is there anything I can do to prevent my hair falling out or regrowth of baby fluff?

Just when you thought no more changes could occur to your body during pregnancy, you can expect some changes to your hair as well.

Pregnancy is often great for hair growth as your hormones will thicken and speed up the growth of your hair. Unfortunately, these luscious locks aren’t always here to stay and about three to four months postpartum you may notice your hair begins to fall out. Once again this is likely due to changes in your hormones. But don't panic, you're not going to go bald. Be prepared to have lots of baby regrowth hairs so get yourself a slick stick ready to slick that baby fluff back.

Although hair loss is often unpreventable there are some steps you can do to reduce the extent of this:

  • Purchase good quality shampoo & conditioner.
  • Be gentle on your hair when handling it / brushing.
  • Avoid harsh accessories such as elastic bands or using heat to the hair as these can contribute to greater hair loss.
  • Ensure you are eating well and consuming vitamins which aid hair production.

Q9. Why do some women ‘glow’ during pregnancy where others suffer from Acne? What can I do to promote a clear complexion?

We have all heard of women having a ‘pregnancy glow’ but for some women this is not always realistic and while some women ‘glow’ many women may experience the opposite – pimples & hormonal rage. However, let’s get one thing straight, both are normal and just as beautiful.

The ‘glow’ or ‘acne’ that women experience in pregnancy is once again due to hormonal changes during pregnancy.

So where does that glowing skin come from? The "pregnancy glow" is caused by an increase in blood circulation and higher levels of hormones, particularly oestrogen. These hormonal changes can enhance skin hydration giving it a radiant glow.

In contrast, some pregnant women may experience acne due to hormonal fluctuations. These hormones, predominantly progesterone stimulate excess oil production which clog pores and lead to breakouts.

To promote a clear complexion during pregnancy, try these things:

Adopt a Regular Skincare Routine: Cleanse your skin regularly with a gentle, pregnancy-safe cleanser. Avoid picking or touching your face which may irritate the area.

Stay Hydrated: Ensure you are drinking enough water throughout the day to stay hydrated.

Eat a Balanced Diet: Eating foods high in sugar can contribute to challenging skin conditions, instead try consuming a balanced diet full of fruits, vegetables, and lean proteins.

Consult a Dermatologist: If you're experiencing persistent or severe acne which is making you feel a little down in the dumps, consult a dermatologist. They can provide you tailored advice to suit your specific needs.


Q10. What are some of the changes women can expect to their breasts during pregnancy?

As early as 3 to 4 weeks pregnant a woman's body can begin to experience changes to their breasts in preparation for breastfeeding their baby.

Some of the most common changes which occur to our breasts during pregnancy include:

Tenderness: Usually one of the first & most common signs that you are pregnant. Breast tenderness and sensitivity is incredibly normal and usually hits its peak in the first trimester before subsiding, however for some women breast tenderness may occur up until the birth of their baby and extend after. Your breasts may be sore and sensitive to touch or even from the pressure of water from the shower.

Breast size: Be prepared for your breasts to grow, and when I say grow it is thought that your breasts may increase by 1.5 times their original size. This is due to mammary gland enlargement. For some, their breasts may grow rapidly or gradually. It is important to adjust bra sizes as your breasts grow.

Darkening of Areolas: Your areola (the dark area around the nipples) may become darker and larger due to hormonal changes. But did you know that your body does this to make it easier for your baby to see and navigate the breast for breastfeeding (That’s amazing).

Montgomery's Tubercles: These are the small, raised bumps on the areola and during pregnancy they can become more obvious. These bumps secrete oils that help to lubricate and protect the nipples during breastfeeding but also have a similar smell as amniotic fluid which helps your baby be guided to the breast after birth.

Colostrum Production: As early as 14-16 weeks pregnant colostrum can be produced. Colostrum is yellow, thick & sticky and is the first kind of milk our body produces.  Some women may leak colostrum prior to their baby being born and others may not. Both are normal but of course leakage can be slightly annoying so wearing a specific absorbent feeding bra or breast pads can be helpful to manage this.

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Written by Monique Maitland

Midwife, Nurse and Childbirth Educator

Founder of The Middee Society 

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