Nausea and Vomiting:  Nausea and vomiting are common complaints, especially during the first trimester.  Measures which may help are small, frequent meals, "seasick bands", which may be purchased for about $10 (these work by applying "acupressure"), vitamin B6 supplements (25 mg three times per day), Emetrol (available without prescription), and ginger ale.  Ginger concentrates should be avoided.  Unless dehydration and severe weight loss develop, nausea and vomiting do not cause any harm to the developing fetus.  If you experience this discomfort, it is common not to gain much weight during the early part of the pregnancy.  If dehydration and severe weight loss do develop, it may be necessary to administer intravenous fluids and/or prescribe medications.

Heartburn:  Heartburn results because the uterus compresses the stomach, causing stomach contents to reflux into the esophagus.  Antacids, such as Mylanta, in small amounts and chewing gum (saliva is a natural antacid) may help.  It is also helpful to elevate the head of the bed and not to lie down right after eating.

Constipation:  Constipation is another frequent symptom during pregnancy.  Hormone changes cause the smooth muscles of the bowel to become sluggish.  The problem worsens as the uterus enlarges and presses on the lower colon, making evacuation of the rectum difficult for some women.  Helpful measures include stool softeners (such as Colace), plenty of fluids, and additional dietary fiber.  A natural laxative may be made by mixing equal parts of applesauce, prune juice, and bran cereal.  The mixture may be refrigerated and added to other foods, like oatmeal or toast.

Insomnia:  Insomnia occurs frequently and often worsens as pregnancy progresses.  When the uterus enlarges, lying flat on the back causes a decrease in blood flow to the heart.  This may cause an uncomfortable shortness of breath, which often leads to awakening and shifting to a more comfortable position.  One measure which may help prevent this is placing a pillow behind your back to prevent rolling over during the night.  Other factors which may lead to insomnia are anxiety, heartburn, and general discomfort.  A comfortable mattress and quiet environment are helpful.  An occasional sleep aid, such as Unisom or Tylenol-PM, is also acceptable.

Fatigue and Dizziness:  The body changes dramatically in pregnancy.  Blood volume increases in such a way that women often become anemic.  This anemia (or low blood count) often causes symptoms such as fatigue and dizziness.  It is important to consume adequate nutritional iron to keep up with the body's demands, and supplements are often required.  The body also adjusts reflexes to preferentially direct blood flow to the uterus.  This may cause lightheadedness or fainting if you stand too suddenly, or if you stand or sit in one position too long.  These uncomfortable symptoms are best relieved by resting when possible and avoiding those actions that bring on the dizziness.

Edema and varicose veins:  Edema (swelling of the extremities) and varicose veins are two other bothersome and very common complaints during pregnancy.  Both can usually be improved by elevating the legs (either by lying on one side or the other, or by resting in a recliner).  Support hose will often provide some relief.  Many women fear that they have "toxemia" if they experience edema.  This is a condition associated with elevated blood pressure and protein in the urine, both of which will be monitored closely during the course of your pregnancy.  Edema by itself does not mean you have "toxemia" but should be brought to the attention of the doctor during your prenatal visits.

Back Pain and Sciatica:  It is also common to experience back pain and sciatica (shooting pains down the buttock, posterior thigh, and calf).  These pains are brought on by changes in posture causing pressure on the lumbar nerves.  Improper lifting techniques and poor posture aggravate this condition.  Relief measures include local heat (avoid hot tubs and saunas), Tylenol, and analgesic creams, such as Ben-Gay.  Properly administered massage and chiropractic treatments may also help.  Specially designed support girdles may be purchased by contacting Orthobionics, Inc. at 1-800-580-4768 or through their website at www.orthobionics.com.

Ligamentalgia:  Many women experience a type of pain known as ligamentalgia during pregnancy.  This is most often described as sharp or stabbing pain in the lower abdominal or groin areas on one or both sides.  It is related to stretching of the "round ligaments", which are fibrous structures attaching the sides of the uterus to the upper leg areas.  Quick movements or staying in one position too long can both bring on the discomfort.  Alternatively, it sometimes occurs spontaneously.  This discomfort usually resolves after a short while and does not present any danger to your or your baby.  Sharp pains associated with fever or bleeding could be a sign of something more serious, however, and should be reported to the physician immediately.

Numbness of hands:  Tingling, pain, and numbness of hands is another common complaint, especially later in pregnancy.  This is related to pressure on the nerves in the wrist and hands.  This develops because the excess fluid retained by many pregnant women causes pressure on those nerves.  This almost always resolves after delivery.  If the symptoms are severe enough to cause inability to use your hands, use of wrist splints to prevent flexion at the wrist should be used.

Headaches:  Headaches can be extremely bothersome, often more so in the early part of pregnancy.  Hormones cause numerous changes that will cause worsening of migraines in susceptible patients.  Unfortunately, there are no miraculous therapies that will provide relief.  Tylenol taken according to the package instructions is acceptable.  Although aspirin and non-steroidal anti-inflammatory drugs (such as Advil and Ibuprofen) are not believed to cause birth defects, they may cause bleeding problems or abnormal changes in the fetal blood flow and should be avoided.  Severe headaches that do not resolve should be reported to the doctor.  Evaluation by a neurologist may be recommended in some cases.

Braxton Hicks Contractions:  It is common to experience irregular tightening of the uterus throughout pregnancy.  As long as these "Braxton Hicks contractions" are sporadic, they are not harmful.  If you are less than 36 weeks, and contractions are occurring more than four times per hour, you should drink plenty of fluids and lie down.  If the contractions persist at this frequency for one more hour, you should contact the office.