Head-to-Toe Changes

Hair. Thanks to increased levels of progesterone, your hair may get thicker during pregnancy. But it’s not because you’re growing more of it (though you may notice strays popping up in less-than-desirable places). Progesterone slows down the rate at which you shed hair, so your head is holding on to individual hairs longer, which makes hair fuller. Meanwhile, if you notice a lot of hair falling out in the shower, definitely mention it to your ob. You could have a thyroid condition: It can be safely treated with hormones during pregnancy, but if left unchecked can lead to miscarriage and birth defects.

Head. Migraines and regular old headaches are more common during pregnancy. In some cases, pregnancy hormones are to blame, which means there’s not a whole lot you can do to prevent them. Acetaminophen (Tylenol) is your go-to headache medication during this time. Aspirin and ibuprofen aren’t recommended.

There are, however, a whole bunch of other reasons your head may be pounding, says Dr. Ross, including:

-          Caffeine withdrawal. “A lot of women mistakenly think that when they’re pregnant they need to completely avoid caffeine,” says Dr. Ross. The result is an awful, dull caffeine withdrawal headache. Pregnant women can safely consume 200 to 300 mg of caffeine per day. The average eight-ounce cup of coffee contains around 133 mg of caffeine. Meanwhile, a Starbucks Grande (16 oz.) brewed coffee contains 320 mg. Teas, colas, chocolate candy and coffee ice cream also contain caffeine. To find out how much caffeine you’re getting, check out this handy chart from the Center for Science in the Public Interest: http://www.cspinet.org/new/cafchart.htm.

-          Sleeplessness. Nausea, heartburn and, later in pregnancy, back pain, muscle aches and your ever-expanding stomach can make getting a restful night’s sleep a serious challenge. Add to that your nervous racing mind, the need to use the bathroom, your congested nose and the PMS-like hormones that are messing with your body’s internal clock. That dull headache? A result of lack of sleep. Optimal sleep conditions include a cool, dark room, pillows to support your back and tummy, and raising the head of your bed with two sturdy books so you’re elevated to prevent heartburn.

-          High blood pressure. “If you get a headache that doesn’t go away with Tylenol, call your doctor,” says Dr. Ross. You could have high blood pressure, which is also a symptom of preeclampsia, a potentially fatal condition that occurs in 5 percent of pregnant women. “If you’re experiencing the worst headache of your life, get yourself to the ER immediately.”

Forehead and face. Even if your complexion’s normally clear, pregnancy can trigger acne flare-ups. Part of the problem is that the skin is regenerating faster underneath but still sloughing off at the same rate — so pores get clogged. The good news: You can safely use over-the-counter acne treatments, including washes and topical creams containing salicylic acid and benzoyl peroxide. Medium/olive-skinned women might also develop what’s known as the mask of pregnancy (brownish or yellow skin around the eyes and cheeks), called chloasma. There’s not much you can do to lighten skin; it will fade back to normal after pregnancy. And don’t forget the sunscreen!

Eyes. Extra fluid sometimes collects around the eyeballs, which can affect your vision enough to require a prescription change (or even make glasses necessary if you don’t currently wear them). “This is no cause for worry. The condition will reverse after delivery,” according to Dr. Ross. However, if you have vision loss, or you’re seeing flashes, auras or blurry spots, call your doctor pronto. These could be signs of preeclampsia.  

Nose. You can thank progesterone for your increased sense of smell (in fact, some women know they’re pregnant when they suddenly can’t stand the smell of coffee or their own perfume). You might also have nasal congestion throughout your pregnancy. Sudafed can be safely used to open and drain your sinuses. If you prefer a drug-free option, try regular saline rinses with a neti pot. If you suspect a sinus infection (you’re blowing out yellow or green mucus and you’ve got a fever and a sore throat), see your doctor. Nosebleeds are also common, thanks to increased blood volume and dry, indoor air, which can inflame the blood vessels that line the nose.  

Mouth. Bleeding gums are more common during pregnancy, thanks to more blood volume. Daily flossing will help prevent inflamed gums, which some research has shown may be a trigger for premature labor. For less than 1 percent of pregnant women, extra saliva is also a problem during pregnancy. The condition usually dissipates after delivery.  

Neck. The neck is where your thyroid gland lives. If you notice swelling in the front (a goiter), tell your doctor — this is a sign of a thyroid condition. Again, thyroid conditions can (and should) be safely treated in pregnancy with hormone therapies to prevent birth defects and miscarriage. 

Heart. The heart works a whole lot harder during pregnancy: Blood volume increases by as much as 40 percent, and your heart has to pump faster to accommodate this increased blood. When you lie down at night, it’s normal to notice your heart skipping beats here and there. Regular skipping or palpitations, on the other hand, should be checked out. Heartburn, which is really happening in your esophagus and not your heart, also plagues many pregnant women. For some it feels like burning, but for others it’s more like a tightness in the chest (which can also leave you feeling short of breath). To relieve symptoms, take Maalox or Mylanta, which coats the esophagus and stomach. For more frequent or severe cases, over-the-counter Pepcid, Zantac and Prilosec are fine during pregnancy.

Lungs. Shortness of breath when you walk up stairs or exert yourself in other ways is common and can even be an early sign of pregnancy. But if you’re short of breath at rest, get evaluated, as you may have asthma.

Breasts. They get bigger early on and can also grow throughout your pregnancy. The tenderness usually subsides after the first trimester as hormone levels of HCG go down. Hormones and the added melanin they produce can also darken the skin around your nipples (those are the same hormones that can cause a darkened line right down the middle of your stomach, called linea nigra). If your breasts leak clear or white fluid, which can happen at any time but is most common in the last three months, take it as a good sign: Your breasts and nipples are preparing for milk production later on. If the leakage is green, red or brown, definitely tell your doctor; while this could signal a polyp, it can also be a sign of cancer.

Lower chest. If you’ve got terrible pain just below your right breast, it could be gas, but it might be gallstones (little bits of crystallized bile that have built up in your gallbladder). They don’t have to be removed surgically unless you’ve got a fever along with the pain (a sign of infection) or the pain doesn’t go away. Dr. Ross says that if you fall into the four F’s (forty, fair, fertile and fat), you’re at a higher risk of developing gallstones.

Intestinal tract. As progesterone slows down your gastrointestinal tract, waste backs up and has a harder time making its way out. The iron in your prenatal pill isn’t helping either. Check out Eating Your Way Through a Healthy Pregnancy for dietary tips on keeping things moving. You can also take a daily dose of Benefiber (a fiber supplement you mix in water) or 100 mg of a stool softener like Colace.

Unfortunately, increased blood volume during pregnancy combined with constipation and a hormone called relaxin can lead to hemorrhoids. The veins inside the anus become swollen, itchy and irritated and can also protrude outside the anus. To ease symptoms, take warm baths, use an OTC hemorrhoid cream and “when they pop, use a finger to push them back in,” says Dr. Ross. If they remain outside the anus and cause chronic pain, see your doctor.

Kidneys/bladder. Thanks to your baby, the kidneys are working 50 percent harder to filter toxins out of the body, which means urine production increases. As your baby grows and starts pressing on your bladder, you’ll need to pee even more. Do yourself and your bladder a favor and practice your Kegel exercises every chance you get: Squeeze the pelvic floor muscles (the same ones that stop your urine flow) for a few seconds, release and repeat. For step-by-step instruction, go to http://kegel-exercises.com/kegels.html.

Kidney stones might be slightly more common during pregnancy. You’ll know if you’ve got them because they produce severe pain in the lower back area and typically show up on the right kidney in pregnant women, according to Dr. Ross. Overdoing it on calcium can lead to stones, but for most women, they’re either prone to them or not (and you might not know until you’re pregnant!).

Back. Pain is normal and, unfortunately, common, especially in later months when that baby is throwing off your center of gravity and your abdominal muscles are no longer in position to support your lower back. Your joints, muscles and ligaments also become more lax, thanks to the hormones progesterone and relaxin, which means you’re less protected when you move. Pregnancy girdles and Ace bandage belts can help. Sciatic pain (which occurs when the sacrum compresses a nerve in the spinal column and creates a burning pain down the leg) can really kick in during months six, seven and eight. To help relieve pain, try lying on your left side with a pillow propped between your knees. Doctors prefer that pregnant women lie on their left side because of the arrangement of the big blood vessels inside. The vena cava is on the right and could get compressed by right side-lying or lying on the back. In general, it’s not a problem, though. If it is being blocked, you’ll know because you’ll feel faint and your heart will race. Even if you’re asleep, your body will protect you: So if you’re asleep on your back and your body doesn’t like it, you’ll automatically turn!

Legs. Leg cramps can occur at any point but tend to flare up during the third trimester, especially during the seventh month. No one knows why leg cramps start in the seventh month, but some think it’s because the baby needs more calcium for its bones and starts taking it out of your muscles. Try getting more fluids during the day and increasing calcium by a glass or two of milk daily. Potassium-rich foods, such as bananas, can also alleviate cramps. Avoid standing for long periods, and take a nice warm bath before bed to help dilate leg blood vessels. (If the pain gets worse when you flex your foot and there’s burning or redness in one area of the leg, see your doctor — it could be a blood clot. While blood clots aren’t common during pregnancy, they do occur more than if you aren’t pregnant.

Varicose veins can show up at any time and are often worse on the left leg, because the uterus tends to sit toward that side. The good news: They usually clear up after pregnancy. Support hose can help with the pain and pressure of varicose veins, but they can also be uncomfortable to wear. Be sure not to wear thigh-high support hose, since they can act like a tourniquet and cut off blood supply to the area. Instead, wear support hose only up to the knee.

Vagina. Increased blood volume and blood flow can mean more watery discharge than normal. A dull pain in the vagina that shoots and then stops could be nerve related. It’s probably nothing to worry about, as long as it’s infrequent. But if you have vaginal pain that doesn’t let up, call your doctor — it could be preterm labor.

Ankles and feet. They swell, typically at the end of the day, after long periods of standing or in warmer weather. While some swelling is normal, severe swelling is not.   For mild to moderate swelling, try raising your feet above heart level for 10 to 15 minutes. You might also be lacking potassium, so try snacking on a banana. Severe swelling of the ankles and feet (and also the face and hands) is a sign of preeclampsia, which should be checked out right away. Due to pregnancy, your feet may also become wider (and stay that way). Which can only mean one thing: new shoes!