Pregnancy can be both an exciting and worrying time, having a significant impact on a woman’s physical and mental health. Every pregnancy is different, but most pregnant women experience minor niggling health issues, such as heartburn or sickness, and some develop more serious pregnancy-related complications, such as pre-eclampsia.
Many minor health problems during pregnancy can be managed with self help measures and suitable over-the-counter medicines. Before taking any medicines during pregnancy, women should check with a pharmacist, midwife or GP, as many medicines can cross the placenta and reach the developing baby.
Constipation and piles
Women may get constipated early on in pregnancy due to fluctuating hormones. Managing (and preventing) constipation involves regular exercise, eating high-fibre foods and drinking plenty of water (or water-based drinks). Certain iron supplements for anaemia can cause constipation.
Hormonal changes can also lead to piles (haemorrhoids) – these enlarged blood vessels around the rectum and anus can become sore and itchy. The pharmacy team may be able to suggest a suitable ointment, cream or gel to ease the symptoms.
“Constipation can also cause piles,” says Dr Hana Patel, NHS GP and GP medico-legal expert witness. “If this is the case, women should try to keep their stools soft and regular by eating plenty of food that’s high in fibre, including wholemeal bread, and drinking fluid throughout the day.”
Sickness
Nausea and vomiting in early pregnancy is often called ‘morning sickness’, but it can happen at any time of day or night. Pregnancy sickness affects up to nine in every 10 pregnant women and is a common cause of hospital admissions. The symptoms tend to clear up by weeks 16-20 of pregnancy. Most cases can be treated with oral rehydration, dietary advice, rest, and prescribed anti-sickness medicines (anti-emetics). Avoiding foods or smells that trigger the sickness, and eating small, frequent meals of plain carbohydrate-rich foods, such as crackers, may help. Some women find acupressure is helpful too.
New international research at the University of Cambridge (published in Nature Mental Health) has confirmed that pregnancy sickness is caused by a hormone produced by the growing baby – called growth differentiation factor 15 (GDF15). GDF15 is also produced in low levels in the mother’s body outside of pregnancy. The severity of pregnancy sickness depends on how much of the hormone is produced by the baby, and how much exposure the mother had to this hormone before her pregnancy.
“The more sensitive she is to this hormone, the sicker she will become,” says Professor Sir Stephen O’Rahilly, who led the study. “Knowing this gives us a clue as to how we might prevent this from happening.”
Hyperemesis gravidarum is a more severe form of nausea and vomiting, affecting up to three in every 100 pregnant women and putting the life of the mother and baby at risk. This needs to be treated in hospital with IV fluids to prevent dangerous levels of dehydration and malnourishment.
“I would recommend that women call 111 or get advice if they’re vomiting and have very dark-coloured urine or haven’t passed urine in more than eight hours, are unable to keep food or fluids down for 24 hours or feel severely weak, dizzy or faint when standing up,” says Dr Patel.
