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Prevention and Treatment

To avoid or treat nausea, nibble on crackers, dry toast, or an apple as soon as you wake up (or whenever you feel nauseous). Get out of bed slowly and sit on the edge of the bed for a minute or two. Try to keep something in your stomach throughout the day. Tell your doctor about the extent of your nausea, especially if it continues or if vomiting is severe. He or she will want to examine you to rule out an underlying condition.

Drinking lots of fluids, especially water, can prevent dehydration. Don’t take an antinausea medication unless your doctor has prescribed it. If your vomiting is severe, you may have to be hospitalized and be given fluids and minerals intravenously (through a vein) to replace those you have lost.

Indigestion

Indigestion, often called heartburn, is a burning pain in the center of the upper chest. It is common during pregnancy and affects almost half of all pregnant women. Indigestion occurs during pregnancy because a woman’s enlarged abdomen presses on her stomach and esophagus and because the increased level of the female hormone progesterone during pregnancy relaxes the muscles in the esophagus that usually prevent the backup of stomach acid. In rare cases, indigestion may be a symptom of polyhydramnios (excess amniotic fluid; see page 526), which puts even more pressure on the abdomen and esophagus. The symptoms of indigestion usually disappear after childbirth unless the indigestion is not related to the pregnancy.

Prevention and Treatment

To prevent indigestion, don’t eat too much at one time, and avoid highly spiced, greasy, or acidic foods. Eat small, frequent meals. Avoid bending over or lying flat. Try some of the suggestions on page 750 for relieving and preventing indigestion. If these steps don’t help, see your doctor. He or she may prescribe an antacid or recommend changes in your diet. If the indigestion persists or is severe, the doctor may order tests to rule out the possibility of a more serious condition.

Abdominal Pain

See your doctor immediately about any abdominal pain during pregnancy. Many women have pain in their abdomen during pregnancy (called round ligament pain) that results from stretching of the ligaments that attach the uterus to the abdominal wall. The pain usually is most severe from the fourth through the sixth month of pregnancy (when the uterus expands most rapidly), but the pain can occur at any time. You can relieve round ligament pain by lying on the aching side. This type of pain usually disappears after childbirth.

Urinary Problems

Problems with urination are common in pregnant women. You may urinate more often than usual during pregnancy or feel a strong urge to urinate, which could be caused by hormonal changes and the pressure of your enlarging uterus on the bladder. You may also be thirsty and drink more liquids and therefore excrete more urine than you did before pregnancy. Some pregnant women leak urine (urinary incontinence; see page 877) when they cough or sneeze. Urinary incontinence during pregnancy can result from pressure of the uterus on the bladder and the relaxation of the muscles in the pelvis in preparation for birth.

Relaxation of the pelvic muscles during pregnancy can also lead to urinary tract infections (see page 877), possibly because bacteria can more easily travel up the ureters to the bladder. But urinary tract infections during pregnancy are more likely to be caused by the uterus pressing on the bladder, which makes it more difficult for the bladder to empty completely. If you have symptoms of a urinary tract infection such as painful urination, cloudy urine, or a sore abdomen or back, see your doctor.

Fatigue

Sometimes the first sign of pregnancy is extreme fatigue, which can result from hormonal changes, but may also be caused by anemia (see next page). In addition, as the pregnancy progresses, you are carrying more weight than usual, which can make you more tired. Fatigue is most common during the first and third trimesters. Being pregnant