American Medical Association Family Medical Guide - American Medical Association [285]
The symptoms of anemia may not be obvious, but you might look pale; feel faint, tired, and weak; be breathless; or have heart palpitations. Because anemia can make you more vulnerable to infection and more likely to have a preterm delivery or a baby with a low birth weight, your doctor will perform a blood test early in your pregnancy to find out if you have anemia.
Prevention and Treatment
To prevent anemia, eat foods that are rich in iron such as liver, beef, whole-grain bread, eggs, and dried fruits. Eat citrus fruits and fresh vegetables that contain vitamin C, which helps the body absorb iron more efficiently. Take your prenatal vitamins every day to help ensure that you are getting sufficient amounts of folic acid. Your doctor may prescribe an iron supplement if you are diagnosed with anemia.
Constipation and Hemorrhoids
Constipation (see page 769) is common during pregnancy because the increase in hormones can slow the movement of food through the digestive tract. In about the fourth month, constipation sometimes results from pressure on the intestines by the enlarging uterus. Constipation can cause hemorrhoids (see page 777). If you already have hemorrhoids, constipation can worsen them by making you strain harder during bowel movements.
Prevention and Treatment
To prevent constipation, eat plenty of fresh fruits and vegetables, legumes, whole grains, and other foods that are high in fiber (see page 37). Drink at least eight glasses of water a day. Some people find prune juice helpful. Don’t wait to move your bowels; go whenever you have the urge, but don’t strain. Regular exercise can also help keep you regular.
Before taking any medications for constipation, talk to your doctor. You probably can safely use milk of magnesia or glycerin suppositories while you are pregnant, but don’t use other over-the-counter laxatives.
If none of these measures work, your doctor may prescribe medication to soften your stools. If you have hemorrhoids, take warm baths. Check with your doctor before using any hemorrhoid creams or suppositories.
Varicose Veins
Many women develop swollen veins in their legs (varicose veins; see page 602) during pregnancy, especially during the last 3 months. During pregnancy, the veins are carrying an increased volume of blood to supply to the developing fetus. In addition, as the uterus enlarges and presses on some major veins, blood flow from the leg veins up to the pelvis can slow down. This combination of factors sometimes produces enough pressure to cause the veins in the calves and thighs to become swollen and painful. The same kinds of pressure can also affect the veins around the entrance to the vagina and rectum.
You are more likely to develop varicose veins during pregnancy if you have a family history of the condition. Varicose veins that develop during pregnancy usually become significantly less swollen or disappear within 12 weeks of delivery.
Prevention and Treatment
To reduce your risk of developing varicose veins, don’t wear clothes that fit tightly around your waist or upper legs. Avoid standing for long periods, but take regular walks every day. Rest with your feet up (preferably higher than the level of your heart) as much as possible. Don’t gain too much weight during your pregnancy because the excess weight can put more strain on your veins. Your doctor may recommend wearing elastic support stockings to help improve your circulation. Put the stockings on in the morning before you get out of bed.
Sleep Problems
Many women find it difficult to get to sleep or stay asleep while they are pregnant. Sleep problems can result from changes in hormone levels, a need to urinate more