American Medical Association Family Medical Guide - American Medical Association [286]
Prevention and Treatment
If you have trouble falling asleep at night, avoid napping during the later part of the day. Take a warm bath and drink a glass of warm milk before going to bed. Because caffeine is a stimulant, cut back on or eliminate coffee, tea, or other caffeine-containing foods or beverages from your diet. Get plenty of exercise during the day, but don’t exercise within a few hours of going to bed. Try performing some relaxation exercises (see page 59) at bedtime.
If you are losing a lot of sleep, talk to your doctor. Most doctors prefer not to prescribe sleep medications such as sedatives because of the possibility of affecting the fetus. This is especially true during the critical first 14 weeks, when the fetus’s organs are developing, and in the days closer to the due date, when the medication could suppress the baby’s nervous system and affect his or her breathing during labor and delivery. Don’t take any medications—including over-the-counter or alternative sleep aids such as the hormone melatonin—unless your doctor has prescribed them.
Back Pain
During pregnancy, the ligaments and fibrous tissue that normally support a woman’s joints become slightly more elastic. This elasticity allows the pelvis to expand during delivery but also makes the joints more susceptible to strain. In addition, the joints of the spine are under increased strain because of the additional weight of a pregnancy and because the growing uterus shifts the woman’s center of balance and can put strain on her lower back.
In the first few months of pregnancy, severe back pain can be a sign of a miscarriage (see page 522) or an ectopic pregnancy (see page 523). Later in pregnancy, back pain can be a symptom of labor (see page 531), especially if it is accompanied by other symptoms, such as bleeding or vaginal discharge.
Relieving backache
A gentle exercise for relieving backache is to get on your hands and knees, keeping your head straight and in line with your spine (don’t let your spine sag). Curve your back up, tightening the muscles in your abdomen and buttocks and lowering your head. Gradually raise your head and return your back to its original position. Repeat several times.
Prevention and Treatment
To reduce the risk of back pain, try not to gain too much weight during your pregnancy. Wear low-heeled shoes, and don’t lift heavy objects. Don’t cross your legs or slouch when you sit; sit in a firm, high-backed chair and use a small cushion to support your lower back. Sleep on a firm mattress, and don’t use a pillow under your head if you sleep on your back (but putting a pillow under your knees can relieve pressure on your lower back). If you sleep on your side, rest your head on a pillow and support your upper leg with a pillow to keep your spine straight.
Stress can sometimes cause or worsen a backache, so try to relax. Don’t use a pain reliever for back pain unless it has been prescribed by your doctor. Before having massage therapy or using hot or cold applications, talk to your doctor. A pelvic support belt, found in most maternity departments, can be helpful. Your doctor or prenatal class teacher can recommend exercises that can help strengthen your back and abdominal muscles, which may relieve your back pain.
High Blood Pressure
Some women are found to have high blood pressure (see page 574) at routine checkups during pregnancy. The high blood pressure may have been present before pregnancy, or it could be related to the pregnancy. It is common for blood pressure to fall slightly during the middle weeks of pregnancy and to rise slightly toward the end.
High blood pressure usually has no symptoms, but a serious form of pregnancy-induced high blood pressure (called