Growing a baby is hard work. Your body will go through a lot of changes as your baby grows and your hormones change. Along with the aches and pains of pregnancy, you will feel other new or changing symptoms.

Even so, many pregnant women say that they feel healthier than ever.

Prenatal care - common symptoms

Being tired is common during pregnancy. Most women feel tired the first few months, then again toward the end. Exercise, rest, and a proper diet can make you feel less tired. It may also help to take rest breaks or naps every day.

Early on in the pregnancy, you will likely be making more trips to the bathroom.

• As your uterus grows and rises higher in your abdomen (belly), the need to urinate often may lessen.
• Even so, you will continue to urinate more throughout pregnancy. That means you also need to drink more water, and may be thirstier than before you were pregnant.
• As you get closer to delivery and your baby descends into your pelvis, you will need to pee much more, and the amount of urine passed at one time will be less (the bladder holds less due to pressure from the baby).

If you have pain when you urinate or a change in urine odor or color, call your health care provider. These could be signs of a bladder infection.

Some pregnant women also leak urine when they cough or sneeze. For most women, this goes away after the baby is born. If this happens to you, start doing Kegel exercises to strengthen the muscles of your pelvic floor.

You may see more vaginal discharge while pregnant. Call your provider if the discharge:

• Has a foul odor
• Has a greenish color
• Makes you feel itchy
• Causes pain or soreness

Certain vaginal infections are important to treat during pregnancy, as they may cause preterm labor.

Having a hard time moving the bowels is normal during pregnancy. This is because:

• Hormone changes during pregnancy slow down your digestive system.
• Later in your pregnancy, the pressure from your uterus on your rectum may also worsen the problem.

You can ease constipation by:

• Eating raw fruits and vegetables, such as prunes, to get extra fiber.
• Eating whole grain or bran cereals for more fiber.
• Using a fiber supplement regularly.
• Drinking plenty of water (8 to 9 cups daily).

Ask your provider about trying a stool softener. Also ask before using laxatives during pregnancy.

While you are pregnant, food stays in your stomach and bowels longer. This may cause heartburn (stomach acid moving back up into the esophagus). You can reduce heartburn by:

• Eating small meals
• Avoiding spicy and greasy foods
• Not drinking large amounts of liquid before bedtime
• Not exercising for at least 2 hours after you eat
• Not lying down flat right after a meal

If you continue to have heartburn, talk to your provider about medicines that can help.

Some women have nose and gum bleeding while they are pregnant. This is because the tissues in their nose and gums get dry, and the blood vessels dilate and are closer to the surface. You can avoid or reduce this bleeding by:

• Drinking lots of fluids
• Getting lots of vitamin C, from orange juice or other fruits and juices
• Using a humidifier (a device that puts water in the air) to decrease dryness of the nose or sinuses
• Use saline nasal spray
• Brushing your teeth with a soft toothbrush to decrease bleeding gums
• Maintaining good dental hygiene and using floss every day to keep your gums healthy

Swelling in your legs is common. You may see more swelling as you get closer to giving birth. The swelling is caused by your uterus pressing on the veins.

• You may also notice that the veins in your lower body are becoming larger.
• In the legs, these are called varicose veins.
• You may also have veins close to your vulva and vagina that swell.
• In your rectum, veins that swell are called hemorrhoids.

To reduce swelling:

• Raise your legs and rest your feet on a surface higher than your belly.
• Lie on your side in bed. Lying on the left side is better if you can do it comfortably. It also provides better circulation for the baby.
• Wear support pantyhose or compression stockings.
• Limit salty foods. Salt works like a sponge and makes your body hold more water.
• Try not to strain during bowel movements. This can worsen hemorrhoids.

Leg swelling that occurs with headaches or high blood pressure can be a sign of a serious medical complication of pregnancy called preeclampsia. It is important to discuss leg swelling with your provider.

Some women feel short of breath at times while they are pregnant. You may notice that you're breathing more rapidly than usual. It happens more often in the early part of the pregnancy due to the changes in your hormones. It may also happen again toward the end of your pregnancy because of pressure from the baby. Mild shortness of breath from exercise that quickly gets better is not serious.

Severe chest pain or shortness of breath that does not go away can be a sign of a serious medical complication. Call 911 or the local emergency number or go to an emergency room right away if you have these symptoms.

You may get short of breath again in the later weeks of pregnancy. This is because the uterus takes up so much room that your lungs do not have as much space to expand.

Doing these things might help with shortness of breath:

• Sitting up straight
• Sleeping propped up on a pillow
• Resting when you feel short of breath
• Moving at a slower pace

Let your provider know if you have a history of asthma, as asthma may worsen during pregnancy. If you suddenly have a hard time breathing that is unusual for you, see your provider right away or go to the emergency room.

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Swartz MH, Deli B. The pregnant patient. In: Swartz MH, ed. Textbook of Physical Diagnosis: History and Examination. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 23.