Read What to expect when you're expecting Online

Authors: Heidi Murkoff,Sharon Mazel

Tags: #Health & Fitness, #Postnatal care, #General, #Family & Relationships, #Pregnancy & Childbirth, #Pregnancy, #Childbirth, #Prenatal care

What to expect when you're expecting (113 page)

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Get the support you need. Support hose may not be sexy, but they’re very effective in relieving swelling. Several types are available for pregnancy wear, including full panty hose (with roomy tummy space) and knee- or thigh-highs (which are at least cooler to wear), though avoid those with tight elastic tops.

The good news about edema, besides that it’s normal, is that it’s temporary. You can look forward to your ankles deflating and your fingers depuffing soon after you give birth (though
some moms find it takes at least a few weeks, sometimes a month or more, for swelling to disappear completely). In the meantime, look on the bright side: Pretty soon your belly will be so big, you won’t even be able to see how swollen your feet are.

Take Them Off, While You Can

Have your rings been getting snugger and snugger? Before they get too tight for comfort (and much too tight to remove), you might want to consider taking them off and putting them away for safekeeping until your fingers have slimmed down again. Having trouble prying them off already? Try taking them off in the morning and after cooling your hands down (the hotter they are, the puffier they’ll be). Some liquid soap can make the rings slippery and easier to slide off, too.

If your swelling seems to be more than mild, talk to your practitioner. Excessive swelling can be one sign of preeclampsia, but when it is, it’s accompanied by a variety of other symptoms (such as sudden excessive and unexplained weight gain, elevated blood pressure, and protein in the urine). If your blood pressure and urine are normal (they’re checked at each prenatal visit), there’s nothing to be concerned about. If, along with your swelling, you’ve suddenly and inexplicably gained a lot of weight in a short time, or if you’re experiencing severe headaches or vision disturbances, call your practitioner and describe what’s going on.

Strange Skin Bumps

“As if it’s not bad enough that I have stretch marks, now I seem to have some kind of itchy bumps breaking out in them.”

Cheer up. You have less than three months left until delivery, when you’ll be able to bid a grateful good-bye to most of the unpleasant side effects of pregnancy—among them, these new eruptions. Until then, it may help to know that although they may be uncomfortable (and slightly unsightly), the bumps aren’t dangerous to you or your baby. Known medically—and unpronounceably—as pruritic urticarial papules and plaques of pregnancy (try saying that fast three times), aka PUPPP, or PEP (polymorphic eruption of pregnancy), the condition generally disappears after delivery and doesn’t recur in subsequent pregnancies. Though PUPPP most often develops in abdominal stretch marks, it sometimes also appears on the thighs, buttocks, or arms of expectant moms. Show your rash to your practitioner, who may prescribe topical medication, an antihistamine, or a shot to ease any discomfort.

A variety of other skin conditions and rashes can develop during pregnancy (lucky you!), making you less than happy with the skin you’re in. Though you should always show any rash that crops up to your practitioner, keep in mind that they’re rarely cause for concern. See
page 240
for more.

Lower Back and Leg Pain (Sciatica)

“I’ve been having pain on the side of my lower back, running right down my hip and leg. What’s that about?”

Sounds like your baby’s getting on your nerves—your sciatic nerve, that is. Toward the middle to end of your pregnancy, your baby begins to settle into the proper position for birth (a big positive). In doing that, however, his or her head—and the weight of your ever-enlarging uterus—may settle on the sciatic nerve in the lower part of your spine (a big negative). Such so-called sciatica can result in sharp, shooting pain, tingling, or numbness that starts in your buttocks or lower back and radiates down the back of either of your legs. Sciatica can be quite intense at times, and though it may pass if your baby shifts positions, it can also linger until you’ve delivered—and sometimes linger for a little while postpartum.

How can you get baby off your nerves and relieve the pain of sciatica? Try these tips:

Take a seat. Getting off your feet can ease some of the leg and lower back
pain associated with sciatica. Lying down can also relieve pressure—as long as you find the position that feels best.

Warm it up. A warm heating pad applied on the spot where you feel the pain can help ease it, as can a long soak in a warm bath.

Work it out. Pelvic tilts or just some stretches can take off some of the pressure.

Get in the swim of things. Since swimming and water exercises aren’t weight bearing, they are particularly good choices when you’ve got sciatic pain. Swimming stretches and strengthens the muscles in your back, providing relief for that searing pain.

Seek an alternative. CAM therapies, such as acupuncture, chiropractic medicine, or therapeutic massage (always with a trained and licensed practitioner), might help relieve your sciatica.

If your pain is particularly bad, ask your practitioner if pain medications would be helpful in your case.

Restless Leg Syndrome

“As tired as I am at night, I can’t seem to settle down because my legs feel so restless. I’ve tried all the tips for leg cramps, but they don’t work. What else can I do?”

With so many other things coming between you and a good night’s sleep in your last trimester, it hardly seems fair that your legs are, too. But for the 15 percent or so of pregnant women who experience restless leg syndrome (RLS)—yes, it’s got a name—that’s exactly what happens. The name captures it all—that restless, creeping, crawling, tingling feeling inside the foot and/or leg that keeps the rest of your body from settling down. It’s most common at night, but it can also strike in the late afternoon or pretty much any time you’re lying or sitting down.

Count Your Kicks

From the 28th week on, it may be a good idea to test for fetal movements twice a day—once in the morning, when activity tends to be sparser, and once in the more active evening hours. Your practitioner may recommend a test, or you can use this one: Check the clock and start counting. Count movements of any kind (kicks, flutters, swishes, rolls). Stop counting when you reach 10, and note the time (if you like, you can use the fetal movement tracker in the
What to Expect Pregnancy Journal and Organizer
). Often, you will feel 10 movements within 10 minutes or so—sometimes it will take longer.

If you haven’t counted 10 movements by the end of an hour, have some juice or a snack, walk a bit, even jiggle your belly a little; then lie down, relax, and continue counting. If two hours go by without 10 movements, call your practitioner. Though such an absence of activity doesn’t necessarily mean something’s wrong, it can occasionally be a red flag that needs quick evaluation.

The closer you are to your due date, the more important regular checking of fetal movements becomes.

Experts aren’t certain what causes RLS in some pregnant women (though there does seem to be a genetic component to it), and they’re even less sure of how to treat it. None of the tricks of the leg cramp trade—including rubbing or flexing—seem to bring relief.
Medications may not be a good option, either, because many of those currently used to treat RLS aren’t safe for use during pregnancy (check with your practitioner).

It’s possible that diet, stress, and other environmental factors may contribute to the problem, so it may help to keep track of what you eat, what you do, and how you feel each day so you can see what lifestyle habits, if any, bring on symptoms. Some women, for instance, find that eating carbohydrates late in the day can worsen RLS. It’s also possible that iron-deficiency anemia may cause RLS, so it’s worth asking your practitioner about testing to rule that out, as well as asking him or her for any other suggested treatments. Acupuncture may help some women, as can yoga, meditation, or other relaxation techniques. And, of course, it couldn’t hurt to try the sleep tips on
page 266
. Unfortunately, however, some women continue to find relief—and sleep—elusive. If you are one of them, RLS is something you may just have to put up with until delivery. If you came into pregnancy with the condition, you may have to wait until after delivery (and possibly after weaning, if you’re nursing) to resume any drug treatment you were using.

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