What to expect when you're expecting (95 page)

If you haven’t already noticed, pregnancy impacts just about every inch of your body—from head (that forgetfulness!) to toes (those expanding feet!) and everything in between (breasts, belly!). So it’s not surprising that your skin is also showing the effects of pregnancy. Here are some changes you may expect when it comes to your expectant skin:

Linea nigra.
Sporting a zipper down the center of your burgeoning belly? Just as those pregnancy hormones caused the hyperpigmentation, or darkening, of the areolas, they are now responsible for the darkening of the linea alba, the white line you probably never noticed that runs between your belly button and your pubic area. During pregnancy, it’s renamed the linea nigra, or black line, and may be more noticeable in dark-skinned women than in those who are fair-skinned. It usually starts to appear during the second trimester and most often will begin to fade a few months after delivery (though it may never go away entirely). Interested in a round of “guess-the-sex-of-my-baby”? According to an old wives’ tale, if the linea nigra runs only up to the belly button, you’re having a girl. If it runs past the navel up to the xiphoid process (near your ribs), it’s a boy.

Mask of pregnancy (chloasma).
Around 50 to 75 percent of expectant mothers, particularly those with darker complexions, develop discolorations—in a masklike configuration or a confetti- like appearance—on foreheads, noses, and cheeks. The patches are dark in light-skinned women and light in dark-skinned women. Not a fan of the blotchy look? Never fear. Chloasma will fade within a few months after delivery. if it doesn’t (or if you’d like to speed up its postpartum retreat), a dermatologist can prescribe a bleaching cream (if you aren’t nursing) or recommend another treatment (such as a laser or a peel). Because those treatments are no-no’s for now, bring on the concealer and foundation in the meantime (see
page 149
).

Other skin hyperpigmentation.
Many women also find that freckles and moles become darker and more noticeable and that darkening of the skin occurs in high-friction areas, such as between the thighs. All this hyperpigmentation should fade after delivery. Sun can intensify the discoloration, so use a sunscreen with an SPF of 15 or more on all exposed skin and avoid spending long hours in the sun (even with sunscreen on). A hat that completely shades your face and long sleeves to protect your arms (if you can take the heat) can also help.

Red palms and soles.
It’s your hormones at work again (plus an increase
in blood flow), and this time they’re causing red, itchy palms (and sometimes soles of the feet) in more than two thirds of white and one third of nonwhite pregnant women. There’s no specific treatment, but some women find relief by soaking their hands and/or feet in cold water or applying an ice bag for a few minutes a couple of times a day. Steer clear of anything that heats up your hands and feet (such as taking hot baths, washing dishes, wearing wool gloves), because that can make the condition worse. Also, stay away from potential irritants, such as harsh soaps or scented lotions. The dishpan look will disappear soon after delivery.

Bluish, blotchy legs.
Due to stepped-up estrogen production, many expectant women experience this kind of transitory, mottled discoloration on their legs (and sometimes their arms) when they’re chilly. It’s harmless and will disappear postpartum.

Skin tags.
A skin tag, which is essentially a tiny piece of excess skin, is another benign skin problem common in pregnant women and often found in high-friction areas, such as under the arms. Skin tags frequently develop in the second and third trimesters and may regress after delivery. If they don’t, your physician can easily remove them.

Heat rash.
Though heat rashes are usually associated with babies, pregnant women get them, too. Caused by the combination of an already overheated pregnant body, dampness from excessive perspiration, and the friction of skin rubbing against itself or against clothing (as it tends to do when there’s more skin to rub), heat rash can be irritating. It is most common in the crease between and beneath the breasts, in the crease where the bulge of the lower abdomen rubs against the top of the pubic area, and on the inner thighs. (The pregnancy beauty bonuses just keep on coming, don’t they?) A cool, damp compress can take some of the heat out of your heat rash. Patting on some powder after your shower and trying to keep as cool as possible will help minimize discomfort and recurrence. A dab of calamine lotion can also be soothing and is safe to use, but before you apply any medicated lotions, check with your practitioner. If any rash or irritation lasts longer than a couple of days, ask your practitioner about next steps.

Irritated skin rashes.
Often, rashes are triggered by pregnancy-sensitive skin reacting to a product you’ve used prepregnancy without a reaction. Switching to a gentler product often relieves these contact rashes, but still do let your practitioner know about any persistent rash.

But wait, there’s more.
Believe it or not, there are a host of other skin changes you might experience. For information on stretch marks, see
page 179
; itchy pimples, see
page 288
; dry or oily skins, see
pages 158
–59; spider veins, see
page 156
.

“My shoes are all beginning to feel uncomfortably tight. Could my feet be growing, too?”

The belly isn’t the only part of the pregnant body that’s prone to expansion. If you’re like many expectant women, you’ll discover that your feet are growing, too. Good news if you’re looking to revamp your entire shoe collection; not so good if you’ve just indulged in a pricey pair or two.

What causes your feet to go through a growth spurt? While some expansion can be attributed to the normal fluid retention and swelling of pregnancy (or to new fat in your feet if your weight gain has been substantial or quick), there’s another reason, too. Relaxin, the pregnancy hormone that loosens the ligaments and joints around your pelvis so your baby can fit through, doesn’t discriminate between the ligaments you’d want loosened up (like those pelvic ones) and those you’d rather it just leave alone (like those in your feet). The result: When the ligaments in the feet are loosened, the bones under them tend to spread slightly, resulting, for many women, in a half or whole shoe-size increase. Though
the joints will tighten back up again after delivery, it’s possible that your feet will be permanently larger.

In the meantime, try the tips for reducing excessive swelling (see
page 286
) if that seems to be your problem, and get a couple of pairs of shoes that fit you comfortably now and will meet your “growing” needs (so you won’t end up barefoot and pregnant). When shoe shopping, put comfort before style—even if it’s just this once. Look for shoes with heels that are no more than 2 inches high and have both nonskid soles and plenty of space for your feet to spread out (shop for them at the end of the day when your feet are the most swollen). The shoes should be made from a material that will allow your swollen, sweaty dogs to breathe (nothing synthetic).

Are your feet and legs achy, especially at the end of the day? Shoes and orthotic inserts specially designed to correct the distorted center of pregnancy gravity not only can make your feet more comfortable but can reduce back and leg pain as well. Getting off your feet periodically during the day can (obviously) help with swelling and pain, as can elevating (and periodically flexing) your feet when you get the chance. You can also try slipping on elasticized slippers while you’re at home; wearing them for several hours a day may not make a great fashion statement, but it can ease fatigue and achiness.

“It seems to me that my hair and nails have never grown so fast before.”

Though it may seem as if pregnancy hormones only team up to make you miserable during your nine months (constipation, heartburn, and nausea come to mind), those same hormones are actually responsible for a substantial pregnancy perk: nails that grow faster than you can manicure them and hair that grows before you can secure appointments with your stylist (and if you’re really lucky, hair that is thicker and more lustrous). Those pregnancy hormones trigger a surge in circulation and a boost in metabolism that nourish hair and nail cells, making them healthier than ever before.

Of course, every perk has its price. That extra nourishment can, unfortunately, have less than happy effects, too: It can cause hair to grow in places you would rather it didn’t (and probably didn’t know it could, at least on a woman). Facial areas (lips, chin, and cheeks) are most commonly plagued with this pregnancy-induced hairiness, but arms, legs, chest, back, and belly can be affected, too. (To read about which hair removal treatments are safe during pregnancy, see
page 145
). And though your nails might be long, they can also turn dry and brittle.

Do keep in mind that these hair and nail changes are only temporary. Your good-hair-day run ends with delivery—when the normal daily hair loss that’s suppressed during pregnancy (thus the thicker hair) resumes with a vengeance. And your nails will likely go back to their slower growth schedule postpartum, too (probably not such a bad thing—you’ll want to keep your nails short anyway with a new baby around).

“My eyesight seems to be getting worse since I got pregnant. And my contact lenses don’t seem to fit anymore. Am I imagining it?”

Nope, you’re not seeing things—that is, you’re not seeing things
as well as you were prepregnancy. The eyes are just another of the seemingly unrelated body parts that can fall prey to pregnancy hormones. Not only can your vision seem less sharp, but your contact lenses, if you wear them, may suddenly no longer feel comfortable. Eye dryness, which is caused by a hormone-induced decrease in tear production, may be at least partially to blame for irritation and discomfort. If that’s not enough, fluid increases that change the eye lenses’ shape can actually cause some pregnant women to become more near- or farsighted. Your vision should clear up and your eyes return to normal after delivery (so don’t bother to get a new prescription unless the change is so pronounced that you really can’t see well anymore).

Now isn’t the time to consider corrective laser eye surgery. Though the procedure wouldn’t harm the baby, it could overcorrect your vision and take longer to heal, possibly requiring a second corrective surgery later on (plus the eyedrops used aren’t recommended for pregnant women). Ophthalmologists recommend avoiding the surgery during pregnancy, in the six months preconception, and for at least six months postpartum (and if you’re nursing, six months postweaning).

Though a slight deterioration in visual acuity is not unusual in pregnancy, other symptoms do warrant a call to your practitioner. If you experience blurring or dimming vision or often see spots or floaters, or have double vision that persists for more than two or three hours, don’t wait to see if it passes; call your practitioner at once. Briefly seeing spots after you have been standing for a while or when you get up suddenly from a sitting position is fairly common and nothing to worry about, though you should report it at your next visit.

“I felt little movements every day last week, but I haven’t felt anything at all today. What’s wrong?”

Feeling your baby twist, wriggle, punch, kick, and hiccup is simply one of pregnancy’s biggest thrills (it sure beats heartburn and puffy feet). There may be no better proof that a brand-new—and impressively energetic—life is developing within you. But fetal movements can also drive a mom-to-be to distraction with questions and doubts: Is my baby moving enough? Too much? Moving at all? One minute you’re sure those were kicks you were feeling, the next you’re second-guessing yourself (maybe it was just gas?). One day you feel your baby’s twists and turns nonstop. The next day your little athlete seems to have been benched, and you barely feel a thing.

Not to worry. At this stage of pregnancy, concerns about your baby’s movements—while understandable—are usually unnecessary. The frequency of noticeable movements at this point varies a great deal, and patterns of movement are erratic at best. Though your baby is almost certainly on the move much of the time, you probably won’t be feeling it consistently until he or she is packing a more powerful punch. Some of those dance moves may be missed because of the fetal position (facing and kicking inward, for instance, instead of outward). Or because of your own activity—when you’re walking or moving about a lot, your fetus may be rocked to sleep; or it may be awake, but you may be too busy to notice its movements. It’s also possible that you’re sleeping right through your baby’s most active period; for many babies that’s in the middle of the night. (Even at this stage, babies are
most likely to act up when their moms are lying down.)

One way to prompt fetal movement if you haven’t noticed any all day is to lie down for an hour or two in the evening, preferably after a glass of milk, orange juice, or other snack. The combination of your inactivity and the jolt of food energy may be able to get your fetus going. If that doesn’t work, try again in a few hours, but don’t worry. Many moms-to-be find they don’t notice movement for a day or two at a time, or even three or four days, this early on. If you’re still worried, call your practitioner for reassurance.

After the 28th week, fetal movements become more consistent, and it’s a good idea to get into the habit of checking on your baby’s activity daily (see
page 289
).

“I’m having a perfectly normal pregnancy, with no problems at all. But my practitioner is still recommending that I have an ultrasound this month. Is it really necessary?”