You May Be Expecting -- but Maybe Not Expecting This
By Michele Bloomquist
April 16, 2001 -- There's no doubt about it, pregnancy is a time of discovery and surprises. But for many moms-to-be, the journey includes some symptoms for which they may be unprepared.
In the spirit of full disclosure, we've gathered a group of new or pregnant moms and persuaded them to tell all. The names of the women have been changed to protect their privacy, but the experiences they share are true to life.
What started out as one little red vein quickly grew into a roadmap of red, blue, and purple streaks on 22-year-old Jessica Thompson's legs.
"It started during the fourth month and got nothing but worse," she says. "My legs looked like those of a 60-year-old!"
While alarming, spider veins are actually common during pregnancy, says Michael D. Randell, MD, an obstetrician and gynecologist at Atlanta's Northside Hospital. They are a result of increased estrogen in the system and usually subside after delivery, he says.
Jessica's baby is now 3 months old and her spider veins are 75% gone.
"There is one big patch above my knee that hasn't faded, but even that looked much better within a week after my delivery."
If spider veins stick around, a dermatologist can make them disappear with saline injections or laser zapping, says Randell.
"Around the seventh month of my pregnancy, the sides of my stomach itched so bad I could hardly stand it," says 28-year-old Laura Smith.
This common annoyance is caused by a combination of dry skin (thanks to pregnancy hormones) and the stretching of the skin as the baby grows, says Lorraine Chrisomalis, MD, assistant clinical professor of obstetrics and gynecology at Columbia Presbyterian Eastside in New York City. But don't scratch -- that can lead to stretch marks, she says.
Instead, slather on moisturizer after bathing and several times throughout the day. And don't worry that you'll be itching for months; it usually passes within a few days.
Bleeding gums and nosebleeds
A common but often surprising symptom during pregnancy is the so-called 'pink toothbrush' effect. Starting in the first trimester, hormonal changes in the body trigger increased blood flow to your mouth and nasal passages that in turn can lead to bleeding gums and nosebleeds.
"When I went to the dentist in my first trimester, she said my gums bled so much during my cleaning that if she hadn't known I was pregnant, she would have been seriously concerned," says 27-year-old Tracy Jacobs, who is now pregnant with her second baby.
Keeping up with good dental hygiene is a must during pregnancy, says Ruth Shaber, MD, the women's health leader for Northern California's Kaiser Permanente Hospital. So keep brushing and flossing as usual throughout pregnancy, pink toothbrush or not, she says.
Changes in sex drive
Jessica recalls a surprising surge in her sex drive during the second trimester of her pregnancy. "I wanted to have sex all the time," she says. "It seemed as if I wasn't having it, I was thinking about it -- I had sex on the brain!"
Her sex drive overdrive continued right up to the final month of her pregnancy. "It's strange because I didn't exactly feel like my body was attractive, but I didn't care," she says.
"Sex drives can go up and down throughout pregnancy," says Ernst G. Bartsich, MD, associate clinical professor of obstetrics and gynecology at the Cornell Medical Center in New York City. "Women should follow their instincts and feelings," he says, and fears that having sex will hurt the baby are unfounded.
So unless a woman is experiencing a problem, such as bleeding, let the games begin!
Vivid dreams and disturbing thoughts
Pregnant women and new mothers often are caught off guard by vivid dreams and thoughts, often disturbing ones, says Bartsich. "It's not uncommon, but many women don't talk about this because it is so taboo," he says.
Laura Smith remembers just such a dream.
"I dreamed I was bathing the baby in a tub and there was steam all around. I slowly picked up a towel and put it over the baby's face, smothering it. Then I woke up suddenly," she recalls.
She knew she would never do such a thing but mentioned it during a prenatal visit, where she was reassured by her doctor that such dream are common and normal in pregnancy.
Bartsich says passing thoughts -- for example, stepping out into traffic or feeling ambivalent about motherhood -- also can occur. While distressing, these too are common.
"Even a woman who has been wanting a baby very much may have second thoughts about becoming a parent. It is very normal," he says.
"I had just gotten out of the shower and was bent over blow-drying my hair when I felt something drip on my knees," says Jessica, who was in her final month of pregnancy at the time. "I thought it was water from my hair but when I stood up, the wetness ran down my belly." Shocked, she realized the source of the flow was her nipples.
"Early lactation is very common, but for women who haven't been warned about this, it can be scary," says Shaber.
Milk production can start as early as the second trimester thanks to increasing levels of the hormone prolactin in the blood. Stimulation is usually the cause, such as the heat from a blow dryer or the massage of the shower. Remove the stimulation and the flow usually will stop, Shaber says. If it happens frequently, nursing pads will come in handy.
"It's definitely not dangerous or a sign that anything is wrong," says Shaber. "In fact, it should reassure a woman that she will have plenty of milk when the baby arrives."
Fatigue is a common problem in pregnancy, especially in the first and third trimesters. Tracy was expecting to be tired at the end of her pregnancy, but she was caught off guard by the fatigue in her first few months.
"Afternoons are the worst," she says. "I try to schedule anything I have to get done in the morning, when I have the most energy."
This fatigue may be nature's way of getting a woman to slow down while her fetus is implanting and getting established, says Chrisomalis. "I encourage women to really relax, take naps in the afternoon if possible, go to bed early, and pamper themselves," she says.
An unfortunate drawback of iron supplementation can be constipation, says Randell.
"As soon as I started taking the iron, I completely backed up," says Jessica.
Even without the iron supplements, the extra progesterone in the body during pregnancy can lead to an overall slowing down of the intestinal tract. Randell advises patients to try to prevent constipation by making sure they eat plenty of fiber-rich foods, like fruits and vegetables, and drink eight or more glasses of water a day. If constipation does occur, your doctor can recommend a pregnancy-safe stool softener to get things moving again.
While all of these symptoms are completely normal and common, that doesn't mean you shouldn't mention them during your prenatal visits.
"We want to hear about these things, even if they are routine," says Randell.
And while most are likely nothing to worry about, some symptoms may overlap with those of a more serious condition, he says. For example, itchy belly is normal, but intense itching all over can indicate a serious condition known as fatty liver. So don't hesitate to tell all.
"There is no such thing as a silly question," he says. "That's what we are here for."
Michele Bloomquist is a freelance writer based in Brush Prairie, Wash. She writes frequently about consumer health.
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