Pain located in the upper or lower segments of the back.
It is common to experience some aches and pains in the upper or lower regions of the back because of the anatomic changes occurring during pregnancy. Enlarged breasts and a growing uterus contribute to a change in weight and the center of gravity. Add to this poor posture, inadequate muscle tone and an exaggerated curve of the lower back (lordosis). Aggravating factors include a posterior fetal position, standing in place for too long and bending forward at the waist.
Carpal tunnel syndrome
Altered sensations, including tingling, numbness, pain, stiffness and weakness in the thumb, index, middle and radial portion of the ring finger that can travel upwards affecting the arm and shoulder.
Infrequent and/or difficult eliminations as stools become hardened and back up within the intestinal tract.
Although it is not considered normal, constipation in pregnancy commonly occurs as a result of the hormone progesterone and its relaxing effect on the peristalsis of the stomach and intestinal tract. The additional transit time allows more water to be absorbed in the intestines. A poor diet, iron supplements and the pressure of a growing uterus, which displaces the organs beneath, also contribute to constipation.
Painful sexual intercourse.
Swelling of the lower body extremities, legs and ankles (can include fingers) evidenced by indentations (from footwear/socks) with possible feelings of tightness.
Swelling can be caused by a variety of reasons. Typically the more common reason is due to the normal, healthy expansion of blood volume and hormones. Other causes can be diet related (not enough salt, fluids and/or protein), duration of standing/sitting and increased perspiration.
Drained, sluggish and general feelings of tiredness.
(extremely common in 1st trimester)
Sharp, dull, throbbing or steady pain located in the front, back or sides of the head.
Burning sensation in esophagus due to reversed peristalsis.
(may be felt in chest or neck)
Progesterone, a pregnancy hormone, affects the cardiac sphincter (top opening) of the stomach by relaxing it and decreasing the movement of the stomach, which prolongs the emptying time. This issue combined with the effects of a growing uterus that pushes and displaces the stomach cause digestive fluids to enter the lower esophageal tract causing an uncomfortable, burning sensation.
Though hemorrhoids can be present without pain, the abnormal dilation of veins located in cushions around the anal sphincter can also protrude, swell, itch and become noticeably painful.
Hemorrhoids are most often caused by constipation, so many of the factors that lead to difficult bowel movements can therefore also be tied to this discomfort. Additional contributors include standing for prolonged periods, weakened blood vessels, lack of venous valves, pooling of blood from backflow during abdominal pressure (such as repeated straining from constipation), progesterone’s effects of relaxing vein walls and poor circulation from the increased pressure of the growing uterus.
Sleeplessness or difficulty falling asleep.
Mentally it may be difficult to get good sleep because the mind is racing with thoughts, concerns, anxieties and/or anticipation! Physically, insomnia could be due to hypoglycemia, deficient intake of B vitamins, discomfort with growing uterus or an active baby.
Sudden pain causing a tight pulling sensation in the leg.
Leg cramps can occur because of deficiencies in the diet, including inadequate salt intake. While there is evidence that too little sodium, calcium, magnesium, potassium and phosphorous can be responsible, it is interesting to note that excess calcium has also been attributed to leg cramps. Additionally, the weight of the growing baby and uterus exert pressure on veins and nerves from the pelvis running below, which contribute to the possibility of leg cramps.
Nausea & Vomiting
Common between 4-14 weeks of pregnancy, this queasy unsettled feeling, which may or may not include vomiting, can occur at any time of day or persist throughout the entirety of the day.
Various influences can be attributed to the nausea and vomiting experienced by 1/2 to 2/3 of pregnant women. In the first trimester the influx of hormones, such as estrogen and HCG (human chorionic gonadotrophin), along with their concentration as the blood volume has not yet expanded can negatively affect some women. In addition, changes in dietary needs versus intake, decreased blood sugar and conflicting emotions have been linked to nausea and vomiting as well. Late in pregnancy, nausea & vomiting can be caused by the increasing pressure and discomfort from the growing uterus.
Intense itching, usually occurring in the third trimester, can begin on the abdomen and spread generally all over; form of jaundice in pregnancy.
Round ligament discomfort
Can be described as a sharp pulling pain or cramp, felt on one or both sides of the uterus extending into the pelvic area (or solely occurring there).
The round ligament is made to stretch with the uterus; therefore as it grows the stretching and pulling itself can be uncomfortable. Pressure from the enlarging uterus in addition to the frequency of contractions toward the end or pregnancy, make triggering this spasm more likely.
Irritation of spinal nerve, felt from the hip area to the back of the upper leg, described as sharp pain, tingling or weakness.
The sciatic nerve is the longest nerve in the body and runs from the lower spine down through the back of the thigh. Because it runs through an opening in the pelvis, pregnancy, more specifically the growing uterus, causes shifting that can impede or encroach on this nerve causing irritation and radiation of the pain.
Dull aching pain from enlarged blood vessels, typically located in the legs or vulva.
Varicosities can occur because of the combination of expanded blood volume and the relaxing effect of progesterone. Lack of vein wall tone and weakened valves from the lower extremities compete with the increased blood flow from the uterus. In addition, family history of varicosities can contribute to a person’s likelihood of developing the condition.
Davis, E. (2004). Heart & hands (4th ed.). Berkeley, CA: Celestial Arts.
Frye, A. (2008). Holistic midwifery: A comprehensive textbook for midwives in homebirth practice (Vol. 1). Portland, OR: Labrys Press.
Myles, M. F. (1975). Textbook for midwives with modern concepts of obstetric and neonatal care (8th ed.). London, UK: Churchill Livingstone.
Parker, S. (2008). The naturally healthy pregnancy: Whole health for your whole pregnancy. Calhoun, LA: Dewdrop Publishing.
Varney, H., Kriebs, J. M., & Gegor, C. L. (2004). Varney’s midwifery (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.