It is quite normal to have a few discomforts throughout your pregnancy. We have put together some commonly experienced symptoms in pregnancy, useful tips on how you can overcome them and red flags when you need to consult a doctor.

Nausea and vomiting / “Morning sickness”
This is a very common symptom experienced by many mothers and affects at least 50% of all pregnancies. It can happen at any time of the day, or any stage of the pregnancy. Nausea and vomiting usually starts around six weeks into your pregnancy and settles by about 14 to 16 weeks. These symptoms may arise as a result of increasing level of pregnancy hormones.

What can be done?

• Eat frequent and smaller meals
• Limit food with high fat content, spicy and fried food
• Try ginger tablets, dry ginger ale, peppermint tea or ginger tea (put three to four slices of fresh ginger in hot water for five minutes)
• Drink enough fluids to avoid dehydration. It is easier to have frequent small drinks than trying to drink a large amount at one go. Try a variety of fluids such as water, fruit juice, clear soups or frozen fruits
• Oral medication can be prescribed for less severe cases
• For severe cases, you may require admission to the hospital for a hydration drip and medication
  

When to consult a doctor?

• Unable to tolerate any meals or fluids at all
• You feel exhausted and losing weight
• Blood seen in your vomit

Fatigue and feeling faint
It is common to feel tired during pregnancy, especially in the first 12 weeks. Later in pregnancy, you may experience difficulty sleeping, which can be due to anxiety about approaching childbirth and parenthood, and feel tired because of the extra weight you are carrying.

Some women may feel faint, especially when you stand too quickly from a chair, get off the toilet, out of a bath, or when you are lying on your back. Other conditions such as anaemia can also make you feel tired during pregnancy.

What can be done?

• Get enough rest and accept any offers of help from your colleagues, friends and family
• Get up slowly after sitting or lying down
• Avoid lying flat on your back later in pregnancy, turn to your side instead
• Do relaxing things before bed, like soak in a bath, listening to music, getting a massage or meditation to help you wind down and sleep better
  

When to consult a doctor?

• Headache or feeling giddy
• Feeling breathless

Heartburn
Heartburn affects up to 60 to 80% of pregnancy and it is partly caused by hormonal changes reducing gastric emptying time, and later when the growing baby presses on your stomach. It can also be caused by eating a heavy meal, food with high fat contents or caffeinated drinks. Women feel burning pain or discomfort in the throat, chest or stomach, accompanied by a bitter taste in the mouth.

What can be done?

• Eating small, frequent meals
• Avoid food and drinks that you suspect can give you heartburn such as oily, fried or spicy food
• Avoid eating just before bed time
• Sit up straight while eating and do not lie down immediately after a meal
• Antacids may be prescribed to reduce symptoms
  

When to consult a doctor?

• Blood seen in your vomit
• Unable to tolerate food and drinks
• Persistent heartburn symptoms that do not go away. This may sometimes be a sign of something more serious, such as pre-eclampsia or heart diseases.
  

Constipation
Constipation is very common especially in early pregnancy affecting up to 40% of women. It means that you are not passing stools as often as you normally do and, you have to strain more than usual or you are unable to completely empty your bowels.

Pregnancy hormones can reduce the speed at which your bowel digest and move food through the body. In later trimesters, fully grown baby can also compress large intestines, contributing to constipation symptoms. Iron supplements, along with reduced intake of water due to poor appetite will also worsen constipation.

What can be done?

• Eat food that are high in fibre, such as wholemeal breads and cereals, fruits and vegetables, pulses such as beans and lentils
• Drink plenty of fluids and water
• Exercise regularly
• A stool softener can be prescribed if required
  

When to consult a doctor?

• Severe bleeding when passing stools
  

Urinary symptoms
Frequent urination and incontinence (leaking urine) are common symptoms experienced by up to 30% of pregnant woman. These symptoms are usually caused by the increased pressure from the developing pregnancy onto the bladder, but sometimes can be due to a urinary tract infection, especially if you feel burning sensation when you pass urine.

What can be done?

• If you find that you need to get up in the night to urinate, try reduce your fluid intake in the late evening
• Pelvic floor exercises can help strengthen the pelvic muscles to reduce urinary incontinence

When to consult a doctor?

• Blood in the urine
• Pain, burning or stinging when you pass urine
• Fever
• Severe urinary symptoms affecting your lifestyle
  

Backache
Most women experience backache at some stage during their pregnancy. The causes include mechanical stress on the lower back to the expanding uterus, shifting of the centre of gravity forwards and changes in your posture, which put strain on your back. It usually goes away after the baby is born, but for many women, back pain lingers for months after giving birth. It can rarely be due to urinary tract infection, kidney stone, or a sign of preterm labour.

What can be done?

• Wear supportive clothing such as an abdominal support garment to help take the weight of your belly off your back muscles, and low heeled shoes with good arch support e.g. athletic or walking shoes
• Pay attention to your position when sitting, sleeping and lifting things
• Use heat or cold packs to sooth sore muscles
• If you need to stand for a long time, rest one foot on a stool or a box to take the strain off your back
• Do back exercises to strengthen and stretch the muscles that support your back and legs
  

When to consult a doctor?

• Blood in your urine
• Fever
• Backache occurs after a fall
• Persistent backache despite adequate rest

Lower limb swelling
Mild lower limb swelling especially at the end of the day is very common and can be simply due to water retention or increase pressure on the blood vessels in your legs. Up to 80% of pregnant women will experience some lower limb swelling.

What can be done?

• Avoid standing for long periods without moving
• Wear comfortable shoes (avoid tight straps)
• Raise your feet up as much as you can
• Exercise regularly by walking to keep your circulation going
• Massage and reflexology
• Compression stockings can help blood flow back to the heart and limit the swelling in the limbs
  

When to consult a doctor?

• If you have high blood pressure and/or feeling breathless (this can be due to pre-eclampsia)
• If it affects only one leg and you feel breathless and/or the affected leg is painful (this can be due to blood clots in the leg, also called deep vein thrombosis)
• Persistent swelling even with adequate rest
  

Leg cramps
Leg cramps are normal but sometimes uncomfortable during pregnancy. They usually happen at night and are more common late in your pregnancy. There are many suggested reasons for cramps, such as carrying extra weight, changes to your metabolism, vitamin deficiency, being too active or not active enough, but the truth is nobody really knows the reasons.

What can be done?

• Gentle exercises such as walking or swimming, may help with blood flow and prevent cramps
• Stretching your calf muscles before you go to bed might help prevent cramps at night
• To ease a leg cramp, stretch the muscle by pulling your toes hard towards your ankle, rub the muscle firmly or walk around for a while.
  

When to consult a doctor?

• Disrupts your sleep
• Very painful
• You feel anxious and concerned about them

Vaginal discharge
During pregnancy, increased levels of progesterone hormone increases vaginal discharge to prevent any infections travelling up from vagina to the womb. It is thus, normal to experience more vaginal discharge during your pregnancy. Rarely, it can be due to a vaginal infection.

What can be done?

• Wear loose cotton underwear
• Avoiding perfumed soap or perfumed bath products can help prevent vaginal infection
• Most vaginal tract infections can be treated with antibiotics or vaginal pessaries

When to consult a doctor?

• Fever
• Blood in the discharge
• Unpleasant smell
• Itchy or sore
• Profuse vaginal discharge especially if it is greenish or brownish
  

Round ligament pain
This is very common and is not dangerous to you or your baby. Pregnancy hormones cause the ligaments to be looser and more elastic. Stretching of these ligaments can cause them to go into spasm, causing pain in the lower abdomen or groin area. It can be made worse by sudden movement such as standing up from a sitting position, rolling over in bed, or any actions that increase abdominal pressure such as sneezing, coughing or laughing.

What can be done?

• Change position slowly, lean forward when you are about to cough or sneeze and support your bump with your hands
• Rest on your side with a pillow between your knees
• Antenatal yoga

When to consult a doctor?

• Persistent lower abdominal pain can be due to other causes. Seek immediate medical attention if it is severe and accompanied by fever and/or chills, bleeding, nausea, vomiting or difficulty walking.

Hair changes during pregnancy
Hormonal changes during pregnancy can affect your hair, making it thicker or thinner. Many women experience their hair feeling thicker around 15 weeks of pregnancy. This is not because each hair strand itself becomes thicker, but because the hair stays longer, means less hair falls out than usual.

Some women experience more hair falling out during and after pregnancy. This is usually nothing to worry about as your hair growth will return to normal by the time your baby is around 12 months old.

When to consult a doctor?

• Hair growth has not returned to normal by 12 months after your delivery

Skin changes during pregnancy
Some women can develop dark patches on their face (called chloasma). Your nipples, birthmarks, moles, freckles and line down the middle of the stomach (called “linea nigra”) may also darken. This is thought to be due to stimulation of pigment-producing cells by female sex hormones. These changes usually fade over a period of several months after giving birth.

Many women (8 out of 10) develop stretch marks during their pregnancy, usually in the last 3 months. They are not harmful and over time, will shrink and fade into paler scars and become less noticeable.

What can be done?

• Careful protection of the skin using sunscreens may make it less likely for chloasma to develop
• Avoid excessive weight gain during pregnancy by eating a healthy, balanced diet
• Applying adequate moisturisers and stretch mark lotions, oils or creams over the abdomen may help the skin maintain its elasticity to withstand the stretching during pregnancy. However, there is also limited evidence about whether they can work.