Regular challenges during pregnancy

Caleb Ihuarulam

Caleb Ihuarulam

A family

Pregnancy is an experience filled with a mix of emotions and a myriad of changes. As someone going through all this change, you always ask what is normal and what is not. This glossary aims to provide you with basic knowledge about common challenges in pregnancy. You will learn what is obtainable and when you should see your doctor. This glossary list will highlight why they occur, give tips on managing the symptoms, and provide red lights to look out for.

We have covered the following pregnancy conditions:

  • Morning sickness
  • Fatigue (early & late pregnancy)
  • Mood swings 
  • Back pains and discomfort
  • Frequent urination 
  • Leg and ankle swellings
  • Constipation, indigestion, heartburn
  • Sleep disturbances
  • Stretch marks & varicose veins
  • changes to the body – acne, weight gain, skin pigmentation

Morning sickness (Hyperemesis gravidarum)

Morning sickness is one of the early symptoms that starts at about the 6th week of pregnancy and continues through the 9th to 16th week. Despite its name, it can last all day and happen anytime. Morning sickness comes with nausea and vomiting.

Why does morning sickness occur:

The exact cause of morning sickness is unknown. The symptoms of morning sickness have been associated with GDF15, a placental hormone responsible for growth that increases during pregnancy. Women exposed to lower levels of GDF15 before pregnancy experience more severe symptoms.

Other contributing factors that may trigger morning sickness:

  • Elevated estrogen and human chorionic gonadotropin (hCG) levels
  • Heightened sensitivity to certain odours and foods
  • Emotional stress
  • Fatigue
  • Motion sickness from travelling
  • Pregnancy with multiples – twins or triplets. This means you will have a larger placenta and increased pregnancy hormones.
  • Family history of morning sickness
  • Trophoblastic disease – a condition that leads to abnormal cell growth in the womb

What this might mean:

Morning sickness doesn’t harm you or your baby. However, severe morning sickness is called hyperemesis gravidarum. It can cause dehydration and malnutrition. If you have hyperemesis gravidarum, you need prompt medical attention.

How to get relief from morning sickness:

  • Stay hydrated by sipping water or ginger tea
  • Eat meals in smaller portions
  • Take vitamin B6 supplements and other prenatal vitamins containing Folic Acid
  • Ventilate your space to get rid of scents that make you nauseous
  • Use acupressure bands

Doctors might prescribe medication if symptoms persist.

When should you see a doctor?

If you notice:

  • No improvements despite trying remedies
  • Severe morning sickness continues in your second trimester.
  • Inability to keep food or liquid down.
  • Dark urine or infrequent urination.
  • Any form of spotting or bleeding
  • Excessive weight loss
  • Concerns about your baby’s well-being.
  • Vomiting blood or material that looks like coffee grounds.

Fatigue (Early & Late Pregnancy)

You can feel overwhelmed or tired during pregnancy. It usually occurs during the first trimester and may resurface in late pregnancy as your body prepares for childbirth.

Why does it occur?

Fatigue occurs at different stages in pregnancy. Factors that contribute to fatigue in the first trimester include:

  • Placenta formation
  • Increased progesterone levels
  • Increased blood supply
  • Changes in metabolism

Factors that contribute to fatigue in the third trimester include:

  • Increase in your baby’s weight
  • Weight gain during pregnancy
  • Disrupted sleep patterns due to frequent urination, leg cramps, and uncomfortable sleeping positions
  • Stress – emotional or physical

What this might mean:

The emotional and physical demands of pregnancy and growing a baby will make you feel tired. It may be indicative of underlying medical conditions like:

  • Anaemia
  • Gestational diabetes
  • Infection
  • Thyroid dysfunction
  • Fibromyalgia – widespread musculoskeletal pain and tenderness
  • Prenatal depression

What to do for quick relief:

  • Prioritize rest, sleep and short naps during the day.
  • Delegate tasks. It is okay to ask and receive help from your loved ones.
  • Eat a balanced diet rich in iron and vitamin B12
  • Stay hydrated
  • Avoid skipping meals
  • Exercise

When should you see a doctor?

Speak to your doctor if your fatigue worsens and if you notice any of the following signs:

  • Dizziness
  • Looking pale
  • Palpitations
  • Pain in the chest, abdomen, or head
  • Shortness of breath or difficulty breathing
  • Swelling in your hands, ankles, and feet
  • Blurry vision

Mood Swings

During this journey, you may experience sudden and intense changes in your emotional state. This change is termed a mood swing. It is normal to feel a range of emotions at different intervals.

Why does mood swings happen?

Fluctuation in hormone levels, especially estrogen and progesterone, is one of the major causes of the change in moods. Hormonal fluctuations start at the 12-week mark. Other contributing factors to mood swings include:

  • Stress and anxiety
  • Fatigue and difficulty in sleeping
  • Physical discomforts like morning sickness, change in body shape, and sleep deprivation

What they might mean:

You may feel anxious when the thoughts of parenthood and childbirth cross your mind. While this is normal, this might be your body’s way of telling you something is wrong. Consistent and intense mood swings may point to mental health concerns like depression or anxiety. If you struggled with your mental health before getting pregnant, it can get worse in pregnancy. Do your best to pay attention to your emotional and mental health.

What to do for quick relief:

  • Communicate with your partner, loved ones, and health provider
  • Seek emotional support if you feel overwhelmed.
  • Practice breathing exercises, meditation, and other stress-reduction techniques
  • Engage in self-care activities that help you to relax
  • Prioritize exercise

When should you see a doctor?

If the following signs persist for two weeks or longer, speak to your doctor:

  • Persistent sadness
  • Changes in appetite
  • Loss of interest
  • distorted sleep patterns

Speak to your doctor if you notice any changes.

Back pains and discomfort

Many expectant mothers complain about back pain. The discomfort is a common consequence of pressure on the upper and lower back and pelvic muscles.

Why it occurs:

The pressure on your spine increases as your body makes room for your baby. Increased relaxin levels help to soften the cervix and expand the birth canal for delivery. Relaxin also relaxes pelvic joints, causing ligament and spinal instability,

Other causes of back pain in pregnancy include:

  • Stress
  • Changes in posture
  • Weight gain
  • Separation of abdominal muscles

What they might mean:

Severe back pain may point to musculoskeletal issues like:

  • Sciatica – pain caused by the compression of the sciatic nerve
  • Symphysis Pubis Dysfunction (SPD) – pain in the pelvic area around the pelvic bone and joints

What to do for quick relief:

  • Engage in pregnancy-friendly exercises and stretches with your doctor’s approval
  • Use pregnancy or regular pillows for back support
  • Instead of sleeping on your belly, sleep on your side.
  • Prenatal massages
  • Apply a warm or cold compress
  • Maintain good posture

When should you see doctor?

If you experience:

  • Severe pain that affects movement and lasts more than two weeks
  • Intense leg cramps and numbness
  • Vaginal bleeding, fever, or burning sensation when you urinate

Frequent Urination

Urinating frequently, especially when pregnant, can often be annoying and may be subjective in the early stages of pregnancy. As your pregnancy progresses, the trips to the restroom will increase.

Why it occurs:

Frequent urination occurs in the first trimester due to an increase in:

  • progesterone levels
  • human chorionic gonadotropin (hCG) levels.

The hormonal changes cause an increase in blood flow to the kidneys, which leads to more urine production.

The bathroom breaks increase in the second and third trimesters due to the pressure exerted on your bladder by the growing uterus and your baby.

What this might mean:

Frequent urination can be a sign of underlying medical conditions like:

  • Urinary tract infections (UTI) if accompanied by pain during urination or foul-smelling urine
  • Gestational diabetes accompanied by increased thirst and blurred vision

What to do for quick relief:

  • Reduce the amount of fluid taken before bed
  • Do exercises that strengthen your pelvic muscles – kegel exercises
  • Empty your bladder regularly

When should you see a doctor?

Speak to your doctor if you experience:

  • Pain or a burning sensation
  • Blood in urine
  • Smelling urine
  • Loss of bladder control while urinating

Leg and ankle swellings

Swelling in the legs and ankles (pedal oedema) may shock you, but you don’t need to panic as this is due to fluid buildup.

Why it occurs:

During pregnancy, your body volume increases by up to 50%, and cell count rises by 30 %. Increased blood volume and pressure on the blood vessels in the legs as your uterus grows will cause your body to retain the extra fluid in your legs. Swelling in your legs and ankles may also be because of malnutrition.

What this might mean:

Normal or mild swelling in your legs is perfectly normal, especially in the third trimester. Excessive or severe swelling may point to more critical health problems, including:

  • Pre-eclampsia
  • Heart conditions due to poor blood circulation
  • Deep-vein thrombosis (DVT) – the formation of blood clots in the deep veins in the legs
  • Infections like cellulitis – a bacterial infection that causes swelling and pain in the skin

What to do for quick relief:

  • Place your legs in an elevated position to aid blood circulation
  • Exercise and take walks regularly
  • Avoid sitting or standing for long
  • Wear comfortable shoes/ Avoid wearing tight-fitting shoes
  • Reduce salt intake
  • Stay hydrated
  • Wear compression socks

When should you see a doctor?

If you notice:

  • Heachache
  • Swelling is severe and lasts for a few days
  • Swelling when you have a history of heart, kidney, and liver disease
  • Discoloration of the skin

Constipation, indigestion and heartburn

The combination of constipation, indigestion, and heartburn can make your pregnancy unbearable. These are health changes that affect the gastrointestinal tract. Constipation usually manifests as difficulty in passing stool. Indigestion, or dyspepsia, is a feeling of pain or discomfort in your stomach. Heartburn, or acid reflux, is a burning sensation in the oesophagus and chest.

Why it occurs:

As the pregnancy progresses, constipation, digestion, and heartburn may happen more often. Factors that contribute to these gastrointestinal problems include:

  • Increased levels of pregnancy hormones
  • Increased pressure from the uterus on the stomach and intestines
  • Changes in your diet

Progesterone will slow down your digestion by relaxing the digestive tract muscles. Indigestion will cause bloating, gas, and discomfort that can lead to constipation if you don’t receive treatment. Progesterone also relaxes the sphincter muscle – a muscular valve between the stomach and the oesophagus.
As your uterus grows, it pushes against your stomach and intestines. The exerted pressure will manifest in two ways.

  • Indigestion and bowel stiffness lead to constipation.
  • The digested food and stomach acid go back into the oesophagus, causing heartburn.

Fibre aids bowel movement. If you skip foods rich in fibre, you have higher chances of experiencing constipation and bloating.

What this might mean:

If the acid reflux happens more often, you may need to get checked for gastroesophageal reflux disease (GERD).

What to do for quick relief:

  • Eat several small meals during the day to ease digestion and prevent heartburn.
  • Avoid spicy, greasy, or acidic foods that trigger indigestion and heartburn.
  • Stay hydrated
  • Include fibre-rich foods in your diet to relieve constipation.
  • Sit upright for at least one hour after eating
  • Avoid eating 2-3 hours before going to bed
  • Use at least two pillows to keep your head slightly elevated while sleeping.
  • Sleep on your left side.

If you need antacids or other medications, ensure your doctor approves them.

When should you see a doctor?

Seek medical attention promptly if you experience any of these symptoms:

  • Difficulty swallowing
  • Pain or swelling in your stomach
  • Blood in stool
  • Weight loss
  • Inability to pass out stool and gas

Sleep disturbances

These are disruptions in your regular sleep patterns during pregnancy. Women often complain about:

  • Struggling to fall asleep
  • Waking up at intervals
  • Restlessness at night

Why it occurs:

This happens due to the combination of hormonal changes, physical discomfort due to weight gain and your growing baby, and anxiety.
The hormonal changes will affect your sleep quality and duration. Increasing progesterone levels sedates you, making you sleepy during the day. Frequent trips to the bathroom, nausea and vomiting, back, fetal movements, weight gain, and acid reflux are some of the physical discomforts that affect the quality of sleep you experience. An amplified concern about your pregnancy, labour, and delivery experience usually causes anxiety.

What this might mean:

Persistent sleep apnea and insomnia will affect your well-being. It may be a sign of pre-existing anxiety and sleep disorders. It can also trigger mood swings and postpartum depression (PPD).

How to sleep better during pregnancy:

  • Reduce caffeine intake
  • Reduce screentime and slowly wind down as it gets closer to your bedtime
  • Maintain your established bedtime.
  • Take as many naps as possible.
  • Create a calm and cosy environment with soft and supportive pillows.


When should you see a doctor? 

If disrupted sleeping patterns worsen over time, leading to chronic insomnia, please get in touch with your doctor as soon as possible.

Stretch marks and varicose veins

Contrary to what you might think, stretch marks and varicose veins are symbols of pride. They remind you of the miracle of housing and growing your little one.
Stretch marks, or striae distensae, usually appear on any part of your skin as streaks, especially your abdomen, breasts, and thighs. Varicose veins, or varicosities, are swollen and twisted veins that usually lie under the skin, especially on your arms, ankles, legs, and vulva.

Why it occurs:

Stretch marks are caused by:

  • Hormonal changes
  • Weight gain

Varicose veins are caused by:

  • Increase in weight
  • Pressure from your uterus

What this might mean:

When your skin tissues stretch and eventually separate, it causes microscopic bleeding. Your stretch marks may look reddish-purple and can be puffy due to the inflammation. They will look pale and thinner as they fade.
Varicose veins can develop in unpredictable areas of your body, causing swelling, decreased blood flow, and complications, including:

  • In the rectum and around your anus, causing haemorrhoids.
  • In smaller blood vessels, such as spider veins
  • Deep vein thrombosis (DVT) – the formation of blood clots in the deep veins in the legs

How to reduce stretch marks and varicose veins:

  • Place your legs in an elevated position
  • Ensure that you stay active
  • Wear compression socks
  • Keep your skin hydrated and moisturized with natural oils to reduce the appearance of stretch marks.

Signs you should see a doctor:

If the varicose veins get swollen and painful, speak to your doctor to eliminate possible complications.


Body changes – Acne, weight gain, skin pigmentation

Acne, weight gain, and skin pigmentation come with the demands and experience of pregnancy. Skin changes flare up during pregnancy because your skin is much more sensitive. They vary from acne breakouts and dark spots to brown patches on your skin.

Why it occurs:

The extra blood flow and hormone level change are why your skin changes. Your oil glands respond to increased androgen levels by producing more sebum, which blocks your oil glands. Progesterone also triggers the fluctuation in skin pigmentation. This will result in dark spots or patches on your face and other body parts. For weight gain, it is natural and expected. It supports your baby’s growth and development.

What this might mean:

Dealing with these changes may be frustrating. They affect your confidence and self-esteem. Embrace your skin and new body while focusing on enjoying a healthy pregnancy.

Be rest assured that your skin can and will get better soon enough.
In some instances, sudden changes may point to hormonal imbalance.

How to maintain your body during pregnancy:

  • Skincare is self-care. Cleanse and moisturize by using a gentle skincare routine.
  • Eat a diet rich in fruits and vegetables to maintain a healthy weight and supply your skin with nutrients from within.
  • Prioritize sleep
  • Avoid stress
  • Avoid isotretinoin except directed otherwise by your doctor

When should you see a doctor?

If acne or dark patches worsen during pregnancy, speak to your doctor. Inform your doctor before you try any product or DIY skincare remedy.

You need to prepare yourself with the proper knowledge to manage these conditions, and don’t hesitate to consult professional medical advice where and when necessary.

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