In early pregnancy the most common problem is morning sickness, which can actually be all day sickness. For most women this gets worse until around 8-10 weeks and then generally gets better after 12-13 weeks. The most important thing is to keep up your fluids, so that you do not become dehydrated. Don’t worry if you lose your appetite for food for a few weeks, you and your baby will both be fine. It is important to remain well hydrated, so if you can’t even keep fluids down and are losing weight then you may need to be admitted to hospital for intravenous re-hydration.
Simple steps to minimise nausea of pregnancy are: avoid large meals, fatty meals, or rich, spicy meals. Start the day with a dry cracker or toast. Have three small meals each day and at least three snacks in between meals. Avoid drinking while eating. Ginger in most forms can help, including the ginger and Vitamin B6 tablets. Acupuncture is less proven but of significant benefit to some women.
You can try Doxylamine (Restavit) and Pyridoxine (Vitamin B6): half a 25mg tablet of each morning and midday, and one 25mg tablet of each at night. These are available without prescription, but the Doxylamine can be very sedating. If you need stronger medication I can prescribe Maxolon. It is easy to take, but does not work for everyone. If it does not work I can prescribe Ondansetron wafers.
The next major challenge in pregnancy is tiredness. In early pregnancy you are often ready to lie down at around 4 or 5pm. You will be especially tired if this is your second pregnancy. Usually you will find that your energy levels improve significantly after about 14 or 15 weeks. That increase in energy should last until around 36 weeks, especially if your iron stores are good.
From around 20 weeks of pregnancy you should start feeling fetal movements. From this time onwards you should try to avoid sleeping flat on your back. Ideally you should go to sleep on your left side, but sleeping on the right side is better than your back. To help avoiding turning onto your back you may try a pillow or a wedge under your hip. All you need is around 15 degrees of tilt to be safe.
If any complications develop in pregnancy I may need to arrange more frequent visits for closer monitoring of either you or your baby. However, if you need very close monitoring you may be admitted to hospital during your pregnancy. If this is the case, I will look after you during your in-hospital stay. I may need to arrange for extra ultrasound scans and blood tests, and I may need to involve other teams in your care. Most interventions are aimed at reducing the risk of stillbirth. Fortunately this devastating event is rare, and can be minimised with good care.
With a growing baby inside it is common for you to feel some aches and pains during the pregnancy, but please ring the Delivery Suite immediately if you experience any of the following:
- vaginal bleeding;
- constant, severe pain;
- a sudden reduction in the number of your baby’s movements after 28-30 weeks;
- itch, especially of hands or feet, and especially after 35 weeks; or
- persistent headache, especially if accompanied by spots in front of eyes, and puffy feet.
My rooms are 20 minutes from the hospital, and I live nearby if I need to attend urgently after hours.