by Nicole Dority, DPT, MSPT, OCS
Today, we are going to visit all of the dirty little secrets surrounding pregnancy. So many women are left shocked and surprised because they experience pregnancy woes and challenges that “What to expect when you are expecting,” never mentioned. We are going to blow the doors off the myths and discuss the not so pretty parts of pregnancy that many women experience. Women do not have to feel alone with these things, nor should we have shame in our culture around these issues. I think the best way to address these myths is to take a ground-up approach to explain these issues.
First and foremost, any and all of the pregnancy issues that exist for you are not individual for just you. Many people experience the same challenges, but people just do not choose to talk about it. There is a degree of embarrassment and shame around some of these challenges. Yet, this should never exist. Women throughout time have suffered with this stuff, and if you can approach it knowing you are not alone, and even with a touch of humor, it can be easier. And, like everything else, taking things with a grain of salt is essential.
The list begins with the following, and the list could be longer, but we only have time for these lovelies for today.
Bigger Feet: Due to the increased laxity of the ligaments from our hormonal changes, our plantar fascia becomes laxer as well. This starts to give the feel of our feet growing and makes our shoes tighter. It can also lead to a lovely case of plantar fasciitis if we are not careful. Wearing shoes with decent arch support is a good way to mitigate this if you can; even wearing shoes when you first get out of bed is a good idea. Check out flip flops and sandals by Merrell and Keen.
Varicose Veins: Many women suffer from varicose veins in the lower extremity due to the increased weight of the body onto the lower extremity, the increase of weight from amniotic fluid, and the increased weight of the baby, in general. It is also important to know and understand that pressure may also occur at other parts of the body, including the labia. Many women will discover in the latter months of the pregnancy that they have severe varicosity at the labia in very odd colors (blue, green, purple). There are pelvic supports women can wear to reduce the pain and add a little bit of support. Supportive underwear can also help provide some stability.
Ligamentous Laxity: As discussed above, ligamentous laxity is a huge factor that starts from the early days of pregnancy, and plateaus around week 12-13 and then sticks around through the completion of nursing. The body starts to adjust and prepare for the coming of the baby by letting down a combination of (progesterone, estrogen) and relaxin. These hormones allow the collagen to start to relax, and the pelvis to relax so baby can start to get into position for delivery. This laxity affects the entire body however and can be deleterious due to pain. Pursuing external support is a good choice for people to provide SIJ stability, wrist stability, ankle stability or any other stability needed.
Pubic Symphysis Pain: As per above, as the baby drops into position in the pelvis, we start to note some pubic sheering pain in pregnant women. This can feel like “knife-like” or “tearing” pain or pressure due to the laxity of the arcuate ligament and the increased separation of the pubis at the joint (cartilage). This can be remedied again by some sort of external support like a pelvic stability belt or maternity SI Belt.
Nipple and Breast Changes: No one ever told me how different all of my body would look during pregnancy. But, absolutely no one told me how strange my nipples would become during pregnancy. Our nipples start to become larger, they change in color, and our areola may grow as well. Breasts and nipples can become extremely painful (this is often a woman’s body’s first sign of being pregnant), as well, to the point that you want to keep your bra on all of the time. Many of my patients will wear two sports bras to prevent anything from grazing the nipples even due to the discomfort that this can cause.
Secretions and Odiferous Changes: Due to the major increase in hormone levels (estrogen and progesterone) in the body during pregnancy, all of the secretions of the body seem to increase multi-fold. This includes sweat. Lots of sweat. Sweat from every pore. And, vaginal discharge, that can be a strange challenge as well. There can be a lot of it, and it can too be quite odiferous for some ladies. I had to change my clothing and underwear with regularity during my pregnancies due to the discomfort of increased sweat, discharge and overall secretions from my body. No thanks! But, girls, you are not alone.
Hair Growth: Coupled with the lovely secretions that we experience during pregnancy comes a plethora of interesting hair growth that can exist anywhere throughout the body. Said hair growth can become quite unnerving, particularly when there are areas of the body that you can’t see with any ease. One day, you might wake up and have an extremely long chin hair, or an overgrowth of armpit hair that came overnight. Either way, you are not alone!
Sacroiliac Pain/Low Back Pain: Many women suffer from chronic sacroiliac and low back pain due to the postural effects of carrying a baby, as well as the increased in ligamentous laxity as we have so deftly discussed. This is an issue that should be addressed, and YOU SHOULD NOT JUST LIVE WITH BECAUSE YOU ARE PREGNANT!!! Find a physical therapist or massage therapist or other provider to help you! Get external support, address your core, improve your posture. You need to enjoy, as best you can, this pregnancy!!!
Body Habitus Changes and Postural Changes: Have you ever noticed the odd posture women adopt during pregnancy. To accommodate to the size of the abdomen as it grows, and provide a better base of support, women take to standing greater than hip-width apart, swayed back, hanging on all of their ligaments in the hips, and in their low back. This is going to hurt. There is a better way. Seek help. Talk to your provider, find a physical therapist and adopt a healthier posture so separation of the abdominal wall, loosening of the hip girdle and other changes are not so deleterious to the body!
Nose Issues: When we are pregnant, our noses will run, bleed, and secrete much like other mucous membranes/glandular covered surfaces in our bodies. Due to the increase in blood volume, bloody noses and capillaries breaking inside the nose are very common, as is the chronic runny nose. This can make for a very messy pillow. But again, you are not alone!
GI distress: Many pregnant women suffer from a whole plethora of GI distress. This can be limited to some mild constipation, some mild heartburn, and can be as bad as all pregnancy long constipation, all-day vomiting and nausea, and horrible heartburn. Every woman, every baby, has a different set of fun for you to experience. If it is terrible, let your provider know, and make a plan. You should enjoy this pregnancy. It is yours to live and bliss with and enjoy!
Mom-nesia: Many women suffer from a strange forgetfulness that I like to call Mom-nesia unto which you will search for your keys with regularity and then realize that your keys were actually in your hand all along. This may also contribute to the glasses-esia, a specific type of memory loss whereas your sunglasses or readers are nowhere to be found…..because they are on the top of your bloody head. No fair!!!! You are not alone…
Carpal Tunnel Issues: Many women experience carpal tunnel pain due to the increased joint play in the ligamentous structure of the wrists during pregnancy, coupled with the increased swelling toward the latter part of pregnancy. The carpal tunnel can get compressed by the excess swelling, which then causes compression on the median nerve and blood vessels at the carpal tunnel. This can cause numbness and tingling in the hands, and when it gets bad, some weakness of the hand. If this persists, please consult with your doctor to ensure you get the proper night splints, pursue massage to get the swelling out of the hands and have an ergonomic evaluation of your work station.
The Case of the 3ams: Every mama will have a specific time in the sleep scape that she wakes up. Every night. At first, it is to urinate. Then, it becomes this self-fulfilling prophecy that you are simply going to wake up at that bloody hour. Every. Night. Every. Damn. Night. Don’t worry, it is just preparation for the baby that is coming that is about to knock your whole sleeping situation on its side (it also gets better, so do not worry or project too much, I promise). It is all preparation for the best thing to happen in your life. I promise.
Ladies, please know you are not alone!!! Talk to your friends, ask your provider, and don’t feel like you are isolated with your challenges. You are not alone!
Nicole received her BS in pre-PT/Biochemistry from the University of Miami in 1996. She then served as an officer in the US Army in the Medical Service Corps. In 2000, she moved to Colorado to study PT and received her Master & Doctorate in Physical Therapy in Denver. She is board certified in orthopedics, women’s health, and is certified in TPDN. She is a certified neuromuscular massage therapist & Polestar Pilates Rehab Professional and integrates both disciplines in her PT practice. She has also received advanced clinical practitioner education through Washington University (Sahrmann-based movement systems analysis) and women’s health education through the Herman & Wallace Institute. Nicole is very involved in teacher training and education of both Pilates & Yoga. She specializes in treating pelvic pain, incontinence issues, women’s & men’s health, lower back pain & sacroiliac dysfunction, pregnancy & pregnancy-related issues, postpartum & orthopedic care.