All changes in your body during pregnancy are associated with or caused by hormones. These changes are necessary to enable you to nurture your baby, prepare your body for labour, develop your breasts for breastfeeding and lay down stores of fat to produce calories for the production of breastmilk.
Breast changes

Swollen, tender breasts are one of the earliest signs of pregnancy and are caused by increases in the levels of oestrogen and progesterone your body. In the early weeks your breasts may feel extremely sensitive and painful but this will resolve around the third or four month. However, your breasts will continue to grow throughout your pregnancy, possibly increasing as much as three cup sizes.

As well as increasing in size, the areola (the dark area around your nipples) will darken and spread. This darkening may fade after your baby is born but will not disappear completely. You may also notice little bumps on the areola. These are sweat glands, which become more prominent during pregnancy but return to normal following childbirth.
The veins on your breasts will be more obvious, particularly if you are fair-skinned. Following childbirth or after you have finished breastfeeding the skin’s appearance will return to normal.

If your breasts enlarge early in pregnancy and then reduce in size and the tender feeling disappears contact your midwife or doctor.

Morning sickness

Approximately 50% of women will suffer from morning sickness. Although it is called morning sickness it can happen at any time of the day or night. And while it can be very unpleasant, it rarely interferes with proper nutrition to the extent that it affects the developing foetus. Morning sickness often goes away around week twelve but some women feel sick and nauseous for the full nine months. If the nausea is excessive contact your midwife or obstetrician.

The exact cause of morning sickness is unknown but it is thought to be related to high levels of the pregnancy hormone HCG (human chorionic gonadotropin) during the first three months of pregnancy combined with elevated oestrogen levels.

Morning sickness is more common in first pregnancies and in women who are carrying more than one baby.
Unfortunately, there is no cure for morning sickness but there are some things you can do to help minimise the symptoms.

• Drink plenty of fluids, especially if you vomiting.
• Take a prenatal vitamin supplement to compensate for the nutrients you are losing.
• Avoid the sight, smell and taste of any foods that make you queasy.
• Avoid tobacco smoke.
• Eat early and often - before you feel hungry.
• Keep some crackers by your bed and have a light snack before you get up in the morning.
• Brush your teeth with toothpaste that doesn’t increase queasiness.
• Minimise stress, as morning sickness appears to be more common in women who are stressed.
• Try Sea-Bands - wide, elastic bands worn on both wrists that put pressure on acupressure points in the inner wrists and often relieve nausea.

Excess saliva

This is thought to be due to hormone levels and is a common symptom of pregnancy. It is unpleasant but harmless and usually disappears after the first three months. It is more common in women who are suffering from morning sickness and seems to make the queasiness worse. There is no cure but you may find that chewing sugarless gum may help.

Mood swings

No matter how delighted you are about your pregnancy you may experience mood swings including depression. These mood swings are hormone-related and are more pronounced in the first trimester. You may be particularly susceptible if you usually suffer from pre-menstrual mood swings.

Sugar, chocolate and caffeine can make depression worse so avoid these foods if you are already feeling low. Getting a good balance of rest and exercise and talking to a friend or partner about your feelings can help keep your mood up.

If your low feelings are consistent or frequent you may be one of the 10%-16% of pregnant women who suffer from mild to moderate prenatal depression. If you are concerned talk to your midwife or doctor.

Backache

From the beginning of your pregnancy, hormonal changes prepare your body for the moment your baby is born. One of the side-effects of this preparation is backache.

During pregnancy the usually stable joints of the pelvis begin to loosen up to allow easier passage for your baby at delivery. This, combined with your ever-increasing abdomen, can throw your body off balance. To compensate, many women tend to hold their shoulders back, arch their neck with and push their belly forward. This results in a deeply curved lower back, strained back muscles and pain.

To help prevent or reduce the backache:

• Avoid excessive weight gain as excess kilograms will only add to the load your back is struggling to cope with.
• Don’t wear heels - even very flat ones - without proper support.
• Learn the proper way to lift heavy objects and avoid lifting as much as possible.
• Do not stand for long periods of time.
• When sitting, always sit on a chair that offers adequate support, preferably one with a straight back.
• Sitting for long periods can put strain on your back so try to walk around frequently.
• Sleep on a firm mattress.
• Learn to relax, as many back problems are aggravated by stress.

Fast-growing hair and nails

Pregnancy hormones have the effect of increasing blood circulation and raising your metabolism with the result that your hair and nails grow faster. Your hair may also become much thicker.
On the downside, the extra nourishment may make hair grow in places you would rather it didn’t! The lips, chin and cheeks are most commonly affected but your arms, legs, back and abdomen may also be affected. Much of this excess body hair will disappear about six months postnatal but it may linger for longer.

Although there are no identified risks associated with the use of depilatories or bleach cream you should avoid them during pregnancy; your skin may not react well to the chemicals and they may be absorbed into your bloodstream. Electrolysis and laser hair removal are not recommended in pregnancy although no adverse affects have been reported. Plucking or shaving the hair is quite safe in pregnancy.

Nosebleeds and nasal stuffiness

Nasal stuffiness and nosebleeds are quite common in pregnancy. They are caused by high levels of progesterone and oestrogen, which bring an increased blood supply to the nasal membranes.
The nasal stuffiness may get worse as your pregnancy progresses, only being relieved after childbirth. You may also develop sinus congestion and a postnasal drip, which can cause you to cough at night.

The use of medication or medicated nasal drops is not recommended unless specifically prescribed by your doctor. Saline nose drops or sprays are quite safe to use and can be very effective. Congestion and bleeding may be more common in winter as central heating systems dry the air in the house that in turn dries your nasal passage. The use of a humidifier may help.

To stop a nosebleed, sit or stand leaning slightly forward. Using your thumb and forefinger, pinch the area just above your nostrils and below the bridge of your nose and hold for five minutes. If the bleeding will not stop or is very heavy, consult your midwife or doctor.

Constipation

The high levels of hormones circulating during pregnancy cause the muscles of the bowel to relax, and slow down bowel movements. There are a number of things you can do to help relieve constipation:

• Drink plenty of fluids, especially water and fruit and vegetable juices. Some women find drinking hot water with lemon particularly helpful. If constipation is severe try small amounts of prune juice.

• Avoid refined foods such as white rice and white bread, which can make constipation worse. Instead, focus on fibre-rich fresh fruit and vegetables. Wholegrain cereals, wholegrain breads, dried fruit and raisins.

• Try to get regular exercise as this encourages active bowels.

• Some calcium or iron supplements can cause constipation. If you think medication may be the cause, talk to your doctor who may prescribe alternative medication.

Heartburn and indigestion

Heartburn or indigestion in pregnancy is caused by progesterone and relaxing. These hormones are produced during pregnancy to relax smooth muscle tissue in the body, including the digestive tract. As a result, food moves more slowly through your digestive system, causing bloating and indigestion.

Heartburn occurs when the ring of muscle that separates the oesophagus (the tube that connects the throat to the stomach) from the stomach relaxes, allowing food and digestive juices to flow back up into the oesophagus. Because of their acidity, the gastric juices irritate and burn the lining of the oesophagus around where the heart is, which is why it is called heartburn, although it has nothing to do with your heart.

There are a number of ways to avoid indigestion and heartburn:

• Eat small meals often.
• Eat slowly and chew your food thoroughly.
• Stay upright for a number of hours after eating.
• Eliminate from your diet any food that you know routinely causes indigestion or heartburn such as hot and highly seasoned food, fried, fatty foods. Alcohol, carbonated beverages and peppermint.
• Avoid bending from the waist – you should always bend from the knees.
• Add an extra pillow under your head at night.

Dental problems

The gums, like the mucus membranes in the nose, become swollen, inflamed and tend to bleed easily because of pregnancy hormones. These hormones also tend to make the gums more susceptible to plaque and bacteria, making the problem worse.

Red, tender, bleeding gums could indicate gingivitis, which if left untreated, can result in the more severe periodontitis. Dental care is therefore of extreme importance during pregnancy. Uncared for teeth can actually become loose and fall out. (This is where the old wives tale came from a woman loses a tooth for every baby she has.)

• Do not eat sweets between meals.
• Consume plenty of foods rich in Vitamin C and calcium.
• Floss and brush regularly.
• If you can’t brush after meals chew some sugarless gum.
• Regardless of whether you are having dental discomfort or not, make an appointment for a check-up and cleaning with your dentist.