During the latter half of pregnancy, many women suffer from aches and pains in various parts of their body including the ribs, back, hips, pelvic region, abdomen and legs. Most are due to a combination of hormone effects, increasing weight and poor posture.

Throughout your pregnancy hormones are working to relax the ligaments and joints, particularly those in the pelvis, softening and stretching the ligaments to allow the baby an easier passage in labour.

In addition the extra weight of your growing baby can weaken your stomach muscles and put added pressure on your lower back. Also, as your centre of gravity changes many women tend to lean backwards, which can result in further strain. If your back pain is constant or severe consult your midwife or doctor who may refer you to a physiotherapist or osteopath.

To help alleviate general aches and pains:

• Try taking gentle exercises to strengthen your spine and stomach muscles;
• Do not to stand for long periods;
• Be aware of your posture when standing, walking, or sitting - keep your back straight and do not slump;
• Do not lift heavy objects;
• Wear low-heeled shoes to allow even distribution of your weight - high-heeled shoes tend to make you lean forward;
• Avoid excessive weight gain.

Varicose veins

You are more likely to get varicose veins (swollen or dilated veins that appear under the skin) if there is a family history of them. Varicose veins often occur in the later months of pregnancy and are caused by the weight of the uterus pressing on the veins in the pelvis, which increases the pressure in the veins in the lower body. Progesterone also makes the veins dilate so that the blood pools in your legs, vulva and anus.

You may notice that the veins in your legs bulge when you are standing for an extended period. Very rarely, redness, swelling and pain in your calves may be a serious condition called venous thrombosis. If you are worried consult your midwife or doctor immediately.

To ease or prevent varicose veins avoid standing for long periods. If you do need to stand, move your feet around if possible to improve your circulation. Walking also helps to improve the circulation so try walking daily - if only for a short 15 minute stroll during lunch hour. Wearing support tights or stockings and resting with your feet up as much as possible will also help.

Haemorrhoids/piles

Haemorrhoids (piles) are varicose veins in the rectum that swell and sometimes protrude when the weight of the baby puts pressure on the main veins in the pelvis. They can be very uncomfortable and may bleed, itch and feel sore.

Haemorrhoids usually reduce or disappear upon delivery of your baby. On rare occasions surgery is required.

Avoid getting constipated or straining as this will add to your discomfort. Eat a high fibre diet, drink plenty of fluids and take gentle exercise daily. Your doctor may also prescribe some ointment or suppositories, which will help relieve any itching or discomfort.

Cramps

Cramp is the excruciating pain of muscles in spasm. Cramp in the feet or leg muscles and thighs is common in later pregnancy, especially at night-time, and may come on suddenly when you point your toes or stretch. The causes of cramp are uncertain but some theories link them to low calcium levels.

If you do get cramp, try extending the leg and then bringing the toes towards your body to help relax the muscle that is in spasm. Having a glass of milk (which contains calcium) before going to bed may prevent cramps.

Swelling

Many women suffer from mild swelling of the fingers, hands and ankles towards the end of their pregnancy. This is also known as oedema or water retention and may be caused by pregnancy hormones, raised blood pressure, extra circulating blood volume, and your increased body size putting pressure on your lower limbs.

Avoid standing or sitting in the one place for long periods. Rest with your feet elevated whenever possible. Foot exercises such as rotating your ankles in clockwise and anti-clockwise circles may help by improving the circulation.

Occasionally general, but marked swelling of the legs, arms and face are symptoms of pre-eclampsia, which is a serious condition requiring medical attention. Always mention signs of swelling to your midwife or doctor.

Pins and needles

Tingling and numbness, and occasionally weakness in your hands and feet, similar to pins and needles can occur in late pregnancy. This sensation of pins and needles in your hands is known as carpal tunnel syndrome.

Carpal tunnel syndrome is due to excess fluid being present in the tissues in your wrist compressing the median nerve. The tingling sensation will affect all fingers except the little one. Lying on your side may help or you may get some relief by raising your arms above your head and moving your fingers around. The condition usually resolves itself completely soon after delivery.

Itching (pruritis gravidarum)

Itching without a visible rash often occurs in late pregnancy and is most often due to your skin stretching as your abdomen expands to accommodate the growing baby. Moisturising your skin with creams, calamine lotion and bath oils will soften the skin and help to reduce the itching.

Although it is uncomfortable and irritating, this condition will resolve as soon as your baby is born. Rarely, severe generalised itching, especially late in pregnancy, needs to be seen by your midwife or doctor as it could indicate a liver disease.