The changes your body goes through during pregnancy are essential for your baby’s healthy growth and your body’s preparation for delivery. Physical and hormonal changes during pregnancy often result in acid reflux, which causes heartburn. The discomfort can be mild for some mothers but intensely painful for others. Either way, there are steps you can take to get relief.

What Is Heartburn?

Heartburn refers to the uncomfortable burning or painful sensation in your chest when acid moves upward from your stomach into your esophagus. Your esophagus is the muscular tube that moves food from your mouth toward your stomach for digestion. At the bottom of your esophagus is a circular muscle called the lower esophageal sphincter. When functioning normally, this muscle prevents acid from leaving your stomach. But when this sphincter doesn’t close completely, stomach acid can reflux or travel upward into your esophagus.¹

What Causes Heartburn During Pregnancy?

Pregnancy can cause an increase in acid reflux and, thus, heartburn because of a hormone called progesterone. Progesterone, aka the pregnancy hormone, can slow digestion and cause the lower esophageal sphincter to relax.² Besides hormonal changes, physical changes can contribute to heartburn. As your baby grows, your uterus expands. This can increase the amount of pressure placed on your stomach.³

When Does Heartburn Start in Pregnancy?

For some women, thanks to progesterone, heartburn starts during the first trimester of pregnancy. For other mothers, they may not experience it until the third trimester.⁸ The frequency of heartburn typically increases as your pregnancy progresses.²

How Common Is Heartburn During Pregnancy?

Heartburn is one of the most frequently experienced symptoms during pregnancy since it is reported by over half of all pregnant women. It happens more commonly in mothers who have either been pregnant before or suffered from heartburn before becoming pregnant.¹

How To Treat Heartburn During Pregnancy

Thankfully, there are effective options for heartburn relief in pregnancy. Be sure to talk with your OB care provider before trying home remedies for acid reflux or taking over-the-counter medications during pregnancy. Antacids, such as Tums, can help reduce heartburn symptoms. However, it is essential to discuss with your OB care provider which medications are safe to take while pregnant.³

Some antacids contain high amounts of sodium, which can cause water retention. Others have aluminum, which you should not take while pregnant.¹ Also, you should avoid taking antacids within two hours of your folic acid or iron supplements because they may reduce your body’s ability to absorb these nutrients.⁴

If your OB care provider recommends taking over-the-counter medications, you can use these to ease the discomfort quickly. But what if you are at work or traveling and don’t have access to antacids when the burning sensation strikes? Knowing how to get rid of heartburn during pregnancy using other remedies can also help provide fast relief:

• Milk: Fortunately, heartburn does not necessarily require taking medication — simply drinking milk or eating low-fat yogurt can help.¹ Of all the milk options, skim is your best bet, as the fat in whole milk can sometimes worsen acid reflux.⁵
• Ginger tea: You may also find relief by drinking ginger tea with a tablespoon of honey.⁶ Ginger is known for its anti-inflammatory properties and is a commonly used digestive aid.⁵
• Lemon water: Even though lemon juice is acidic, drinking a small amount with honey and warm water can help neutralize the acid in your stomach.⁵

Can You Prevent Heartburn During Pregnancy?

There are several steps you can take to reduce acid reflux and heartburn symptoms during pregnancy:

• Diet: Choose foods that won’t cause heartburn during pregnancy, especially ones that are high in fiber (oatmeal, sweet potatoes, or carrots), less acidic (bananas, melons, or nuts), and contain plenty of water (watermelon, celery, or cucumbers).⁵ Avoid greasy or spicy foods and caffeine since these can worsen heartburn.¹
• Take your time: Eat your meals slowly and try eating smaller meals more frequently.⁷
• Alcohol and smoking: Avoid both of these. Alcohol and smoking not only contribute to heartburn, but they can also negatively impact your baby’s growth and development.¹
• Posture: Pay attention to your posture while you eat. Sitting up straight when eating can aid in preventing acid reflux.¹
• Sleep position: Don’t lie on your back immediately after eating, and try to elevate the head of your bed.⁷ You can try sleeping with a wedge-shaped pillow or pillows under your shoulders.¹

The good news is that some of the more uncomfortable pregnancy-related symptoms don’t last forever. If you are experiencing heartburn during your pregnancy, you don’t have to suffer. There are things you can try to reduce the discomfort. Talk with your OB care provider about your options, and keep in mind that as hormones return to their pre-pregnancy levels, for most mothers, heartburn resolves shortly after delivery.

While pregnancy is a miracle, there are times when it can be uncomfortable and not so glamorous. People hear about morning sickness and swollen feet, but not necessarily about pregnancy complications. Pregnant women need to know what is normal and abnormal in pregnancy so they can know what to look for regarding any concerns. One of the first tips today’s guest shared on this episode is choosing a primary care provider you like and trust. Having a good relationship with your doctor or midwife and having continuity of care throughout your pregnancy can help you have a healthier pregnancy.

We learned a lot of insightful tips from our special guest, Dr. Alison Cowan. If you are interested in learning more about pre-eclampsia, tips for self-advocacy, common pregnancy complications and what to look for, this episode is for you!

Who is Dr. Alison Cowan?

Dr. Alison Cowan is an OBGYN, a mom of three (ages 10, 7, and 3), and the Head of Medical Affairs for Mirvie. Mirvie is a maternal health company pioneering a new way for women, expecting parents, and their doctors to predict potential pregnancy complications early on.

Alison attended Emory University Medical School, where she also received a master’s in clinical research before moving on to do her OBGYN residency at Northwestern University. With over a decade of bedside experience, Alison has delivered hundreds of babies. She is now on a mission to help change the status quo for pregnancy health. She is passionate about sharing tips for self-advocacy, having the healthiest pregnancy possible, and advocating for change and equity in pregnancy health at every opportunity. Alison resides in Colorado with her husband, Patrick, and three children.

What Did We Discuss?

In this episode, we chat with Alison about the facts behind common pregnancy complications, like pre-eclampsia, how women can advocate for themselves during pregnancy, and equity in pregnancy health. Here are several of the questions that we covered in our conversation:

• What steps can women take to ensure they have the healthiest pregnancy possible?
• Why is self-advocacy an important part of a woman’s pregnancy?
• What tips do you have for self-advocacy during pregnancy?
• What are some common pregnancy complications? And what symptoms should women look for?
• Can you tell us more about the science and facts behind some of these common pregnancy complications?
• How common is pre-eclampsia?
• What causes pre-eclampsia? Can it be prevented?
• Are some women at a higher risk for developing pre-eclampsia than others?
• What are the symptoms of pre-eclampsia?
• Does pre-eclampsia go away after delivery?
• I know you advocate for equity in pregnancy health. Can you elaborate on this and what it means?

Dr. Cowan’s passion and knowledge about women’s health is evident in this episode. We learned some helpful information that can help every person have a healthier pregnancy. We hope you learned something new, too! Cheers to healthy pregnancies!

Mentioned in the Episode

• ACOG.org
• Comprehensive care plan to prevent pre-eclampsia
• Care providers should be mindful of these CUS words from their patients:
  • I’m Concerned.
  • I’m Uncomfortable.
  • Safety: I feel unsafe.

Dr. Alison Cowan’s Resources

• Website: Mirvie.com
• Instagram: @mirviedx
• Facebook: @MirvieDx
• X: @MirvieDx
• Dr. Alison Cowan’s LinkedIn

Pregnancy has its fair share of aches, pains, and other health concerns and discomforts. Because many common medical treatments can be expensive and may cause side effects to both mom and baby, women and providers are turning toward complementary and alternative treatments to ease discomfort. One of these interventions during pregnancy is acupuncture.

Acupuncture has been used during pregnancy in an attempt to relieve many common pregnancy ailments, such as morning sickness, back pain, and pelvic pain. It has also been trialed for turning a breech baby and for pain relief and natural induction of labor.¹ We will examine acupuncture’s uses, effectiveness, and safety during pregnancy.

What Is Acupuncture?

Acupuncture is a traditional Chinese medicine that balances energy throughout the body to relieve pain and optimize physical and mental health. An acupuncturist inserts very thin needles through the skin into specific points throughout the body. These points are located along meridians corresponding to specific organ systems.²

The locations of needle insertion throughout the body vary depending on the ailments you’re attempting to treat. Multiple points can also be stimulated at once.³

Sometimes, after the needles are placed, an electrical current can be applied through the needles into the skin and body tissue, called electroacupuncture. This is thought further to increase healing and pain relief.⁴

While some view acupuncture as a way to balance body and life forces, Western medicine believes that acupuncture’s effectiveness may be attributed to nerve, muscle, and tissue stimulation to promote healing and recruit “natural painkillers.”³

Is Acupuncture Safe During Pregnancy?

In the general population, acupuncture is regarded as very safe.⁵ Prenatal acupuncture is probably safe as well. Traditionally, acupuncturists avoid certain points during pregnancy, as there is concern they may stimulate early labor. However, research has not substantiated this risk of acupuncture during pregnancy.⁶

Side effects linked to prenatal acupuncture are generally mild, if they occur at all.⁵ These side effects may include fatigue, arm heaviness, dizziness, bruising, and headache.^7,8

While these effects of acupuncture are mild and severe effects are considered rare, increased caution is recommended during pregnancy.⁵ If you feel dizzy or lightheaded after acupuncture, sit, drink water, and have a snack.

When seeking acupuncture treatment in pregnancy, speaking with your doctor first is essential. If you do seek out acupuncture treatment, be sure to choose an acupuncturist specializing in fertility and pregnancy, and be sure to share with them that you are pregnant, even if you’re early in pregnancy.

Benefits of Acupuncture During Pregnancy

Acupuncture has been used to treat or relieve a multitude of pregnancy ailments. You can also address multiple symptoms in one acupuncture session and reap multiple benefits from stimulating a single point. Here are some of the benefits of acupuncture during pregnancy:

Acupuncture for Morning Sickness

Over half of pregnant women experience morning sickness, and contrary to that name, nausea and vomiting in pregnancy can last all day through the first trimester and beyond. This affects a mother’s comfort and ability to function, work, and socialize, and if the vomiting is severe, it can even cause dehydration and malnutrition.⁹

The medications often used to treat morning sickness are neither effective nor safe. Therefore, the Western world has been adopting and testing traditional Chinese medicine interventions for relief.⁹

Prenatal acupuncture for morning sickness may be effective at decreasing nausea and vomiting during pregnancy. Some points that may be stimulated include ST36, PC6, CV12, SP4, SP6, TE5, N12, and CV17.^7,9

Some studies even conclude that acupuncture is more effective than many nausea drugs and very safe.⁷ If morning sickness is significantly affecting your life, acupuncture may be a treatment to consider.

Acupuncture for Back and Hip Pain

Pain in the pelvis, lower back, and hips can become increasingly common as pregnancy progresses. It can be severe and interfere with daily life for a pregnant woman. Not all pain medications are safe to take during pregnancy, and those that are safe may not be effective at relieving pain.¹⁰

Studies have demonstrated that acupuncture can reduce pelvic pain in pregnancy when compared with either standard care alone or with tailored exercises for pain relief.^8,10

Some specific acupuncture points that may be stimulated for pelvic pain relief during pregnancy include BL32, BL54, GB30, and KI11.¹¹

Acupuncture for Breech Presentation

One study examined the effect of acupuncture and moxibustion on the turning of breech babies.¹² Moxibustion is the burning of ground mugwort flower, often at specific acupuncture points.¹³ When acupuncture and moxibustion were applied at the BL67 point, located at the tip of the pinky toe, the number of breech babies at term was reduced, and the C-section rate decreased compared to an observation group.¹²

Acupuncture To Induce Labor

If there comes a point when remaining pregnant puts you or your baby at risk, your provider may recommend labor induction. There are many methods of inducing labor, from a Foley bulb to vaginal medications to Pitocin. However, some of these interventions can be painful and may involve risks.¹⁴

Acupuncture may be a less invasive, non-pharmaceutical way to kickstart labor. Studies have shown acupuncture may be 83% effective at inducing labor.¹⁵

Experts believe acupuncture may trigger uterine stimulation via hormones or the nervous system. In particular, acupuncture has been shown to increase cervical readiness or ripeness for labor.¹⁵

Some acupuncturists individualize point selection to each patient, while others use a fixed set of points for labor induction. Some common acupuncture points used to induce labor include ST36, LR3, CV4, TH6, LI4, GB41, KI6, SP6, HT7, LU7, BL31, BL32, BL60, BL67, and GV20.¹⁵

Acupuncture Points To Avoid During Pregnancy

While not all acupuncturists agree on the exact list of forbidden points during pregnancy, generally, it is recommended to avoid any points that may stimulate the uterus, at least until 37 weeks of pregnancy, and any points near the abdomen and sacrum that could accidentally puncture the uterus.¹⁶ It is commonly recommended to avoid points GB21, BL60, BL67, BL32, and BL33; however, some of these forbidden points overlap with treatment points for certain ailments in pregnancy.¹¹

A systematic review examining traditionally “forbidden” pregnancy acupuncture points concluded no greater risk of preterm or stillbirth when these points were stimulated.¹⁶

As always, weighing the risks and benefits of all treatments and no treatment is best. Always consult your doctor before considering treatments like acupuncture.

Tips for Getting Acupuncture When Pregnant

Seeking acupuncture when pregnant can be exciting but also nerve-wracking, especially if you do not know what to expect. To prepare your mind and body for acupuncture, review these tips:

• Talk to your provider about your interest in acupuncture. They may have an acupuncturist they recommend.
• Find an acupuncturist specializing in pregnancy acupuncture and the condition you seek to treat.
• Be sure to share that you are pregnant when making your appointment.
• Fill out all forms and answer questions honestly so your acupuncturist can appropriately tailor your treatment.
• Carve out enough time so you are not rushing to or from the appointment.
• Wear loose, comfortable clothing and dress in layers. You may need to remove long sleeves and pants to access points.
• Avoid excess jewelry, particularly in the ears, as acupoints in the ears may be stimulated.
• Eat a snack before your session, particularly if you are prone to light-headedness. Also, pack a small snack for after the session.
• Bring water and ensure you are well-hydrated before the appointment, but not so much that you must use the bathroom mid-session.
• Bring music that is relaxing to you. After the needles are inserted, you may be instructed to lay in the same position and rest for some time. Some people doze off, but having something to listen to in the background can be nice.
• Follow up on your appointments as recommended, as it may take several sessions to see results.³

Acupuncture during pregnancy can be a great alternative or additional way to relieve certain pregnancy stress, aches, and pains. It is relatively safe, probably effective, and an easy intervention. Be sure to choose a reputable acupuncturist and share with your provider that you seek this treatment. You will be well on your way to an easier, more comfortable pregnancy!

Pregnancy is an incredible journey to motherhood, but it can also be an exhausting one. Pregnancy fatigue, the overwhelming sense of tiredness, often hits hardest during the first and third trimesters. It results from hormonal changes, increased blood volume, and the body working hard to create a new life.¹

Let’s look into what causes pregnancy fatigue and how long it lasts and explore helpful tips to get you through the exhaustion and increase your energy.

What Does Pregnancy Fatigue Feel Like?

Everyone may experience pregnancy fatigue differently. It may feel like you can never get enough sleep, and extreme tiredness in early pregnancy is very common. Pregnancy fatigue feels like:²

• Having difficulty waking up in the morning
• Being constantly sleepy throughout the day
• Finding it difficult to complete daily tasks
• Having trouble focusing
• Feeling like you never have enough energy

If you are one of the lucky ones, you may not experience it at all!

What Causes Pregnancy Fatigue?

Pregnancy fatigue lets you know it’s time to slow down and adjust to all the changes inside your body. You will likely feel the brunt of your fatigue during the first trimester, and then third-trimester fatigue will start back up as you get closer to delivery.³

Your developing placenta requires the heart to pump faster and stronger as your blood volume increases to keep up with your fetus’ needs. All this activity can leave you sleepy and sometimes out of breath. Progesterone, the hormone responsible for helping you stay pregnant and suppress contractions, also rises sharply in the first trimester and plays a big part in making you feel exhausted.^3,4

When Does First Trimester Pregnancy Fatigue Peak?

Most women begin to experience fatigue, one of the earliest symptoms of pregnancy, during the first 12 weeks, and it can last through the end of the first trimester.⁵ You may be unable to stay awake the whole day without taking a nap. If you are feeling sluggish and tired all day despite sleeping well at night, don’t worry — it’s perfectly normal. That first-trimester fatigue should subside by about 13 weeks.

How Long Does Pregnancy Fatigue Last?

Pregnancy fatigue usually shows up at the beginning of the first trimester and eases off at the beginning of the second trimester.¹ After 13 weeks, you may have more energy and feel like your old self again. Take advantage of this newfound energy to do what you must before the baby comes. More than likely, your pregnancy exhaustion will tiptoe back in during the third trimester as your baby (and you) continue to grow.

How To Get Energy While Pregnant

Consider these tips on how to overcome tiredness during pregnancy and bring you some much-needed energy:

Prioritize Rest and Sleep

Aim for seven to nine hours of quality sleep per night, and take short naps during the day whenever you feel your pregnancy fatigue. Create a comfortable sleep environment by dimming lights, using a pregnancy pillow for sleeping support, and maintaining a comfortable room temperature. Having a comfortable place to sleep and establishing a regular sleep schedule can help you get the rest you and your growing baby need.

Stay Hydrated

Dehydration can exacerbate feelings of tiredness. Drink eight to 12 glasses of water daily to stay hydrated. Sip water, herbal teas, and natural fruit juices, and try to limit caffeine intake.⁶

Drinking water helps you digest your food, helps nutrients circulate in the body, and aids in excreting waste. Staying hydrated also helps form amniotic fluid around your baby.⁶

Eat a Balanced Diet

Eating a balanced diet is essential for combating pregnancy fatigue. When you feel nauseated, it is hard to even think about eating, but try to eat small, frequent meals and snacks every three to four hours to stabilize your blood sugar and prevent energy dips. It is okay to indulge occasionally, but try to consume various foods, including lean proteins, whole grains, fruits, vegetables, and healthy fats. These foods provide essential nutrients that can boost your energy levels.⁷

Exercise Regularly

While pregnancy fatigue may have you feeling exhausted and wanting to curl up on the couch, gentle, regular exercise can help increase your energy. Moving your body can help improve your mood, strength, posture, and endurance. Exercise can also help with those annoying pregnancy symptoms like bloating, constipation, and aches and pains. Physical activity during pregnancy can decrease your risk for C-section rates, gestational diabetes, and high blood pressure.^7,8

Prenatal yoga, pilates, swimming, and walking are excellent low-impact options that help boost your energy, improve circulation, and reduce swelling. Try to exercise for about 30 minutes five days a week or as much as you can handle. Always consult your healthcare provider before starting or continuing any exercise routine during pregnancy.⁸

Listen to Your Body

Pay close attention to your body’s signals. When you’re tired, take a break to rest. Napping may not always be an option when the overwhelming fatigue hits, but taking a few minutes to sit down can be helpful, especially at work. Overexerting yourself will only lead to increased fatigue and discomfort. Remember that pregnancy is not the time to push yourself to the limits.⁹

Manage Stress

Stress can contribute to feelings of fatigue. You can practice relaxation techniques such as deep breathing, meditation, and prenatal massage to reduce stress, relieve pregnancy hormones, and promote a sense of calm. Surround yourself with supportive, understanding people who can provide emotional support.¹⁰

Delegate and Ask for Help

Don’t be afraid to ask for help from family and friends. Pregnancy is when you need to prioritize yourself, and accepting assistance with household chores, childcare, or other responsibilities can be immensely helpful.

If you can, hire a cleaning person to help lessen your load around the house. If you have other children, ask a trusted friend or family member to help take them to activities or give you a few hours to rest.

Plan for Restorative Activities

Every expecting mama needs to practice self-care. Engage in activities that recharge your energy and spirit. Reading, meditating, taking a warm bath, or enjoying a soothing hobby can provide a welcome break from daily life and pregnancy demands.

When To Call Your Doctor

Although it’s natural to feel more tired during pregnancy, you should call your doctor if you experience extreme fatigue, especially if it is accompanied by dizziness. Chances are, you may be experiencing anemia (a low red blood cell count), where insufficient oxygen is transported throughout your body, making you feel tired and weak.^11,12

Fortunately, boosting your diet with more iron-rich foods such as lentils, liver, shrimp, turkey, enriched cereals, beans, and iron supplements can help. Extreme cases of anemia may require an iron transfusion. Your doctor will discuss your best options depending on your iron levels.^11,12

Prioritizing rest, staying hydrated, maintaining a balanced diet, and engaging in regular exercise can help you feel more energized. Listen to your body, manage your stress, and don’t be afraid to ask for help to ensure you don’t get burned out. Taking care of yourself and implementing these tips can help reduce pregnancy fatigue and allow you to enjoy a healthier, more comfortable pregnancy.

“Sleep while you still can” is considered good pregnancy advice. But what if you cannot sleep? Pregnancy insomnia seems like a cruel joke; at the exact time you should be capitalizing on sleep before a newborn arrives, there is often an unrelenting inability to fall or stay asleep. What is pregnancy insomnia, and what can you do about it?

What Is Pregnancy Insomnia?

Insomnia is the inability to fall asleep, difficulty falling back to sleep following nighttime awakenings, or waking too early from sleep. Sleep deficiency, while not considered insomnia, is inadequate sleep of less than seven hours a night.¹

Don’t worry! You are not the only pregnant one struggling with sleep. Sleeping difficulties and insomnia impact an estimated 66%-94% of pregnancies.⁴ The more pregnant you are, the greater your sleeping difficulties may be.¹

You or your obstetric provider may not fully recognize or address the lack of quality sleep. Adequate sleep is essential for a healthy pregnancy. Carefully consider any sleeping challenges or insomnia you may experience. Discuss them with your provider and become proactive in finding ways to battle pregnancy insomnia.

When Does Pregnancy Insomnia Start?

Unfortunately, first-trimester insomnia and sleep challenges can impact about 13% of pregnancies.^1,3 Hormones and classic first-trimester pregnancy symptoms may cause early pregnancy insomnia. Insomnia and sleep challenges may start or worsen as pregnancy progresses. Third-trimester insomnia can affect nearly 75% of pregnancies, with night waking being the most significant complaint.¹

Causes of Pregnancy Insomnia

Pregnancy is an intense time of physical, hormonal, and emotional body changes that have the potential to impact sleep quality and duration significantly. Causes of pregnancy insomnia may include:^1,3

• Nausea and vomiting
• Hyperemesis gravidarum
• Frequent urination
• Pelvic or back pain
• Nasal congestion
• Fetal movements
• Contractions
• Heartburn
• Uncomfortable sleep positions
• Intense dreams or nightmares

Other Causes of Pregnancy Insomnia

Other pregnancy-related complications can contribute to or cause insomnia. Speak with your obstetric provider if you have concerns that you may be suffering from any of the following:

Sleep Disordered Breathing (SDB)

SDB includes obstructive sleep apnea that can cause snoring, nighttime awakenings, headaches, dry mouth, and extreme fatigue.^3,7 SDB may increase your risk of miscarriage.⁷

Restless Leg Syndrome (RLS)

RLS is characterized by troublesome feelings in the legs, often described as creeping, crawling, burning, and itching. These feelings are generally worse at night when your body is at rest. The cause of restless leg syndrome during pregnancy is not fully understood. Some studies have discovered an association between RLS and iron deficiency. Pregnancy is a risk factor for iron deficiency, and iron supplementation may be helpful.⁷

Anxiety or Mood Disorders

Mental health disorders such as major depressive disorder (MDD), bipolar disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD) can all negatively contribute to pregnancy insomnia or sleeping difficulty.³

How Long Does Pregnancy Insomnia Last?

Unfortunately, sleeping difficulties do not necessarily end when pregnancy does. Pregnancy insomnia can last well into the postpartum period.⁸ Sleep challenges and insomnia can be further complicated by spending many potential sleeping hours caring for your new baby. A whole night’s sleep may not be possible in this early postpartum period, but many of the tips below, in addition to addressing any mental health issues, can provide a more restful night’s snooze.

Complications of Pregnancy Insomnia

Sleep can greatly influence critical female hormone cycles, including estrogen, progesterone, and prolactin.⁷ Pregnancy is also physically demanding, internally and externally. Pregnant people require adequate rest for optimal function and a thriving pregnancy. Sleeping difficulties, disturbances, and insomnia during pregnancy are associated with increased risks of the following:^1,3

• Perinatal depression and anxiety
• Postpartum depression
• Gestational diabetes
• Low birth weight newborns
• Preterm delivery
• Prolonged labor
• Cesarean section

Tips for Coping With Pregnancy Insomnia

Developing healthy sleep hygiene habits and trying non-pharmacological strategies is the first defense for insomnia treatment:^1,3,6

• Establish a regular sleep-wake cycle.
• Reserve naps for the earlier part of the day
• Maintain a dark, cool sleep environment
• Avoid caffeine before bed
• Avoid screens before bedtime
• Limit fluids in the later half of the day to limit nighttime awakenings (be sure to hydrate earlier in the day adequately)
• Consume frequent, light meals throughout the day while avoiding heavy meals in the evening.
• Aim for 30 minutes of daily exercise or movement if your healthcare provider approves.
• If you have difficulty falling asleep, do a non-stimulating activity like reading.
• Prioritize sleep comfort using pillows for support
• Consider alternative therapies such as acupuncture, acupressure, massage, and meditation

Your obstetric provider can guide you in finding an approach that may work for you. Additionally, other treatments may be necessary if you suffer from sleep-disordered breathing, restless leg syndrome, or an anxiety or mood disorder.

Can I Take Melatonin During Pregnancy?

Melatonin is a frequently used and highly marketed supplement that can promote a more restful sleep. But can you take melatonin while pregnant?

Melatonin is a hormone produced by your body that assists in regulating your sleep cycle. It is also vital during pregnancy. Some studies have concluded that melatonin secretion positively impacts pregnancy, from maternal egg quality through birth. Melatonin has a developmental impact on your baby’s nervous and endocrine systems. It can also act as an antioxidant to protect the developing organs from oxidative stress.⁵

Though the studies are limited, several have suggested that melatonin use in pregnant and lactating persons is probably safe and without side effects.^4,5 However, melatonin supplementation for sleep purposes during pregnancy is not officially recommended. Because the Food and Drug Administration does not regulate the quality of melatonin supplements, the product’s safety cannot be assured.⁴

Consult your obstetric provider if you have questions about taking melatonin during pregnancy.

Can I Use Sleep Aid Medications During Pregnancy?

If melatonin use during pregnancy is up for debate, what about other sleep aid medications? If you are experiencing significant sleeping difficulties and natural remedies have proved ineffective, sleep aid medication may be an option.

Over-the-counter antihistamine medications such as diphenhydramine (Benadryl) and doxylamine (Unisom) are considered safe during pregnancy.⁹ However, not all prescription sleep aids are considered safe during pregnancy and postpartum, including benzodiazepines, zolpidem (Ambien), and barbiturates. But that doesn’t mean they can’t be taken, especially if the benefits outweigh the risks.^10,11 Always speak with your obstetrician or midwife about your sleeping difficulties and interest in medication options.

Poor sleep quality and insomnia symptoms during pregnancy are not something to overlook. Restful sleep is vital for your growing baby and your well-being during pregnancy and postpartum. Do not hesitate to discuss your challenges and symptoms with your obstetric provider. Together, you may find solutions for a more restful night’s sleep during this perinatal period.

While the idea of pregnancy can be quite exciting, the symptoms of pregnancy can be uncomfortable. From experiencing morning sickness to pelvic pain, many women find themselves wishing they could fast forward through these issues to meet their baby. One complaint during pregnancy can be constipation.

Coming from someone who was very regular before pregnancy, pregnancy constipation can be frustrating and uncomfortable. It left me and many other women wondering why this happens and how to relieve it. Here, we will look at common pregnancy constipation issues and treatments.

What Is Pregnancy Constipation?

Constipation is a term that can mean something different to everyone, depending on how often you have bowel movements. Constipation during pregnancy generally refers to infrequent bowel movements and difficult or painful bowel emptying.¹ Besides infrequent and difficult-to-pass bowel movements, constipation can cause bloating, abdominal pain, and sluggishness.²

What Causes Pregnancy Constipation?

If you were used to a regular stooling schedule pre-pregnancy, you might wonder what causes constipation during pregnancy. Many factors contribute to slowed motility through the intestines while pregnant.

Hormones

The hormone progesterone increases early in pregnancy and remains elevated until delivery. Progesterone increases the time it takes for food to move through the bowels. The hormone motilin decreases in pregnancy, further slowing down intestinal movement.^1,3

Stool becomes harder when food moves slower because more water is absorbed as food sits in your bowels for longer. The harder the stool becomes, the less frequently and easily it will be evacuated.¹

Decreased Activity

Exercise and body movement help to move food through the digestive system. The fatigue and busyness of pregnancy can make you slow down and exercise less, increasing the likelihood of constipation.³

Vitamin Supplementation

Many pregnant women take a prenatal vitamin and are advised to supplement with iron. Does your iron supplement cause constipation? The answer is it’s possible. Iron has been associated with slowed intestinal transit time and increased bloating and constipation.⁴ Calcium supplementation may also contribute to pregnancy constipation.¹

Anatomy

As pregnancy progresses and your uterus grows, it may increase pressure on your bowels and slow movement. The changes in the structure and layout of your abdomen and intestines during pregnancy may contribute to pregnancy constipation.¹

When Does Constipation Start in Pregnancy?

Constipation can start at any point in pregnancy. Some women experience it early in the first trimester, while others do not feel it until later. Some don’t experience it at all.³

The hormone progesterone rises after ovulation, continues to increase, and remains elevated if you become pregnant. Since progesterone may contribute to constipation, some women experience constipation starting very early in pregnancy.^3,5

However, the onset of constipation for others may be later in pregnancy, as your baby grows significantly and adds pressure inside your abdomen. Some women do not experience pregnancy constipation at all, and some may feel it one week and not the next.³

Is Constipation a Sign of Pregnancy?

While constipation can begin early in pregnancy and might be linked in some cases, constipation can happen for different reasons.

Many causes of constipation are not pregnancy-related, so constipation is not necessarily a sign that you are pregnant. There are more specific early pregnancy symptoms that might signify you are pregnant. It can be tempting to “symptom-spot” or speculate whether you are pregnant based on physical symptoms you are experiencing, but the best way to know for sure if you are pregnant is to wait until your missed period and then take a pregnancy test.³

How Common Is Pregnancy Constipation?

Constipation during pregnancy is common, with some studies reporting over a third of women experiencing it.¹ But just because constipation is common during pregnancy does not mean it should be ignored.

How Can I Prevent Pregnancy Constipation?

To prevent pregnancy constipation and get your bowels moving, there are nutrition, hydration, and exercise goals you should aim to reach:

Fiber

While it can be difficult to stomach certain foods during pregnancy, shoot for 25-30 grams of fiber daily from fruits, vegetables, legumes, and whole grains. Fiber helps to soften stool and move it through the intestines. It can help produce a bowel movement and prevent constipation.³

Fluids

Your need for water increases during pregnancy, from increased blood volume to amniotic fluid production. You may become constipated if you do not increase your water consumption to meet these needs. Aim for 8-12 cups of water per day to prevent constipation during pregnancy.³

Exercise

While pregnancy can make movement more difficult and uncomfortable, waste is more likely to accumulate in your gut when you are sedentary. Getting 20 to 30 minutes of moderate exercise during pregnancy three times per week can help keep things moving. If you have any concerns or doubts, speak with your provider about safe exercises and activities during pregnancy.³

Probiotics

Good gut bacteria help move food through the digestive system quickly and efficiently. Adding a daily probiotic may alter the intestinal flora and increase gut motility.¹

What Is Safe To Take for Constipation While Pregnant?

If you are feeling desperate to have a bowel movement, you might be wondering how to relieve constipation during pregnancy immediately. Many stool softeners and laxatives are available over the counter. While many medications are safe for pregnancy, you have to be careful, especially before full term, because many that stimulate bowel contractions can also stimulate uterine contractions. You do not want to end up in early labor because of constipation.⁶

The best stool softener during pregnancy can vary from person to person. Most laxatives are not absorbed systemically, meaning they stay in the gut and do not reach the baby.¹ However, your provider knows your medical situation and history and can recommend the best pregnancy constipation relief. The various options for stool softeners in pregnancy are outlined below.

There are many stool softeners and laxative options during pregnancy. It may take some trial and error before you find a solution that works for your pregnancy constipation. Always consult your provider before starting any new medications.

Bulk-Forming Agents

For some people, bulk-forming agents or fiber supplements such as bran or psyllium are effective at relieving pregnancy constipation. They are safe to take but can increase gas, bloating, and cramping in some women. Fiber supplements can also take up to three days to work.¹ Chia seeds can also help relieve constipation due to their high fiber content.⁷

Stool Softeners

Stool softeners such as docusate sodium or Colace increase your stool’s salt and water content, making it softer and easier to pass.^1,7 Other substances that soften stool during pregnancy include magnesium and polyethylene glycol or Miralax. These draw water into the bowels and soften stool, relieving constipation. However, prolonged use of these stool softeners may lead to electrolyte imbalance in you or your baby.¹

Laxatives

Stimulant laxatives act directly on the nerves and muscles of the intestines, causing food to move more quickly through. Examples of these include bisacodyl or Dulcolax, and senna. These medications are also poorly absorbed and will likely not reach your baby. Therefore, they are likely safe for pregnancy but can cause intense intestinal cramping. In some cases, intestinal cramping can irritate the uterus as well. They can also cause electrolyte imbalance and dependence on the medication.¹ They should only be taken at your doctor’s recommendation and only for short periods.

Castor oil is a laxative that is also known for inducing labor in overdue pregnancies.⁸ Whether you are trying to evacuate your bowels or evict your baby, extreme caution should be used when taking this substance during pregnancy.

Can Constipation Hurt the Baby?

No. While constipation can be uncomfortable and frustrating for you, the increase in abdominal pressure due to constipation will not hurt your growing baby.³

Constipation can cause fecal impaction, which can be a severe complication, but this is rare.¹ Although your baby is safe, you still want to get ahead of pregnancy constipation so it does not reach the point of danger. Constipation can also cause anal tears or fissures and can cause or worsen hemorrhoids.³ Softening your stools and passing them more easily and frequently can prevent these side effects of pregnancy constipation.

While constipation during pregnancy is rarely severe, you still want to get ahead of it for both comfort and safety. If fiber, fluids, and movement are not working, talk to your provider about getting occasional relief from a stool softener or laxative. As you progress through pregnancy, they can help you find a balance between diet, exercise, and medication that works for you.

Pregnancy is a trying time for any woman. From our mothers telling us to avoid this and that, to friends giving us their two cents on what we should or should not do, to strangers adding their random opinions to the growing list — getting through pregnancy without getting overwhelmed by all these opinions can be challenging. While your doctor will confirm some are silly pregnancy myths you can ignore, others can be dangerous to you or your baby.

14 Common Myths About Pregnancy

Here are common pregnancy myths that you don’t actually need to (or want to) follow:

1. You Can Eat What You Want

Doctors agree that pregnant women need to eat a bit more than those who are not pregnant. However, this should only add approximately 340 calories to your diet starting in the second trimester, not a thousand or more.^1,13 You are not eating for an army! If you are pregnant with twins, you should add 600 extra calories a day.¹³

See also:

• Healthy Pregnancy Weight Gain
• The Eating For Two Myth

2. Cocoa Butter Will Prevent Stretch Marks

This pregnancy advice is a myth, as cocoa butter doesn’t reduce or prevent stretch marks. In fact, cocoa butter has been found to make our skin even more sensitive. For some women, it can also cause an allergic reaction (which is something to avoid when you’re pregnant).²

See also:

• 7 Tips to Prevent Pregnancy Stretch Marks
• The Truth About Stretch Marks During Pregnancy
• The Best Stretch Mark Cream for Expecting Moms

3. You Can’t Touch Your Cat

Petting your cat during pregnancy is fine. However, you should not clean your cat’s litter box because of the risk of toxoplasmosis, a parasitic infection. The CDC also has specific guidelines for pregnant women regarding pet cats, including keeping your cat indoors and only giving them commercial dry or canned food.³

4. You Can’t Take Hot Baths To Relax

This is a pregnancy myth because it depends on the temperature. The American Pregnancy Association says a hot bath is generally safe, as there’s less risk of overheating. Meanwhile, taking a scalding hot bath when you’re pregnant should be avoided. You should also avoid things like saunas and jacuzzis because they will quickly raise your body temperature to over 102 degrees, which is unsuitable for your baby.⁴

See also:

• Can You Take a Bath While Pregnant?

5. Don’t Snack Throughout the Day

Eating three meals a day is good, but when you are pregnant, it is better to eat five to six small meals throughout the day from various food groups.¹⁶ This will keep your blood sugar in a constant range, which is healthy for you and your baby.¹⁷ While you don’t want to go overboard on snacking, it’s okay to have healthy snacks throughout the day, such as fresh fruit and raw vegetables, in moderation.¹⁶

See also:

• 22 Pregnancy Snacks To Keep In Your Purse
• 8 Healthy Pregnancy Snacks Perfect for You and Baby

6. A Big Baby Is a Healthy Baby

The average baby weighs about 7 ½ pounds. Fetal macrosomia and babies who are large for their gestational age weigh greater or equal to 4,500 grams. They have an increased risk of birth trauma or cesarean delivery. They are also at increased risk of developing obesity or diabetes as they grow older.⁵

See also:

• Macrosomia: What It Means When Your Baby Is Measuring Big

7. A Small Baby Is a Healthy Baby

While a big baby has its disadvantages, a tiny baby also comes with several risks. A smaller baby born weighing less than 2,500 grams can suffer from serious health problems as a toddler and as an adult compared to a baby with a healthy weight. If they have a low birth weight, they also have an increased risk of developing a disability.⁶

8. You Should Stop Working Out

This is another common pregnancy myth! Staying active while pregnant is important for preparing you for birth and keeping you healthy for your baby. Although you should avoid high-intensity workouts, you should continue working out for nine months. However, you should discuss your plans for exercise with your OB-GYN before beginning or continuing a routine.¹⁴

See also:

• Work Out When Pregnant: Dos and Don’ts of Exercise

9. One Drink Won’t Hurt the Baby

Some pregnant women allow themselves a sip of wine, while others abstain entirely. Much of this myth depends on the mother, but studies have shown that drinking during pregnancy increases the risk of fetal alcohol spectrum disorders (FASDs).^7,15 According to the CDC, alcohol can also be dangerous during pregnancy and lead to miscarriage, stillbirth, and other issues.¹⁵

See also:

• Alcohol During Pregnancy: The History and Dangers
• Is Using Marijuana During Pregnancy and Breastfeeding Safe?

10. Smoking Won’t Affect the Baby’s Health

Some women smoke during their first pregnancy, and when they see that their baby is fine, they think they can get away with smoking during their consequent pregnancies. However, studies have shown the severe health risks that smoking can cause for babies. So, even if the health issues are not evident, abstaining from smoking during this time is highly recommended by medical experts worldwide.^8,18

11. You Can Tell the Gender by Your Stomach

I always heard old wives’ tales that if you carry low, it means you’re having a boy. More than enough, moms have told me that this isn’t true! There is no scientific evidence linking the way you carry to the gender of your baby.⁹ The only way to honestly know what you are having is to find out the gender with your doctor or wait until the baby is born to find out the gender (if you have that kind of patience). This is among the most circulated pregnancy myths!

For fun:

• 23 Signs You’re Having a Boy (Supposedly)
• 23 Signs You’re Having a Girl (Supposedly)
• Old Wives’ Tales to Predict Baby’s Gender
• Chinese Gender Calendar

12. You Can’t Wear Heels

This one was a bit disappointing for me, as any excuse to avoid heels is a good thing in my book. But for all the women who love putting on their favorite pair of stilettos for work or a dinner date, you don’t have to stop just because you’re pregnant! The reason this pregnancy myth went around is that wearing heels may increase your chance of falling, which could hurt the baby. However, as long as you are careful and comfortable in your heels, there is no need to stick to flats for all nine months. Some experts, though, advise against wearing heels during the later months of pregnancy.¹⁹

See also:

• The Best Shoes to Wear During Pregnancy

13. You Can’t Dye Your Hair

Yes, it’s true; this is one of many pregnancy myths! You don’t have to deal with dark roots or gray hairs while pregnant. It’s smart for women to feel their best while pregnant, and if a hair touch-up does that for you, then, by all means, get your hair done! It’s been proven that hair dye is not toxic enough to harm your baby and that the skin only absorbs a tiny amount, so it won’t affect the fetus.^10,11 If you perm or chemically straighten your hair, you may want to wait until the baby is born to get these treatments done.

See also:

• Is it Safe to Dye Your Hair While Pregnant?

14. You Must Avoid Traveling

This one is a mixed bag. Many people will tell you not to get on an airplane in your first trimester, while others are adamant about steering clear of travel in your third trimester. Research has shown there isn’t necessarily a correlation between planes and pregnancies.¹² Still, many doctors have pregnant women avoid plane travel due to the inability to get help from a doctor and the small confines if you have an issue. Always consult your doctor before traveling to determine the best option for you and your baby.

See also:

• Flying While Pregnant: Tips and Tricks

As soon as you get pregnant, be prepared to hear everyone’s opinions about what you should and shouldn’t do while pregnant. And be ready to combat the pregnancy myths! Just remember: this is your body and your baby, and usually, you are the best person to know what feels right.

Our fourth pregnancy was a pleasant surprise. But learning that we would have twins was, honestly, overwhelming. When staring at the first ultrasound of those two perfect blebs, it’s hard to imagine the miracles that our bodies are capable of. But is there a way to know if you are carrying multiples before the ultrasound? Are there early signs that you are pregnant with twins? Yes and no. What’s different about a multiple gestation pregnancy?

Twins and Higher-Order Multiples

A conception that results in a twin or more pregnancy is extraordinary. Twin pregnancies can result from the fertilization of multiple eggs or from a lucky fertilized egg that splits just days after conception.²

Monozygotic or identical twins come from one fertilized egg by one sperm that has split in two. Identical twins are always the same sex and have the same set of genes or DNA. Dizygotic or fraternal twins result from two separate eggs being fertilized by two individual sperms. Genetically, fraternal twins are no different than siblings born of other pregnancies who share half of the same genetic material.²

Higher-order multiples like triplets, quadruplets, or more can combine fraternal and identical babies.

What Are My Chances of Having Twins?

Twin births represent about 3% of all births in the United States. Approximately 70% of twins are fraternal without assistive reproductive technology (ART) or ovulation-inducing medication.¹

ART, such as in vitro fertilization and ovulation-inducing medications, has increased the rate of twins and higher-order multiples such as triplets and quadruplets. These practices often have a 30-35% chance of resulting in twinning.³

What Are the Signs and Symptoms of a Twin Pregnancy?

You may wonder about the difference between single pregnancy and twin pregnancy symptoms. Many pregnant people experience different symptoms between these types of pregnancies. Here are the early signs you’re having twins:

1. Elevated hCG

Levels of hCG vary greatly from person to person. Typically, hCG levels for twins are significantly higher.⁴

Human chorionic gonadotropin (hCG) is a hormone released by the embryonic tissue destined to become the placenta. In the early weeks, this hormone is responsible for maintaining pregnancy and is detectable in urine and blood. Levels of this hormone rapidly increase with each passing week of early pregnancy and peak around 10 weeks.⁵ However, high levels of hCG are not a confirmation of twin or multiples pregnancy. Only an ultrasound can positively identify twins.

2. Intense Nausea and Vomiting

The exact cause of nausea and vomiting in early pregnancy is not fully understood, but it is generally accepted that the hormone hCG is the culprit.⁶ This tell-tale sign of pregnancy affects up to 80% of pregnant people. Because hCG levels are higher in twin and other multiple gestation pregnancies, nausea and vomiting may also be worse. Carrying multiple babies also increases the risk for hyperemesis gravidarum or extreme nausea and vomiting, which can negatively impact the pregnant parent.⁷

3. Rapid Weight Gain

Double the babies, double the weight gain? Not quite, but nearly so. Weight gain of 25 to 54 pounds, depending on pre-pregnancy BMI (body mass index), is considered appropriate when carrying multiples.¹ Fundal height, or the belly size measured from the pubic bone to the top of the uterus, will grow much faster as the uterus expands to house two or more babies.⁸ Parents who are pregnant with twins will be reaching for those maternity clothes much sooner!

When Do Twins Show Up on an Ultrasound?

Ultrasound evaluation offers a definitive diagnosis of twin pregnancy. Twins or other multiples are visible on transvaginal ultrasound at four to five weeks gestation.⁸ It is also possible to determine if the twins are identical or fraternal. Around eight weeks of pregnancy, an ultrasound can determine if each baby lives within its amniotic sac, an essential factor for growth, development, and survival.⁸ It is possible to receive a diagnosis before twin pregnancy symptoms even begin.

Can Twins Cause a False Negative Pregnancy Test?

Pregnancy tests screen for the presence of hCG in urine. Home pregnancy tests are highly reliable and offer fast results. Occasionally, a false negative result occurs if a test is taken too soon after conception.¹²

False negatives can also occur in the case of a twin or multiples pregnancy. The concentration of hCG can be very high, causing an oversaturation of hormones for the antibodies of a urine pregnancy test to detect.¹²

How Is Prenatal Care Different With a Twin or Multiples Pregnancy?

Prenatal care with twins or multiples generally means more appointments and monitoring to ensure those little ones grow well. Standard pregnancy testing is recommended, but it is not as sensitive in pregnancy with multiples. Prenatal care visits will be more frequent than with a singleton baby, especially in the third trimester.¹⁰

One of the most significant determinants for increased ultrasound monitoring or other testing of twins is whether the babies have their own placenta and amniotic sac. Dizygotic pregnancies have enough placenta and amniotic sacs to go around. Identical or monozygotic pregnancies share a placenta and, in rare cases, an amniotic sac.⁹

Monozygotic twins are at an increased risk for complications like discordant growth and twin-to-twin transfusion syndrome.⁹ Frequent ultrasounds monitor the health and development of the babies. A fetal echocardiogram at 22 weeks is also recommended because of the increased risk of cardiac anomalies in monozygotic twins.¹ It is safe to say that attending appointments in some twin pregnancies can feel like a part-time job!

Risks of a Multiples Pregnancy

Unfortunately, growing more than one baby at one time does come with the potential for complications and risks, including an increased risk of:³

• Gestational hypertension or preeclampsia
• Gestational diabetes
• Bleeding
• Postpartum depression
• Preterm birth
• Growth disparities between twins
• Twin-to-twin transfusion syndrome

Growing, birthing, and raising twins or more can feel daunting. There is double (or more!) the baths, the diapers, the bottles, the laundry, etc. But those extra blessings also come with double the smiles, laughs, and joy. Parents of multiples are specially chosen.

Exercise during pregnancy is a great way to help you and your baby have a healthy journey together. Whether you did regular physical activity before you became pregnant or want to start exercising now, there are important things to know about how to work out when pregnant safely.

About Working Out When Pregnant

Talk to your obstetric care provider about exercise at your first prenatal visit.³ Healthy women are encouraged to get at least two and a half hours of moderate-intensity aerobic exercise during pregnancy per week. However, there are a few conditions in which exercise may harm you or your baby.^1,4 If your OB care provider does give you the green light to work out when pregnant and you were already active before, you can discuss modification recommendations. If you were not physically active before pregnancy, they can help you develop a pregnancy workout routine to help promote your and your baby’s health.²

If you already have a packed schedule, you may wonder how you can make time to get the recommended 150 minutes a week of exercise.³ You can get creative and break it up into 30 minutes of activity at least five days a week. If that doesn’t sound feasible, try dividing 30 minutes into 10 minutes of activity three times daily.^3,4

Changes in Pregnancy

As your body undergoes significant changes, your ability to work out when pregnant may require some adaptations due to the following:

Relaxin

This pregnancy hormone helps soften your pelvic ligaments to make room for your growing baby.² Relaxin also loosens ligaments in other joints, making them more mobile, which can put them at an increased risk for injury. Try to avoid high-impact jerking movements that may strain your joints.³

Balance

As your baby grows, the distribution of weight in your body changes, causing your center of gravity to shift forward. This can impact your ability to keep your balance when performing certain exercises.² To increase your stability and avoid falling, try to move mindfully and perhaps a bit more slowly during your prenatal workout.³

Breathing

During pregnancy, your body demands more oxygen.⁴ You may notice some shortness of breath performing activities that you could previously do without much effort, such as walking uphill. This is due to an increase in progesterone, a pregnancy hormone that can cause you to breathe faster even in early pregnancy. As your uterus grows, this reduces the space your lungs have to expand, so feeling winded during exercise is common.⁵ It is okay to scale back your workout intensity to breathe more comfortably.

Heart Rate

The natural progression of pregnancy causes the average heart rate for pregnant women to increase.³ Your heart must beat harder and faster, even without physical activity, To keep up with your body’s and baby’s oxygen demands.⁴ During exercise, your pre-pregnancy target heart rate is no longer helpful in monitoring the intensity of your workout. Your goal is to exercise at a moderate level of intensity, which means you are sweating, but you can talk throughout your activity.¹⁰

Benefits of a Workout When Pregnant

Here are some of the physical and psychological benefits you can gain when you exercise during pregnancy:^2,4,10

• Increased energy level
• Maintenance of or increase in physical fitness
• Less back pain
• Healthy weight management
• Quicker physical recovery after childbirth
• Stress reduction
• Better-quality sleep
• Prevention or relief from constipation
• Possible decrease in risk for developing gestational diabetes or
• Preeclampsia
• Lower risk of Cesarean delivery

The Dos: Exercise When Pregnant

Fatigue during pregnancy can make it hard to want to be physically active. To maintain motivation, you’ll want to choose things you will enjoy. There are lots of ways to work out that are safe to do when pregnant, such as walking, riding a stationary bike, and doing pregnancy exercises like prenatal yoga.⁴ But what about other activities?

Can You Run While Pregnant?

If you were a runner before your pregnancy and have talked with your OB care provider, continuing to run should not hurt your baby’s health.⁷ If you want to begin running during pregnancy, let your OB care provider know before starting a running regimen.⁸

Can You Lift Weights While Pregnant?

If your pregnancy is uncomplicated, strength conditioning with weights or resistance bands can be beneficial during and after pregnancy. Discuss weight lifting with your OB care provider for individualized weight amount recommendations.⁹ After your first trimester, try to avoid overhead weight lifting to prevent worsening of lower back discomfort.¹

Can Pregnant Women Bowl?

Bowling is a low-impact activity, and as long as your OB care provider clears you, it should be safe. You may need to modify your form to keep your balance, as your growing belly causes your center of gravity to move forward. Also, remember that loosening joints increases your risk of injury, so bowl gently.⁹

What About Swimming When Pregnant?

Swimming is one of the safest pregnancy exercises you can do, and many OB care providers recommend it for their patients who are healthy enough to do so. Swimming gives you the benefit of getting a good aerobic workout while being gentle on your joints and without having the risk of losing your balance and falling.⁸

The Don’ts: Exercises To Avoid During Pregnancy

Certain activities are not recommended if you’re looking to work out when pregnant due to their increased risk of causing injury to you and your baby. These include anything that puts you at risk for:

• Getting hit in the abdomen. Examples include boxing, ice hockey, martial arts, and other contact sports.^2,3
• Falling. Examples include downhill skiing, horseback riding, mountain biking, and gymnastics.³
• Overheating. Examples include exercising outside on a hot and humid day and “hot yoga” or “hot Pilates.” ^3,4
• Experiencing extreme changes in pressure. An example would be scuba diving.²
• Exercising at a high altitude. An example would be hiking above 6,000 feet if you don’t already live at a high altitude.³

If you are uncertain if a specific workout is safe when pregnant, check with your OB care provider before trying it. Also, tune into your body. If you don’t want to work out on a day you had planned to exercise, it’s okay to rest and conserve your energy.²

When Can You Work Out Again After Giving Birth?

After delivery, you and your OB care provider can discuss when it is safe to resume workouts. If you have an uncomplicated vaginal delivery, it may be as soon as a few days after giving birth if you are feeling up to it. If you have a C-section, you may need to take things more slowly, as this is a major abdominal surgery, and your body will need more time to recover.⁴

Gradually increasing the intensity of exercise is vital postpartum. Physical activity postpartum has been shown to decrease the incidence of postpartum mood and anxiety disorders like postpartum depression. Physical activity is also encouraged in lactating women and should not affect your milk supply.¹⁰

If your OB care provider has given you the go-ahead, regular exercise during pregnancy is a great way to take care of yourself and your growing baby. Try to choose low-impact activities that you enjoy and make modifications as needed. This may mean reducing the intensity of your pre-pregnancy workouts or slowly building up your activity level if you weren’t physically active before pregnancy.⁴ When deciding how to work out when pregnant and achieve the recommended two and a half hours or 150 minutes a week of exercise, make it fun, be safe, and appreciate what your body can do.

It’s no surprise the body goes through many changes during pregnancy. The hormonal and physical changes of pregnancy can make you more susceptible to a urinary tract infection or UTI. And even though it’s common to get a UTI while pregnant, it’s also very treatable.

UTI Symptoms

A UTI is a urinary tract infection, also known as a bladder infection. They occur when harmful bacteria get into the urinary tract or bladder. UTIs while pregnant are common and may cause many uncomfortable symptoms.¹

Symptoms may include the following:¹

• Burning while urinating
• Frequent urge to urinate
• Nausea or vomiting
• Cramping in the lower abdomen
• Blood in the urine
• Foul-smelling urine that looks cloudy
• Pain or tenderness in the lower abdomen
• Pain or tenderness in the lower back if the infection has spread to the kidneys
• Fever or chills

Some people may have what is known as an asymptomatic UTI or asymptomatic bacteriuria, where harmful bacteria reside in the urinary tract, but no symptoms exist. If left untreated, this may progress to a symptomatic UTI or a more serious kidney infection called pyelonephritis.³

If you’ve ever experienced a UTI, you know that they are uncomfortable. You may wonder if you can safely take over-the-counter medications, such as AZO, for a UTI while pregnant.

While medications can alleviate the uncomfortable symptoms of a UTI while pregnant, it is not a treatment for UTI. It is unclear if AZO is safe to take during pregnancy, as there haven’t been enough studies. So, it’s essential to discuss with your healthcare provider if taking AZO is a viable option for you.⁷

Is a UTI While Pregnant Common?

Unfortunately, UTIs are common while pregnant, as if you weren’t already going through enough at this time! The hormone increase during pregnancy dilates the ureters, and your growing uterus adds pressure onto the bladder. These both cause urine to sit in the bladder longer than usual, putting you at risk for an infection.⁴

Your provider will routinely test your urine to screen for infection as part of your prenatal care. However, if you feel you have symptoms of a UTI, don’t delay and wait to be tested. Let your provider know right away.²

UTI While Pregnant: Treatment

Your provider will diagnose your UTI with a urine sample. The earlier they test you, the sooner you can receive treatment. This may prevent the spread of the infection to your kidneys.²

UTI treatments include antibiotics and are safe to take while pregnant. Most UTIs can be treated at home. UTI treatment typically involves a short course of oral antibiotics at home for up to seven days.⁵

If your infection has spread and has now become a kidney infection (pyelonephritis), this may require intravenous antibiotics at a hospital.² Your provider will choose the right antibiotic based on what kind of bacteria is present in your urine sample.³

How Long Do UTIs Last?

UTIs rarely go away on their own; unfortunately, there are no natural ways to treat a UTI.⁶ Luckily, UTIs are easily treated with the correct antibiotic. Once you’ve seen your provider and begun treatment, you can expect to have symptoms for 24-48 hours. But you’ll want to finish your course of antibiotic treatment to prevent reinfection. This is five to seven days typically.⁵

Treating the infection may take longer if the infection has spread to the kidneys. This type of infection typically requires intravenous antibiotics and close monitoring in the hospital for 24-48 hours. After your infection is under control, you will be discharged with oral antibiotics for up to 14 days.⁵

What Happens if You Don’t Treat a UTI?

UTIs are very treatable. However, they rarely resolve on their own without treatment. An untreated UTI can spread to the kidneys and other body parts, causing a more severe infection.⁸

If the infection has spread to the kidneys, this can lead to complications such as:^2,3,5

• Sepsis (a severe infection of the blood that can spread throughout the body)
• Preterm labor
• Premature delivery
• Low birthweight of the newborn at delivery

Can a UTI Cause Miscarriage?

Having a UTI alone does not cause a miscarriage, especially if it is treated properly. However, it can increase the likelihood of other complications, possibly increasing the risk of a miscarriage. If the UTI develops into a more severe infection, it could result in further complications that might harm the expectant mother or cause premature delivery.²

How Can You Prevent a UTI While Pregnant?

You can try some things to keep a UTI at bay during your pregnancy. Remember that you may do everything right to prevent a UTI and still get one.¹

Some things you can try to reduce the likelihood of getting a UTI include:⁶

• Stay hydrated by drinking six to eight glasses of water per day
• Avoid fruit juices, caffeine, alcohol, and added sugars
• Urinate frequently and thoroughly empty the bladder
• Change your underwear daily
• Take vitamin C and zinc daily
• After urinating, be sure to wipe front to back
• Avoid harsh body wash, douching, and feminine sprays
• Urinate before and after intercourse
• Drink no-sugar-added, 100% cranberry juice

It’s best to treat urinary tract infections early, especially during pregnancy. Contact your provider immediately if you suspect you have a UTI while pregnant.