Expect physical and mental changes when you're expecting

Donya Betancourt, Pediatrician, drdonya@hotmail.com

Joy and anxiety come together with pregnancy. A lot of changes, both physical and mental, occur in the expecting mother.

First of all, pregnancy will affect the body because of the fetus inside the womb and the hormones produced to support its growth, which may also cause mood swings.

To start with, in the first trimester of pregnancy, fatigue and morning sickness are usually common. These two can make many women feel worn out and fuzzy.

The breasts also swell and become tender, hormones fluctuate and moodiness may settle in. Mood swings are incredibly common during pregnancy. About 10 percent of pregnant women experience depression during pregnancy.

If you suffer from premenstrual syndrome, you're likely to have more severe mood swings during pregnancy, which may make you go from feeling happy one minute to feeling sad the next.

If you have symptoms such as sleep disorders, change in eating habits -- a complete lack of appetite or an inability to stop eating -- and exaggerated mood swings for longer than two weeks, you should talk to your doctor.

In addition to an increase in the size of your breasts, your bra size may be affected by your expanded rib cage. This is because during pregnancy, your lung capacity increases so you can take in extra oxygen for yourself and the baby.

As for the skin, have you heard about the glow of motherhood?

This is only one of many epidermal changes during pregnancy due to altered hormone production, which also increases pigment production and causes the skin to stretch to accommodate the fetus.

Some women develop brownish or yellowish patches called chloasma, or "the mask of pregnancy", on their faces. Others will notice a dark line running down the middle of their lower abdomen, or linea nigra, as well as hyperpigmentation -- a darkening of the skin -- of the areola, genitalia and around the anus. This increased pigmentation may not be even, so the darkened skin may appear splotchy. Unfortunately, chloasma cannot be prevented, but wearing sunscreen and avoiding exposure to ultraviolet light can minimize its effects.

Acne is also common during pregnancy, and pimples induced by pregnancy might not be the only spots on your face, as moles and freckles may also become bigger and darker.

Except for the darkening of the areola, which is usually permanent, these epidermal symptoms will likely disappear after you give birth.

Many women also develop heat rashes, caused by dampness and perspiration, during pregnancy.

The hormones secreted by your body will cause your hair and nails to grow faster and your hair will fall out less, but these changes are usually not permanent. To maintain healthy nails, avoid using nail polish and nail polish remover.

Swelling feet may also affect pregnant women. Because of extra fluid in the body, many pregnant women will be more comfortable wearing slip-on shoes in a larger size.

During pregnancy, the body produces a hormone known as relaxin, which is believed to help prepare the pubic area and the cervix for birth, but relaxin also loosens the ligaments in your body, making a pregnant woman less stable and more prone to injury.

When exercising or lifting objects, do so slowly and avoid sudden, jerky movements.

Varicose veins may develop in the legs and genital area, and some women may develop hemorrhoids, which are varicose veins in the rectum.

Varicose veins often disappear after pregnancy, but you can minimize them by avoiding standing or sitting for long periods of time. Try to elevate your feet when sitting and wear loose- fitting clothing or support hose.

Hemorrhoids can be extremely painful and may bleed, itch or sting, especially during or after bowel movement. Coupled with constipation, another common pregnancy woe, hemorrhoids can make going to the bathroom unpleasant.

Constipation is common throughout pregnancy, because the hormones produced slow the rate of food passing through the gastrointestinal tract. During the latter stages of pregnancy, the uterus may push against the large intestine, making it difficult for waste to be expunged. Constipation can also contribute to hemorrhoids, because straining may enlarge the veins of the rectum.

Constipation and hemorrhoids can be prevented by eating a fiber-rich diet and drinking plenty of fluids to help bowl movement. Stool softeners -- but not laxatives -- may also help. Regular exercise can help keep bowel movements regular as well.

If you develop hemorrhoids, see your doctor for a hemorrhoidal treatment cream or ointment.

You should discuss any concerns you may have about your or your baby's mental or physical health, regardless of how unrelated or trivial they may seem, with your doctor.

Your gynecologist/obstetrician has seen many expectant parents, all more or less worried about the pregnancy, and can reassure you when there is no problem or provide information and advice when there is one.

If your doctor does not take the time to listen to your concerns or does not seem to take them seriously, you should get a second opinion.

There are lots of surprises and changes in store for you during a pregnancy, but none will be sweeter than how you will feel once your newborn is in your arms!