Most pregnancy discomforts are ordinary and manageable. One of them isn’t, so read the itching section even if nothing else here applies.
Severe itching without a rash, especially on the palms and soles, and worse at night, needs a blood test, not a cream.
It can indicate obstetric cholestasis, a liver condition of pregnancy that poses risks to the baby and requires monitoring and sometimes earlier delivery.
Contact your obstetrician the same day. Don’t wait for the next appointment, and don’t accept “it’s just pregnancy” without the test.
Heartburn
Very common from the second trimester, as hormones relax the valve at the top of the stomach and the uterus pushes upwards.
- Small, frequent meals, not large ones
- Don’t lie down for two to three hours after eating
- Prop the head of the bed up, or sleep on extra pillows. This works better than most remedies
- Avoid the usual triggers: fried and fatty food, chilli, citrus, tomato, chocolate, caffeine, carbonated drinks
- Calcium- or magnesium-based antacids are safe in pregnancy; ask a pharmacist for a suitable one
- If it’s severe or disturbing sleep, ask your doctor. Stronger acid-reducing medications are used in pregnancy when needed
Constipation and haemorrhoids
- Iron supplements are the usual culprit. Don’t stop them. Ask about a different preparation or a stool softener alongside.
- Fluid, fibre and movement, in that order of impact
- Lactulose and bulk-forming laxatives are generally considered safe; check with a pharmacist
- Don’t strain. This is what produces haemorrhoids, which are then miserable for months and worse after delivery
- For haemorrhoids: cold compresses, avoid sitting on the toilet for long, and ask a pharmacist for a pregnancy-suitable topical treatment. Report any bleeding to your doctor, don’t assume
Leg cramps and restless legs
- Usually at night, most common in the third trimester
- Stretch the calf by pulling the toes upwards towards you, and walk it off
- Stay hydrated; stretch before bed
- Do mention restless legs to your doctor. They’re associated with iron deficiency, which is common in pregnancy and treatable
- Calf pain that’s one-sided, with swelling, warmth or redness, is different. That needs same-day assessment for a clot
Back and pelvic pain
- Ask for physiotherapy instead of enduring it. Pelvic girdle pain is common, treatable, and frequently dismissed
- A support belt helps some women a great deal
- Avoid asymmetric loading: carrying a toddler on one hip, standing on one leg to dress
- Keep the knees together getting in and out of a car, and turn in bed as one unit
- Sleep on your side with a pillow between the knees
Swelling
Gradual swelling of feet and ankles, worse by evening, is normal. Elevate the feet, move regularly, and avoid standing for long periods.
Sudden swelling of the face, hands or feet, particularly with a headache, visual disturbance or upper abdominal pain, isn’t normal. That combination suggests pre-eclampsia and needs urgent assessment.
The rest of it
- Blocked nose: rhinitis of pregnancy is common and harmless. Saline spray, a humid room. Avoid decongestant sprays and tablets unless a pharmacist confirms one is suitable.
- Bleeding gums: keep brushing gently, and see a dentist. Treatment is safe in pregnancy.
- Nosebleeds: common, from increased blood volume. Lean forward and pinch the soft part of the nose.
- Carpal tunnel: tingling and numbness in the hands, often at night. Wrist splints help and it usually resolves after delivery.
- Insomnia: side-lying with pillows, no screens late, and accept that broken sleep in the third trimester is largely unavoidable.
- Dizziness: stand up slowly, eat regularly. Report fainting.
- Bloating and wind: smaller meals, less carbonated drink, and movement after eating.
What not to take
- Ibuprofen and other NSAIDs: avoid, particularly from 20 weeks, unless specifically prescribed. Paracetamol is the usual first choice.
- Aspirin unless prescribed. Low-dose aspirin is deliberately used for some women at risk of pre-eclampsia, which is a different thing.
- Herbal remedies, unless cleared. “Natural” isn’t a safety claim, and several aren’t advised in pregnancy.
- Anything from an old prescription, or borrowed from someone else.
- Check with a pharmacist before any over-the-counter medicine. It takes two minutes and they’re used to the question.
Frequently asked questions
What relieves heartburn in pregnancy?
Small frequent meals, not lying down for two to three hours after eating, and propping the head of the bed up, which works better than most remedies. Calcium- or magnesium-based antacids are safe; ask a pharmacist. If it’s severe or disturbing sleep, stronger acid-reducing medication is used in pregnancy when needed.
When is itching in pregnancy serious?
When it’s severe, there’s no rash, and it affects the palms and soles or is worse at night. That can indicate obstetric cholestasis, a liver condition that carries risks to the baby. Contact your obstetrician the same day for a blood test. Don’t accept “it’s just pregnancy” without one.
What can I take for constipation?
Fluid, fibre and movement first. Iron supplements are usually the cause, so ask about a different preparation or a stool softener instead of stopping them. Lactulose and bulk-forming laxatives are generally considered safe. Check with a pharmacist. Above all, don’t strain, which is what causes haemorrhoids.
Is swelling in pregnancy normal?
Gradual swelling of the feet and ankles, worse by evening, is normal. Sudden swelling of the face or hands, especially with a headache, visual disturbance or upper abdominal pain, isn’t, and needs urgent assessment for pre-eclampsia.
Can I take ibuprofen while pregnant?
Avoid it, particularly from 20 weeks, unless specifically prescribed. Paracetamol is the usual first choice. Low-dose aspirin is sometimes deliberately prescribed for women at risk of pre-eclampsia, which is a different situation from taking it yourself.
What helps back and pelvic pain?
Ask for physiotherapy instead of putting up with it. Pelvic girdle pain is common, treatable and frequently dismissed. A support belt helps some women, and avoiding asymmetric loading such as carrying a toddler on one hip makes a real difference.
What to remember
Severe itching with no rash, on palms and soles or worse at night, is a same-day phone call and a blood test. That’s the one on this page that isn’t just discomfort.
Heartburn: small meals, upright after eating, bed propped up, antacids are fine.
Constipation: it’s usually the iron. Ask for a different preparation instead of stopping it, and never strain.
And check any over-the-counter medicine with a pharmacist. Two minutes, every time.
Read next
- Morning sickness: what helps, and when it needs treating
- Exercise during pregnancy
- Prenatal vitamins: what you need
This article is general information and not a substitute for medical advice. Check any medicine with a pharmacist or your doctor, and contact your obstetrician urgently about severe itching, sudden swelling or one-sided calf pain.