1) What is SPD?
Q. I’m 34 weeks pregnant and have pain around my pubic area, particularly when walking. My midwife said its SPD and normal in pregnancy. What does that mean?
A.SPD, which stands for symphysis pubic dysfunction, is a relatively common but painful condition that some women develop during their pregnancy. Pregnancy hormones have the effect of stretching ligaments and muscles and loosening joints.
The combination of unstable joints, the growing baby and changes in posture can result in pain. This can be felt in the lower back, hips, groin and lower abdomen, down the inner thighs. Pain in the pubic area, which you describe, is where the cartilage starts to separate, and it would be helpful if you’re referred to a physiotherapist or osteopath who can recommend exercises, and also may suggest you wear a properly fitted support belt. So you don’t aggravate the condition, keep your legs together, avoid lifting and/or twisting movements, and place a pillow between your knees in bed.
When you give birth, good positions include all fours, kneeling, standing or laying on your side. The worst position if you have SPD is on your back with your legs away from the midline of your body.
2) Are my aches and pains normal?
Q: I’m 20 weeks pregnant and the sides of my bump often ache. My midwife doesn’t seem concerned and calls them growing pains. What does she mean?
A: Your body’s working overtime at the moment, so it’s normal to have some aches and pains. Your womb’s supported by thick bands of ligaments, a bit like rubber bands, which run from your groin and up the side of your tummy, and it’s stretching as your baby grows. The ligaments stretch and relax as you move, and sometimes this can feel quite uncomfortable or even a little painful if you move suddenly.
On top of this, those pregnancy hormones are making your ligaments and muscles stretchier and your joints looser so move slowly when going from sitting or standing to avoid straining your ligaments or muscles. If you start to get severe cramp-like or continual pain, don’t just ignore it. You should contact your midwife or doctor for further advice. However, the general aches and pains you’re describing here do sound perfectly normal.
3) Unsure about shingles
Q. I’m pregnant and I’ve just found out that I’ve got shingles. Should I be worried for my baby, and what can I do?
A. There’s no evidence that shingles will cause any problems to your unborn baby, but if you need treatment for the symptoms, you’ll need to check with your GP whether the drugs are licensed for use during pregnancy.
The problem with shingles is that, although other people can’t ‘catch’ it from you, it can cause chickenpox, as it comes from the same virus (herpes zoster). Try to keep the blisters covered.
Chicken pox can sometimes cause a problem up to 28 weeks of pregnancy, or after 36 weeks for a very small number of women. So even though around 90 per cent of adults are immune to the virus, it’s best to avoid contact with other pregnant women until the blisters have healed over.
4) Why do I keep getting pins and needles?
Q. I’m 30 weeks pregnant and keep getting pins and needles in my left hand and lower arm, particularly at night. My midwife said it’s normal but I’m still worried. Can you explain a bit more?
A. It sounds like carpal tunnel syndrome (CTS) – when the nerve that runs through your wrist is irritated by swelling or damaged tendons. It’s common in pregnancy because increased fluid can put pressure on the nerve. The carpal tunnel, through which the nerve runs, then becomes swollen. Symptoms are worse at night is because of the build-up of fluid during the day.
Try not to sleep on your hands, and do exercises such as circling and flexing your wrists. If it doesn’t improve, your midwife or GP may be able to organise a supporting splint for your wrist. Some women find that getting an osteopath to manipulate the wrist encourages the drainage of the fluid. In severe cases, where it doesn’t improve after the birth, surgery may be an option.
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5) My bump’s itchy
Q. I’m 25 weeks pregnant and have had an itchy bump for the past two weeks. Should I be worried?
A. Itching in pregnancy is common, around 17 per cent of women will experience it. It could be because your skin becomes drier or because of your skin stretching.
But there is a liver disorder in pregnancy called obstetric cholestasis (OC) that affects around 1 in 135 women and can cause unbearable itching of the bump, soles of feet and palms of the hands, mainly at night.
If left untreated, it can be dangerous for the baby so it’s worth ruling the condition out
if you’re showing symptoms of it. Blood tests will diagnose OC and if confirmed you’ll be given medication to control the itching but there won’t be any long-term effects to you after the birth. In the meantime, apply a mild body lotion or baby oil to keep the skin moisturised.
6) Will I get HELLP?
Q. In my last pregnancy I developed HELLP syndrome. Will it happen again second time around?
A. HELLP stands for Hemolysis, Elevated Liver enzymes and Low Platelet count. It’s a serious condition that goes hand-in-hand with severe pre-eclampsia and eclampsia. It affects around 10 per cent of pregnant women who have either illness, which can occur any time after 20 weeks. Symptoms may include nausea, vomiting and upper abdominal pain. Unfortunately, because you had it before, there is an increased risk of you developing HELLP again and you may already know it carries a risk of early delivery, as the only ‘cure’ is birth. The best thing to do is stay calm, and keep all your appointments so that your midwife can monitor you closely for any signs of the condition.
7) Swollen down below – why is this?
Q. I’m seven months pregnant and feel really swollen ‘down below’. There appear to be veins bulging out as well. What’s going on?
A. What you’re suffering from sounds like vulval varicosities or varicose veins of the vulva. This is a bit like haemorrhoids or piles, which you get around your back passage, but in this instance the bulging veins are around your vulva. This condition is very common in pregnancy and is caused by pregnancy hormones that make your veins more elastic. As your baby grows, the increased weight puts pressure on the veins too. The first symptom a woman often complains of is a heaviness and that her pelvic floor is aching, particularly by the end of the day.
There’s not a huge amount that you can do, but try wearing a chunky sanitary towel to provide some support, don’t stand for long periods of time and do your pelvic floor exercises. After the birth, when the pressure is no longer there, the feeling will disappear.
8) Why am I always blocked up?
Q. Since 18 weeks of pregnancy, my nose has continually felt blocked up. Is this normal?
A. As long as you don’t have any other symptoms such as a sore throat or feeling unwell, the bunged-up feeling is caused by your pregnancy hormones making the soft tissue of your nose swell, and the blood vessels widen. This is one reason why women are more prone to nosebleeds and snoring during pregnancy.
A warm bath or shower might help, especially if the room gets steamy, or try filling the sink with hot water and inhaling the steam with a towel over your head. If the blocked nose is so bad that it’s affecting your sleeping and getting you down, your GP may be able to prescribe medication, which will lessen the symptoms. But the good news is that once you’ve given birth your nose should return to normal.