You know what having a baby on board does to your belly, but did you know that it transforms just about every other part of you, too? Fortunately, many of those changes are temporary. In the meantime, here are ways to cope until the alien life form that's abducted your body returns it to you (more or less) unharmed.
What's going on: Hair grows in cycles, and under normal circumstances each strand is either growing, resting, or falling out. Thanks to the hormonal shifts of pregnancy, though, more follicles are locked in the growing and resting phases, and fewer are in the falling-out phase, explains Amy McMichael, M.D., an assistant professor of dermatology at Wake Forest University School of Medicine, in Winston-Salem, North Carolina. For many women, the result is a luxurious mane. For others, their 'do simply feels flat and heavy. "My hair is completely unmanageable," laments Jean Dykstra of Brooklyn, New York. "It's so thick and there's just way too much of it."
Pregnancy hormones such as estrogen and progesterone can also alter oil production and follicle structure, so curly hair may calm down, and limp hair may spring to life. A few months after your baby's born, your follicles will finally enter the falling-out phase, leaving up to 500 hairs -- compared with the 100 you normally shed -- on your brush every day. Don't panic: Your follicular follies should be over for good within about six months.
What to do about it: If you like your new look, regular trims will keep your locks in great shape. If you're less than thrilled, hold off on any major fixes until after the first trimester. There's no proof that the chemicals in perms or dyes cause miscarriage or birth defects, but since they're absorbed through your scalp and into your bloodstream, it's probably best to avoid exposure while your baby's organs are developing. Highlights (which don't touch the scalp) or a vegetable-based color rinse are considered safe at any time during pregnancy.
What's going on: Think you're losing your mind? You may be right -- MRI scans of pregnant women have shown that brain size actually shrinks in the third trimester (but plumps back up a few months after birth). Other research has found that concentration, short-term memory, and learning ability are significantly impaired in late pregnancy. No one knows just what turns expectant moms' minds to mush, but lack of sleep during this fairly uncomfortable period may contribute to this mental fogginess.
What to do about it: Update your "to-do" list daily and leave reminders in hard-to-overlook spots. Most importantly, though, cut yourself some slack. After all, pregnancy has a way of reminding you that there's more at stake than picking up your dry cleaning on time or beating your husband at Trivial Pursuit ? like growing, giving birth to, and being responsible for a brand-new life.
What's going on: If you find yourself straining to see the movie screen, blame the fluid retention and hormonal havoc of pregnancy. Why? "The corneas of your eyes swell along with the rest of your body," says Anne Sumers, M.D., an ophthalmologist in Ridgewood, New Jersey. As your corneas thicken and curve more, the way they refract visual images into the eyes changes. "My glasses don't really work anymore," confirms Minneapolis mother-to-be Emily Boettge. "I'll be driving down the street and start waving at someone I think I know. Then I'll get closer and realize I've been waving like a lunatic at a total stranger." The good news: Eyesight should return to normal within 3 months of delivery.
Even if vision remains unchanged, nearly one in four pregnant contact wearers find that once-comfy lenses become torturous. The cause, again, is hormonal. Curvier corneas mean contacts no longer fit well, and fluctuating hormone levels dry the corneas and cut tear production.
What to do about it: Pay a visit to an eye doctor, who may temporarily adjust your prescription. If your contacts are bothering you, "switch to glasses until you have the baby," says Dr. Sumers. You can also try using lubricating drops or wearing contacts for shorter periods of time. Let your obstetrician know right away if you have severely blurred vision, tunnel vision, or spots in front of your eyes -- these can signal a potentially serious problem such as gestational diabetes or pregnancy-induced hypertension.
What's going on: Expectant mothers are famous for their "glow" (caused by high estrogen levels, which boost the amount of blood coursing through your veins by up to 50 percent to support circulation to the fetus). Unfortunately, they're prone to a whole host of less glamorous skin conditions, too. Pregnancy hormones can rev up oil glands, for instance, triggering acne flare-ups. "I feel like I'm in high school again," moans Sue Craver of Marinette, Wisconsin.
Other common pregnancy skin woes include: Melasma (blotchy pigmentation on the face brought on by increased melanin production); spider veins (blood vessels grow and dilate, making capillaries visible through the skin); skin tags (tiny, leathery flaps that crop up in high-friction areas like the neck and underarms); moles (hormones cause the spots to multiply and grow); dry, itchy skin (blame stretching and hormone-induced skin dehydration); linea nigra (a dark line running down the center of the belly due to excess melanin); stretch marks (hormones and pressure from your growing girth cause the support structures in the skin to tear, leaving your belly etched with red striations, which will eventually fade to a silvery white); rashes such as polymorphic eruption of pregnancy (itchy, red lesions that appear in stretch marks); and red palms (caused by increased blood volume).
What to do about it: To keep skin supple, drink eight glasses of water a day, take warm -- not hot -- showers, and use a moisturizing cleanser, advises Dr. McMichael. To zap zits, wash with a gentle cleanser a few times a day, but don't use any acne treatment without your doctor's okay. If you've been eyeing fancy stretch-mark creams, save your money -- a genetic predisposition for elastic skin is the only thing that will ward them off (though smoothing lotion on your taut belly will feel good, if nothing else). Creams containing Retin-A or alpha-hydroxy acids may help fade stretch marks after they develop, but such treatments aren't safe to use during pregnancy or breastfeeding. Finally, wait it out -- most skin conditions clear up or fade within a few months of delivery. If you develop a serious or persistent skin problem, though, see a dermatologist.
What's going on: No one's sure if pregnant women actually have a sharper sense of smell, but they do perceive odors differently. "If a smell becomes aversive to you, you notice it more," says Beverly Cowart, Ph.D., director of the Monell-Jefferson Taste and Smell Clinic in Philadelphia. This is especially true during those queasy early months, when the slightest whiff of something malodorous may send you sprinting for the nearest bathroom.
What biological function might this bionic nose serve? One theory: During the first trimester, an aversion to noxious odors helps women stay away from foods with a high bacteria content or natural toxins, which could harm the fetus during this crucial period of development. (Not coincidentally, this is also when morning sickness -- with its accompanying food aversions -- reaches its apex.)
As pregnancy progresses, though, moms-to-be may become less attuned to smells than normal, since increased blood flow to the mucous membranes causes them to swell. The result can be what feels like a never-ending head cold and a less-keen nose. If you have frequent nosebleeds or a chronic case of postnasal drip, you can blame hormone-induced nasal engorgement for these problems, too.
What to do about it: Aside from steering clear of fish markets and asking your mate to pick up his java on the way to work rather than brewing a pot at home, not much. For congestion, runny noses, or nosebleeds, use saline nose drops, drink fluids, take 20-minute steamy showers, run a humidifier at night, and keep a box of tissues handy.
What's going on: Ever heard the old saying, "Have a baby, lose a tooth?" While the calcium needed to build your baby's bones comes from your diet -- not your teeth -- your pearly whites could be at risk from pregnancy gingivitis. The malady, which affects nearly all expectant moms, crops up when dilated blood vessels leave gums swollen, tender, and less resistant to infection, explains Barbara Rich, D.D.S., a spokesperson for the Academy of General Dentistry. And since puffy gums give germs more places to hide, cavities are ten times more likely during pregnancy. Hormonal changes also make saliva more copious and odor-causing bacteria more prevalent.
What to do about it: Keep germs in check by brushing your teeth and tongue with a soft-bristled toothbrush after meals and bouts of morning sickness. Floss your teeth and swish with an antimicrobial mouthwash once a day, too. Don't skip your semi-annual checkup (just be sure to let the dentist know you're pregnant, and ask her to save the dental X-rays for another visit). In fact, you may want to step up the frequency of professional cleanings, since they'll prevent gingivitis from turning into a full-blown gum infection.
What's going on: Your immune system hunts down and destroys invading organisms. So why does it leave your fetus (which, genetically speaking, is half foreign) unharmed? Because the placenta -- the organ that delivers oxygen and nutrients to your growing baby -- cranks out an enzyme that stops the "natural killer" cells circulating in your blood and lymphatic system from attacking. Does this downshifting of the immune system mean that expectant moms are more prone to colds and flus? Paradoxically, the opposite may be true: Pregnant women seem to be less likely to catch them. "We're not sure how this happens, but immunity to viruses revs up in pregnancy," says Roberta Ness, M.D., an epidemiologist at the University of Pittsburgh School of Public Health.
What to do about it: You may be less prone to illness now, but you can still get sick. So keep bugs at bay by washing your hands religiously and avoiding sick people like, well, the plague. Cutting down on stress, getting lots of rest, and eating well will also keep your defenses up. If you're in your second or third trimester during flu season, consider getting a flu shot, too.
What's going on: A surge in estrogen and progesterone in early pregnancy, and the milk-making hormone prolactin later on, spurs dramatic changes in your breasts that help them gear up to feed your baby-to-be. Nipples become erect, the areolas around them expand and darken (all the better for a hungry, nearsighted newborn to zero in on), and small milk-producing glands that dot the areolas grow more prominent. Transformation is going on inside, as well: Blood flow to the breasts increases; milk sacs, lobes, ducts, and sinuses grow and multiply; and protective fatty tissue plumps up. As a result, your breasts pack on up to two pounds each -- a cup size or more. (Sorry, this voluptuousness will subside once the baby's weaned). Not surprisingly, breasts also become achingly tender and sore.
What to do about it: If your cups runneth over, invest in a good support bra with wide straps and smooth material that won't irritate hypersensitive nipples. Be sure to have it professionally sized, and sleep in it if you have to.
Heart and Circulatory System
What's going on: Long before you hear the pitter-patter of little feet, you'll feel the thump-thump of your heart. "Because the heart has to pump extra blood, it beats faster and harder than normal, especially when a woman exerts herself," says Ann Bolger, M.D., a San Francisco cardiologist and spokesperson for the American Heart Association. Since there are so many more blood vessels to fill (especially in the placenta, which has tens of thousands of them), and since pregnancy hormones make the tone of these vessels a bit lax, blood pressure tends to drop slightly in the second trimester. "This is why a pregnant woman may feel faint or dizzy if she stands up too fast," Bolger explains. For reasons that aren't yet clear, though, blood vessels may constrict instead of relax, causing blood pressure to rise in about 7 percent of pregnancies. The result is pregnancy-induced hypertension, or preeclampsia, which reduces blood flow to the uterus and can lead to an emergency delivery.
What to do about it: Iron is vital for the development of all those extra red blood cells, so consuming 6 milligrams (mg) a day of this mineral will help prevent anemia. To keep your heart strong and healthy during pregnancy, get regular doses of moderate aerobic exercise, and drink plenty of water before, during, and after. "Walking just 20 minutes a day strengthens your heart and lungs for labor and delivery and keeps your blood pressure down," says Bolger. Just be sure to get your caregiver's okay before embarking on a prenatal exercise regimen, and ask what your target heart rate should be. When you're working out, check your heart rate often and take a breather when it starts to inch past that number.
If you feel faint, sit or lie down and breathe deeply until the lightheadedness disappears. Finally, let your doctor know right away if you spot any of the warning signs of preeclampsia: constant, severe headaches; swelling in your face or hands; abdominal pain; visual disturbances; or sudden weight gain of more than a pound a day. Bed rest and other measures can help keep the condition under control.
What's going on: Your stomach is roiling, all right, but it's not just from morning sickness. Heartburn, indigestion, and constipation are common side effects of a digestive slowdown. The likely culprit? Progesterone. "It makes the gut sluggish, so your stomach takes longer to empty and food moves through your intestines more slowly," says John Jennings, M.D., chairman of obstetrics at Texas Tech Health Sciences Center in Amarillo. This will probably bother you in the form of acid regurgitation, as well as increased gas and uncomfortable constipation. Annoying, yes -- but this may serve an important purpose: The longer food stays in your system, the more nutrients are absorbed and delivered to your baby.
What to do about it: To head off heartburn, avoid fatty, acidic, and spicy fare and don't lie down right after meals (prop yourself up with pillows when you do hit the sack). If you're already feeling the burn, have a few spoonfuls of yogurt, chew gum, or crunch a calcium-based antacid to neutralize stomach acid and wash it back where it belongs. To combat indigestion, eat six small meals a day rather than three big ones. To keep things moving on the other end, bulk up on fiber, drink plenty of water, and get regular exercise.
What's going on: If your wrists ache, your fingers are numb or tingly, and pain shoots up your arm or into your hand, you could have carpal tunnel syndrome (CTS), a condition brought on by hormonal changes and fluid retention. "Tendons in the wrist swell and put pressure on the median nerve that runs down the arm and into the hand," says William Hagberg, M.D., an orthopedic surgeon at Allegheny General Hospital in Pittsburgh. The good news: Although up to 45 percent of pregnant women develop symptoms of CTS, the problem almost always clears up after delivery.
What to do about it: Repetitive motions raise the risk for CTS, so if your job involves computer work or other nonstop hand movement, change position often and take frequent breaks to give your wrists a rest. Also make sure that your work station is ergonomically correct and that your arms and wrists are straight when you type (a wrist rest, available at office supply stores, will help). If you already have CTS, your doctor may recommend cortisone injections and a wrist brace. Consider taking a prenatal yoga class, too, since yoga offsets some of the postural changes that contribute to CTS.
What's going on: The levels of estrogen, progesterone, and androgens (male hormones produced by fetuses of either sex) may enhance your libido; an increased blood supply pumps through your erogenous zones; and intensified vaginal secretions may help lube things up. The happy result: hot second-trimester sex. (Some women may be too tired to get much pleasure out of lovemaking during the early months and feel too unwieldy to maneuver later on.) Some mothers-to-be even luck into multiple orgasms.
According to Iffath Hoskins, M.D., chief of obstetrics at New York University Downtown Hospital, in New York City, all that extra blood flow can result in vulvar varicosities and hemorrhoids (essentially, varicose veins of the vagina, vulva, and anus). And hormonal changes alter vaginal flora and make your vaginal area a breeding ground for yeast infections, she says.
What to do about it: As long as your pregnancy isn't high risk, go ahead and enjoy sex as often as you can -- soon enough, a wailing newborn and extreme sleep deprivation will make those sexy interludes seem like they happened in another lifetime. To soothe hemorrhoids and vulvar varicosities, make liberal use of ice packs and witch hazel compresses. See your doctor if these uncomfortable veins don't subside after delivery. If you suspect a vaginal infection, ask your obstetrician to recommend a safe treatment. Women prone to yeast infections may be able to head them off by eating yogurt with live acidophilus cultures (an easy way to pack in extra calcium, too).
What's going on: Extra blood volume and the pressure of your expanding uterus on the veins in your groin cause blood and fluid to pool in your lower body, which in turn makes varicose veins bulge and ankles balloon. What's more, extra pounds, the weight of your growing uterus on certain nerves, and possibly a calcium shortage can bring on painful nocturnal leg cramps.
What to do about it: To ease swelling and minimize varicose veins, wear maternity support hose (not knee-highs), chug fluids to help flush out your body, avoid prolonged standing or sitting, and kick back with your feet up at least as high as your waist a few times a day. Let your doctor know right away if swelling is severe or accompanied by sudden puffiness in your face or hands, since these symptoms can signal dangerously high blood pressure. If leg cramps are a problem, try doing a few gentle calf stretches before bed and make sure you're getting at least 1,000 mg of calcium a day (a warm glass of milk at bedtime will get you a third of the way there).
What's going on: Not for nothing was the term "barefoot and pregnant" coined. "If I take my shoes off after 3 P.M., I can't get them back on again," says Bonnie Scofield of Morrison, Colorado, who keeps a spare pair of extra-large flats at work for such emergencies.
Temporary weight gain and water retention are to blame for some of this increased foot girth, of course, but the old saying about growing a shoe size with every pregnancy may actually be true. That's because when the aptly named hormone relaxin helps open the pelvis in preparation for birth, it also loosens up other parts of the body. "When the ligaments in the feet stretch out, the bones there aren't held together as tightly, and the foot spreads," says Carol Frey, M.D., an orthopedic surgeon in Manhattan Beach, California. You may be stuck with those pudgy piggies, too: More than half the women in one study reported permanent foot growth of up to a whole size after pregnancy.
What to do about it: To ease swelling, treat your tootsies to cool foot baths and prop up your feet as often as you can. If that doesn't do the trick, stock up on a few pairs of comfortable, versatile shoes a half or whole size bigger than normal -- and learn to love living large.
Leah Hennen is a contributing editor to BabyTalk.