By Dr Mama-Aso Peprah
During the first year of starting my practice as an OBGyn in 2018, I fell pregnant. I had to find ways to manage nausea and vomiting, fatigue and light headedness while pregnant, but still perform at a high level to look after my patients. It’s especially difficult in the early parts of your pregnancy when you feel so sick, because of our reluctance to tell people too early on that we are expecting.
This article will talk about the early symptoms of pregnancy, why they occur, what it means and then what tools can be used to get through it. This is not comprehensive medical advice, so please consult with your doctor should you have any of these problems.
The first thing I realised is that we have to change our mindset about the symptoms. The fact that we call them symptoms implies that we see pregnancy as a disease. The “symptoms” we experience are mostly seen as bothersome, because we are trying to get on with our day and fulfil our responsibilities at work, at home etc. At some point we need to try to stop and listen. Our bodies are actually offering us solutions to what is needed to transition and meet the physical demands of growing a human being.
- Fatigue and fogginess
Why this happens
Progesterone is a hormone necessary in pregnancy to allow for muscle tone relaxation in the uterus and blood vessels. An increase in progesterone levels also has an effect on brain function, resulting in feelings of tiredness and fatigue. To deal with this you need to try and increase the amount of sleep and rest. Granted there are times when you have deadlines and too much work, but prioritising rest is important in between.
Tools that help
- This includes going to bed much earlier than you usually do. If you are a night owl you need to re-train your body and brain to wind down in the night by not engaging with any form of technology after 7pm (no TV’s or devices in the bedroom).
- Help your body to wind down by having a quick shower or bath, going through the ritual of putting on your pjs, getting into a bedroom with dim lights or a side lamp, listening to soothing music or reading a physical book. You can also use this time to write or journal and reflect.
- Including naps in your day, even if it’s only on the weekend. If you aren’t able to nap in the day I encourage just a quiet time where you get in bed and rest. You will still feel tired but you will have a little bit more reserve to manage the day.
- You can also ask your doctor for recommended supplements to help keep you going at work.
2. Nausea and vomitting in pregnancy
Why this happens
This one was hard for me. I remember consulting a patient and having to excuse myself to go and vomit then come back and continue like nothing happened. The main culprit is the hormone human chorionic gonadotrophin (HCG). Yes that’s the same hormone you tested and told you that you were pregnant. Its levels increase exponentially in the first trimester, basically doubling every other day, the levels peak at about 10 weeks then stabilise. That is why most symptoms improve by about 16-20 weeks of pregnancy in about 80% of women (1).
Tools that help
- Firstly pack an extra toothbrush and an extra set of clothes with you every day.
- Secondly it’s about survival: so eat what your body will allow you to eat.
- Never get hungry. Pack a constant supply of nutritious snacks and just munch on them all day. Get a food diary and note what things made you feel queasy.
- Another thing I personally found is that I seemed to get food poisoning much more often in pregnancy. So be very careful about the source of food– avoid take out and ready-made food and try as much as possible to make it yourself or at least to put it in the oven yourself to complete the process.
- Keeping well hydrated is also essential. On average you need about 2-2.5lL of water a day so have a bottle add a flavour if you prefer and hydrate.
- We have clinical evidence to suggest that ginger really does help. Acupuncture can also play a role in relieving symptoms if they are mild.
The one question my patients often ask is how they know if the NVP is just mild or severe. In simple terms, your NVP is severe when it consistently stops you from doing you activities of daily living (ADLs).
3. Constant hunger
Why this happens
There is a change of the hormones progesterone, oestrogen and leptin that control appetite and metabolism. The aim is to increase fat stores during pregnancy and to prepare for breastfeeding.
Tools that help
- Pack your own food with lots of small snacks.
- Include a hot drink such as tea or decaf coffee into your diet as this helps to fill the tummy.
- Food aversions and cravings: provided the food being craved is safe to eat during pregnancy, go ahead (in moderation of course).
4. Dizziness and light-headedness
Why this happens
As your cardiovascular system adjusts to meet the increased demands of your developing baby, the wall of your blood vessels enlarge and become more relaxed. Great news for baby but for you it can result in a drop in your blood pressure and hence the dizzy spells.
Tools that help
- Make sure you keep hydrated and keep your sugar levels constant by eating nutritious food/snacks regularly.
- On hot days keep cool and try to avoid performing multiple tasks that take physical exertion– like walking around a shopping mall.
- Before you faint your body has an amazing way of warning you- either through headaches or dizziness. Its important to be aware of your body and listen.
- Also standing up abruptly can cause a rapid drop in your blood pressure (postural hypotension), so stand up slowly and take your time before you walk again.
5. Moodiness
Why this happens?
Often the cause of this is related to the above: hunger, fatigue, light-headedness, nausea and vomiting. If you follow the steps above, some of the emotions will not be so severe. However you need to be kind to yourself and accept that this is just a phase.
If may also be worthwhile to let you employer/ human resource department or close confidant know that you are pregnant so that they can to step in and help you if there is an issue. You need someone to have your back at work.
Comment below if you have any tips and tricks that helped you deal with symptoms of pregnancy in the workplace. Let’s learn from each other.
References
- From feeding one to feeding many: hormone-induced changes in bodyweight homeostasis during pregnancy. J Physiol. 2008 Jan 15; 586(Pt 2): 387–397.Published online 2007 Nov 22. doi: 10.1113/jphysiol.2007.146316
- Antenatal care: Management of nausea and vomiting in pregnancy. NICE guideline NG201Evidence reviews underpinning recommendations. accessed Feb 2023 http://www.nice.org.uk/guidance/ng201/evidence/r-management-of-nausea-and-vomiting-in-pregnancy-pdf-331305934365.
