Embarrassing Pregnancy Symptoms No One Warns You About

Quick answer

Gas, constipation, leaking urine, bleeding gums, snoring, body odour and leaking breasts are all common in pregnancy and almost always harmless. They happen because hormones relax your muscles and gut, your blood volume rises, and a growing uterus presses on everything. A few of them, particularly intense itching and sudden swelling, can also be signs of something serious, so it is worth knowing which is which.

Key takeaways

• Almost none of this is your fault, and almost all of it is temporary. Progesterone, blood volume and pressure from the uterus explain most of the list.

• Two symptoms on every "normal pregnancy" list deserve more care than they usually get. Intense itching, especially on palms and soles, and sudden swelling of the face or hands, can both indicate serious conditions.

• Leaking urine when you sneeze is extremely common and is treatable. Pelvic floor exercises work, and you do not have to accept it as permanent.

• Restless legs and craving non-food items are often signs of iron deficiency, which is very common in Indian pregnancies and is worth testing for.

• Nothing here is too embarrassing to tell your doctor. They have heard all of it, many times, this week.

Why does pregnancy do all this?

Four mechanisms explain most of the list, which helps because you can stop taking each symptom personally.

• Progesterone relaxes smooth muscle throughout the body. That includes the gut, the bladder, the valve at the top of the stomach and the blood vessels. Hence constipation, gas, heartburn, and needing the toilet urgently.

• Blood volume increases substantially, which swells mucous membranes. Hence blocked nose, nosebleeds, bleeding gums and snoring.

• The uterus takes up space, pressing on the bladder, bowel and diaphragm.

• Hormones change secretions and sensitivity, affecting discharge, sweat, saliva and smell.

The full list, and when each one is not just embarrassing

The two that deserve more attention than they usually get

Intense itching

Mild itching from stretching skin is common. Intense itching is different and needs a blood test.

Itching that is intense, worse at night, affects the palms of the hands and soles of the feet, and comes without any visible rash, particularly in the second half of pregnancy, can indicate intrahepatic cholestasis of pregnancy. This is a liver condition of pregnancy that is associated with increased risks for the baby, and it is managed by monitoring and by planning the timing of delivery.

It is diagnosed with a simple blood test for bile acids and liver function. It is not diagnosed by looking at your skin, because there is often nothing to see.

Tell your doctor about itching rather than buying a cream. This is the single most commonly missed symptom on lists like this one.

Swelling

Mild swelling of the feet and ankles, especially by evening and in hot weather, is normal and very common in Indian summers.

Swelling that needs same-day attention:

• Sudden swelling of the face, around the eyes, or of the hands

• Swelling with a severe headache, visual disturbance, flashing lights, or pain under the ribs

• Rapid weight gain over a few days

• Swelling, pain, warmth or redness in one calf only

The first three can indicate pre-eclampsia. The last can indicate a blood clot. Neither is an embarrassing symptom, and neither should wait.

Things that help across the board

• Do not cut back on water to reduce urination or swelling. Dehydration makes constipation, urine infections and fatigue worse

• Walk daily, even briefly. It helps constipation, bloating, swelling and sleep together

• Start pelvic floor exercises now, not after delivery. Squeeze, hold a few seconds, and fully release. The release matters as much as the squeeze

• Get your haemoglobin and ferritin checked. Anaemia is very common in Indian pregnancies and drives fatigue, restless legs and pica

• Ask before taking anything, including antacids, laxatives, piles creams, balms and traditional preparations

• Wear what is comfortable. Tight waistbands make bloating, heartburn and reflux measurably worse

When to call your doctor

Contact your doctor or go to hospital immediately for:

• Intense itching, especially on palms and soles, or itching without a rash

• Sudden swelling of the face or hands, or swelling with headache, visual changes or pain under the ribs

• Pain, warmth, redness or swelling in one calf

• Any vaginal bleeding

• A gush or steady trickle of clear fluid from the vagina

• Burning urination with fever, or pain in your side

• Reduced or changed baby movements

• Vomiting that prevents you keeping fluids down

• Fever

• Gasping or stopping breathing during sleep

• Severe abdominal pain

Mention at your next visit:

• Cravings for mud, chalk, raw rice or ice

• Restless legs that disturb your sleep

• Leaking urine

• Piles, constipation or bleeding gums that are not improving

• Anything that is affecting your sleep, your eating or your mood

Frequently asked questions

Is it normal to pass so much gas in pregnancy?
Yes. Progesterone slows digestion, which produces more gas. Smaller meals, fewer fizzy drinks and a short walk after eating all help.

Why do I leak urine when I sneeze?
Because the pelvic floor is under more load. It is very common and it is treatable. Start pelvic floor exercises, and ask for a women's health physiotherapist if it is not improving.

Is itching in pregnancy normal?
Mild itching from stretching skin is common. Intense itching, especially at night and on the palms and soles, needs a blood test, because it can indicate a liver condition of pregnancy. Tell your doctor rather than using a cream.

My breasts are leaking at 30 weeks. Is that a problem?
No. Colostrum often leaks from the second trimester onward. Nursing pads help. Bloody discharge, or discharge from one breast only, should be checked.

Is swelling in my feet something to worry about?
Mild swelling of feet and ankles, worse in the evening, is usually normal. Sudden swelling of the face or hands, or swelling with headache or visual changes, needs same-day medical attention.

I have started snoring loudly. Does it matter?
Snoring itself is common and harmless. Gasping, choking or pausing in your breathing during sleep, or heavy daytime sleepiness, needs assessment, because sleep apnoea in pregnancy is linked to raised blood pressure and blood sugar.

Why do I want to eat mud or chalk?
This is called pica and is often linked to iron deficiency. Do not eat these things, since they carry lead and infection risk. Tell your doctor and ask for an iron test.

Will bleeding gums harm my baby?
There is an observed association between gum disease and some pregnancy outcomes, but treatment trials have not clearly shown a causal link. Get your gums treated anyway, because dental care is safe in pregnancy and untreated infection is not good for you.

Do haemorrhoids go away after delivery?
They usually improve significantly. Treating constipation is the most effective thing you can do, both now and afterwards.

Will all of this go back to normal?
Most of it settles within weeks of delivery. Pelvic floor symptoms, piles and varicose veins can take longer and respond well to treatment, so mention them at your postnatal check rather than assuming they are permanent.

The bottom line

Almost every symptom on this list is common, explainable and temporary, and none of it is anything to feel embarrassed about with your doctor. The two worth separating from the rest are intense itching, particularly on the palms and soles, and sudden swelling of the face or hands, because both can point to conditions that are managed rather than tolerated. And if you are craving mud or chalk, or your legs will not settle at night, ask for an iron test, because that one has a straightforward answer.

Sources

• NHS, common health problems in pregnancy, and itching and intrahepatic cholestasis of pregnancy

• Royal College of Obstetricians and Gynaecologists, intrahepatic cholestasis of pregnancy, and venous thromboembolism in pregnancy

• American College of Obstetricians and Gynecologists, common discomforts of pregnancy, preeclampsia, and oral health in pregnancy

• World Health Organization, recommendations on antenatal care, and anaemia in pregnancy

• Ministry of Health and Family Welfare, Government of India, Anemia Mukt Bharat guidance

• Federation of Obstetric and Gynaecological Societies of India, antenatal care recommendations

This article is for general information and is not a substitute for medical advice. Contact your doctor immediately for intense itching, sudden swelling of the face or hands, one-sided calf pain, bleeding, fluid leakage, fever, or reduced baby movements.