Your Pregnant Body: What to Expect

by Dr. Gerard M. DiLeo

Heartburn (Pyrosis)

This is a common pregnancy complaint. Progesterone, abundant in pregnancy, slows down the movement of the gastrointestinal tract, causing decreased stomach emptying. You may feel as though your food is just sitting in your belly . . . and it is! Your esophagus also softens and lessens its pressure, which results in less of a barrier to stomach acid refluxing upward.

The distortion of your anatomy due to pregnancy forces your organs—including your stomach—to fight for space. Additionally, the upward displacement and pressure against the stomach by the growing uterus can cause nausea long after any morning sickness.

The opening in the diaphragm through which the esophagus passes (from the chest into the abdomen) widens in pregnancy. It is a physiologic hiatal hernia, and if a stomach portion slides up through it, this can interfere with stomach acid going back down. This particular aspect of heartburn is worse when lying flat instead of being slightly elevated with your head up. Propping yourself up will allow gravity to do its thing and the stomach can fall back into place.

Due to their increased iron content, prenatal vitamins can irritate the stomach, too. If this is the case for you, ask your doctor about prescription alternatives that may be easier on sensitive stomachs.

The most conservative treatment for stomach upset is an antacid other than sodium bicarbonate (the sodium in sodium bicarbonate can cause considerable swelling). Milk of Magnesia and Maalox, for example, are good choices. The trick is to use these about twenty minutes before you eat, otherwise you're just pouring antacid over the food instead of applying it directly to the site of acid production, the stomach lining.

Pigmentation

Estrogen and progesterone affect hormones (such as Melanotropin, which is produced in higher quantities during pregnancy) and stimulate the deposit of pigment in the skin. About 40 to 70 percent of moms-to-be experience chloasma, the mask of pregnancy, during the fourth month. This discoloration usually occurs across the cheeks, nose, and forehead, and is worsened by sunlight.

Cosmetics can help cover the mask of pregnancy, and in most cases the discoloration fades after childbirth. The discoloration may continue after delivery if birth control pills (also an estrogen and progesterone source) are taken. Interestingly, brunettes are the most vulnerable to chloasma.

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