Other effects of Pregnancy

Hormonal Changes In Pregnancy :

Initially pregnancy hormones are produced by the ovaries, and then in larger amounts by the placenta.
Oestrogen promotes growth
Progesterone relaxes smooth muscle tissue (small muscles in the capillaries, gut and bowel)

Relaxin relaxes ligaments and fibrous tissue

Hormones are responsible for the growth of the uterus during pregnancy. The uterus increases in volume from being about the size of a grapefruit at week 12 to the size of a watermelon at the end of a pregnancy. The smooth muscle in the wall of the uterus hypertrophies during pregnancy and increases in weight 45g- 480g.

Normal weight gain in pregnancy is generally under influence of oestrogen, which also affects how fat is distributed.

Metabolic Changes :

There is a gradual increase in energy expenditure over the time of the pregnancy. In the final four weeks, the baby gains about 500g per week. Baby growth requires the mother to eat and rest sufficiently. In pregnancy, fat stores are not used first, therefore blood sugar levels can drop rapidly and care should be taken to refuel well after exercise and to be aware of this to prevent blood sugar drops.

Weight gain is caused by fluid retention, fat storage, breasts and uterus enlarging, amniotic fluid and baby growth, and fat is more likely to be stored around abdomen and thighs.

Contrary to popular belief, it is not necessary to “eat for two” for the whole pregnancy, and this can lead to excessive weight gain, which can be hard to lose after the birth. It is only in the last trimester of the pregnancy where there is a slightly greater requirement for extra calories, which actually amounts to 200-300 extra calories per day, about the equivalent to two slices of bread. It may be worth seeking the advice of a nutritionist. In mothers who breastfeed there is an increased need to stay hydrated.

Digestive Changes :

Progesterone has a relaxing effect on the smooth muscles of the bowel, the contraction of which are required for normal transit times and bowel movements. Constipation can contribute to haemorrhoids, so is important to try to avoid. Other digestive changes are associated with circulating oestrogen, which can cause nausea, vomiting and low blood sugar.

Heartburn is caused by hormonal changes and the uterus pushing the stomach and stomach contents up into the diaphragm. Take care to keep fluid intake sufficient to help reduce constipation; exercise and movement is also useful to help with movement of food and digestive products through the digestive tract.

Changes In Urinary System :

Changes in the urinary system are associated with relaxin affecting smooth muscle and ligaments. There is likely to be an increased frequency in micturition (passing urine) associated with pressure on the bladder, and the hormonal effects of relaxin on smooth muscle tissue.

Urinary tract infections are more likely and are associated with urine pooling and insufficient fluid intake. It is important to remain hydrated, and to commence and continue with pelvic floor exercises throughout pregnancy and after the birth.

Respiratory Changes :

There is an increased demand for oxygen (O2) , due to an increased basal metabolic rate. Additionally progesterone increases sensitivity to carbon dioxide (CO2), resulting in increased breathlessness. The uterus also restricts the movement of the diaphragm, further increasing breathlessness, and causing compensatory rib flaring. There is a gradual increase in tidal volume, while vital capacity remains unchanged. It is important that pregnant women do not hold their breath, especially when exercising.

It is particularly important not to do a Valsalva Manoeuvre i.e. Holding the breath and pushing down as one would when lifting weights. Rib and back pain can be relieved by overhead reaching. Concentrating on the types of slow breathing taught in yoga or at prenatal classes are good to do for short periods during the day, to help with relaxation and improve the quality of breathing mechanics.

Circulatory System :

There is an increase in plasma by about 40% more than red cell mass, which causes physiological anaemia. This can result in increased feelings of tiredness. The heart increases in size by 12% to accommodate the extra work required during pregnancy and heart rate can increase by 10-15 beats per minute. Increased blood flow can also cause the gums and nose to bleed, nasal congestion, vaginal discharge, cramp and carpal tunnel syndrome.

If experiencing carpal tunnel syndrome or pain in the wrists, raising the hands and arms, resting them frequently when typing, and supporting the hands on a pillow at night can all help to relieve symptoms.

Swelling in the calves and feet can be reduced by sitting for periods of time daily with the feet elevated.

Emotional Changes :

Mood swings can occur due to hormones, especially in early and late pregnancy. Blood sugars dropping easily (see above) can also cause mood swings.

Refuelling well after exercise and making sure there are snacks available if blood sugars do drop, and making sure there aren’t large gaps between meals can help to avoid this.

Skin Changes :

During pregnancy, easier adaptation to body temperature occurs as pregnant women sweat more readily and breathe more deeply.

It is important to stay cool when exercising (see section on exercising when pregnant), by wearing the fewer or loose clothes and using a fan.

Sitting For A Long Period Of Time :

Sitting in a hot theatre or cinema for example, can increase the likelihood of fainting, due to the redistribution of blood into the skin as you get hot, and blood pooling in the lower legs.

It is advisable to remain well hydrated, wear thin layers of clothing to help regulate temperature control and to raise and lower the heels while sitting to help pump the blood away from the calves and back into the system.

Over the years I have worked with a number of the physios at CSPC, I have found them to be up to date with their thinking and treatments, willing to share their knowledge with one and other and clients. I always recommend CSPC to friends and clients. They have helped hold body and soul together, thank you.

I am absolutely delighted with the shockwave treatment I have received at CSPC physiotherapy Clinic and the results it has produced. Each session has measurably reduced the size of my bursitis to the point it has almost gone, with corresponding improvement in my range of movement and comfort in the affected area. It has also ameliorated calcification in my shoulder. A great big thank you to Alison and Julianna for your help!

I cannot believe how well I feel. Four years ago, I felt consigned to the ‘rust pile’, today I feel ‘shiny’ and ready for the next challenge. CSPC can seriously alter your way of life …for the better.

Within the one hour appointment I received hands on treatment that relieved most of my pain and by the evening I was breathing and moving pain free. By the following morning I was back to ‘full dad duties’ much to the surprise of my partner, who with seeing how quickly I had recovered, started to think I’d made it all up to have a good rest!

After a long car journey to Leeds, I arrived with some discomfort in my upper back that worsened over the next day to the point that I could hardly breathe or move without feeling excruciating pain.

I’d done a gym session a week or so previously and had felt some discomfort in my back but rested and thought nothing of it. A long car journey combined with caring for two young children resulted in me having excruciating back pain and if it wasn’t for getting an emergency appointment at CSPC physiotherapy clinic I would not have made it home and probably checked myself into A&E!

Within the one hour appointment I received hands on treatment that relieved most of my pain and by the evening I was breathing and moving pain free. By the following morning I was back to ‘full dad duties’ much to the surprise of my partner, who with seeing how quickly I had recovered, started to think I’d made it all up to have a good rest!
Thanks CSPC physiotherapy for getting me back to my best – super quickly!



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