Common Discomforts During the First Trimester

Discomforts during the First 3 months of Pregnancy

The First Trimester

Nausea and Vomiting

• Called as morning sickness, but it may occur anytime during the day.

Causes

• Hormonal changes;
• Fatigue;
• Emotional factors; and
• Changes in carbohydrates metabolism

Interventions

• Instruct the mother to avoid greasy, highly seasoned foods;
• Encourage her to eat small frequent meals;
• Advise her to eat dry toast or crackers before getting out of bed in the morning; and
• Suggest intake of complex carbohydrates with the onset of nausea.

Nasal Stuffiness, Discharge, or Obstruction

Causes

• Edema of the nasal mucosa from elevated estrogen levels

Interventions

• Encourage the use of a cool-moist humidifier;
• Suggest the use of normal saline nose drops or nasal spray; and
• Advise the mother to apply cool compress to the nasal area.

Breast Enlargement and Tenderness

Causes

• Increased estrogen and progesterone level

Interventions

• Encourage the use of a well-fitting bra with wide shoulder straps for support;
• Reinforce the need for maintaining good posture; and
• Advise the mother to wash her breast and nipple area with water only.

Urinary Frequency and Urgency

Causes

• Pressure of the enlarging uterus on the bladder
• Around the 12th week the  uterus rises into the abdominal cavity, causing symptoms to disappear; and
• Symptoms recur in the thir trimester as the uterus again presses on the bladder.

Interventions

• Suggest to the mother that she decrease her fluid intake in the evening to minimize nocturia (urinary frequency at night times);
• Encourage her to limit the intake of caffeinated beverages;
• Reinforce the need to promptly respond to the urge to void in order to prevent bladder distention and urinary stasis;
• Teach her how to perform Kegel's Exercises; and
• Teach her the signs and symptoms of urinary tract infection and instruct her to promptly report any she experiences.

Increased Leukorrhea (vaginal discharges)

Causes

• Hyperplasia of vaginal mucosa; and
• Increased mucus production by the endocervical glands.

Interventions

• Encourage the mother to bathe daily and avoid using soap on the vulvar area;
• Reinforce the need to wipe from front to back;
• Urger her to wear loose, absorbent cotton underwear and to avoid tight pants and pantyhose;
• Suggest the use of panty liners or perineal pads and frequent changing if discharges is bothersome;
• Caution her to avoid douching; and
• Instruct her to notify the health care provider immediately if the discharge changes in color or odor.

Increased Fatigue

Causes

• The increased effort of the body to manufacture the placenta; and
• The need to adjust to the many other physical and emotional demands of pregnancy.

Interventions

• Encourage frequent rest periods as much as possible;
• Offer suggestions to obtain rest during the day at home or at work;
• Encourage intake of a balanced diet with iron supplements;
• Suggest the use of warm milk or warm shower or bath before going to bed at night to aid in relaxation; and
• Advise engaging in moderate regular exercise.