Top symptoms patients might not expect during pregnancy

October 1, 2019

Robyn Horsager-Boehrer, M.D. Obstetrics and Gynecology

Hip and joint pain and trouble sleeping are just a few of the unanticipated effects of pregnancy that a lot of women encounter.

Food cravings. Morning sickness. Swollen feet. Many pregnant patients expect these normal pregnancy symptoms thanks to stories and education from friends and Ob/Gyns.

But some pregnancy symptoms are not so well-discussed because they’re less noticeable to others or potentially scary – or because some women might simply feel weird talking about them.

Many pregnant patients come see us with concerns about these unexpected, but fairly common pregnancy symptoms.

Let’s discuss what you might not expect when you’re expecting, as well as a few signs that something might be wrong.

Related reading: Debunking 5 common pregnancy myths

Normal pregnancy symptoms you might not expect

Hip and joint pain

The further your pregnancy progresses, the more weight you'll carry. Similar to gaining weight outside pregnancy, additional weight adds pressure on the joints – to the tune of 4 lbs. of pressure on the knees for every 10 lbs. of extra weight a patient carries.

As your abdomen grows and the baby drops lower toward the pelvis, your hips will spread, which can lead to sore joints. Also, it likely will cause you to walk differently, which can cause aches and pain.

Ice and rest can go a long way to manage symptoms. Most women can safely take acetaminophen or ibuprofen according to the label instructions.

Trouble sleeping

There are two overarching reasons for sleep issues during pregnancy: physical and emotional.

Physically, your growing belly might make it uncomfortable to sleep in your favorite position. Many patients resort to sleeping on one side with one pillow between their knees and one under the baby bump for support.

And let’s not forget what sits below your growing belly – your bladder. The further along your pregnancy progresses, the more frequently you will likely wake up at night to use the bathroom. Some patients also might experience heartburn, leg cramps, or restless leg syndrome that keeps them awake.

During pregnancy, your hormone fluctuations can cause insomnia, or difficulty falling asleep even when you’re exhausted. Worrying about the baby or daily responsibilities can also make it tough to get enough rest.

Sleep is important for everyone’s health, especially during pregnancy. Check out “How pregnant moms can get better sleep” for tips to catch more Zzzs.

Skin problems and itching

The skin over your abdomen will stretch during pregnancy, and as it does, it might become itchy.

Skin conditions such as dermatitis and eczema are caused by hormone changes. Approximately half of patients who had eczema prior to pregnancy will experience worsening of their symptoms, while approximately 25% will see their eczema improve.

It's also common for pregnant women to develop skin irritation from friction caused by clothing that doesn't fit the way it once did.

Topical creams or ointments, either prescribed or over-the-counter, can alleviate itching and redness. Typically, these conditions clear up after delivery.

Postpartum hair loss

Taking prenatal vitamins, as well as additional estrogen from pregnancy, stimulates hair growth and fullness. So, when you stop taking them, the extra hair is likely to fall out.

It might look as if you are losing handfuls of hair at a time, but it's probably not as much as it seems. If you're concerned, talk with your doctor about diet or supplement changes to maintain your mane.

Tummy troubles

The bigger the abdomen expands, the less room there is for your intestines and stomach to function properly. So, you might experience GI issues such as nausea, increased or new heartburn, constipation, or diarrhea.

Most patients can use over-the-counter remedies such as laxatives, anti-diarrheals, and antacids according to the label instructions. If these don't provide symptom relief in a few days, see your doctor. You might have a stomach bug or gastroesophageal reflux disease (GERD), which is characterized by persistent heartburn.

When to see a doctor

Craving non-food items

Also known as pica, craving non-food items might sound bizarre, but it's a real and potentially dangerous eating disorder. Pica is Latin for magpie, a bird known for eating almost anything.

We’ve had patients who craved a range of non-food items, such as:

Chalk
Dirt
Hair
Paint chips
Rocks

Eating non-food items can cause serious health issues, from oral infections to blood and digestive issues, as well as potential pregnancy complications.

If you suspect you have pica, don’t be embarrassed – see your Ob/Gyn right away. Your doctor will recommend tests to make sure any items ingested have not harmed you or the baby. Tests might include blood work to check for iron-deficiency anemia or imaging to check for potential gastric blockages.

Related reading: Why women should 'pump iron' during pregnancy

Bleeding

In early pregnancy, light spotting is fairly common. However, heavy bleeding – as much or more blood as you might expect during a period – at any time during the pregnancy can indicate a problem.

After delivery, if you feel like you are bleeding too much or if you notice clots (lumps or clumps in the blood) or feel like something just isn't right, seek emergency obstetric care. You might be having a hemorrhage, which is excessive bleeding that can lead to serious complications such as iron deficiency, heart failure, or death.

Excessive fatigue

Feeling more tired than usual is normal during pregnancy, but feeling excessively tired can be a sign of infection or it could be related to an underlying condition.

Rarely, a heart condition called peripartum cardiomyopathy can arise during pregnancy that can affect the heart’s ability to pump blood. This condition occurs in approximately 1 in 2,000 to 3,000 pregnancies, causing ongoing fatigue, shortness of breath, and eventual heart failure.

Depression symptoms

Postpartum depression is a commonly recognized condition, but more and more we are talking with patients about depression during pregnancy. Depression can cause feelings of sadness, loss of appetite, lethargy, or sleep disturbance. In severe cases, patients might experience thoughts of self-harm or suicide.

Some patients might be diagnosed with depression for the first time during pregnancy. Those who have been previously diagnosed might experience different or worse symptoms due to hormonal or emotional changes.

Patients who take depression medication often are concerned about how the drug can affect the pregnancy. If you have depression, continue to take your medication and discuss any concerns with your doctor. Dosage changes or switching to another drug might be an option to control your symptoms while reducing potential effects on the pregnancy.

Vomiting after the first trimester

Vomiting after 16 weeks of pregnancy often indicates a viral or bacterial infection. In these cases, we’re concerned about maternal hydration and nutrition, as well as illness that could affect both the patient and the pregnancy.

Depending on the condition, the doctor might recommend anything from rest to medication deemed safe for pregnancy. More serious issues such as blood infections or extreme dehydration might require admission to the hospital.