Q. I have found that I am not sleeping as well since I became pregnant. I also find I am more constipated than usual which is now giving me hemorrhoids. What can you suggest?
A. Sleep is something many of us cherish and a first time mother-to-be may understand the importance of getting good rest now before the many disruptions that may arise upon the arrival of their newborn. As your baby grows, so does the potential bloating, frequent urination and leg cramps which are common reasons pregnant women have difficulty sleeping. Try some of these relaxing non-drug methods to help assist you with a good night sleep.
· Have a warm bath
· Listen to calming music
· Read (but you might want to avoid a riveting page turner)
· Don’t go to bed until you are sleepy tired
· If not asleep within 20 minutes, get out of bed and continue to read or listen to music until you are sleepy tired
· Though exercise is good for you, doing so right before bedtime can stimulate you
What is promising is that sleeplessness (insomnia) will not be harmful to yourself or the baby directly. It may, however, give you a sense of impairment and make you more at risk of daytime drowsiness so be mindful of your activities. If the above non-pharmacological measures are not helping your sleep issues, consult your healthcare provider to discuss options.
On another note, while you have an incredible being growing inside you for many months, you may experience some unwanted effects such as constipation. In fact, 25-30% of pregnant women complain of constipation in the later stages of their pregnancy and after birthing their child.
There are a few reasons for this ailment.
Firstly, the changes to your hormones may slow your digestion process which ultimately can result in bowel movement issues.
Secondly, as your baby grows bigger, there is less room for your digestive system to perform.
Thirdly, some of the important minerals (calcium and iron) that pregnant women take are known culprits of causing constipation. The best way for constipation to be corrected is by enhancing your natural fibre in your diet through fruits (apples, pears and prunes are fabulous choices), vegetables, whole grains and other high fibre foods. Many of us do not consume enough fibre in our diet. It is suggested that pregnant women aim for 28 grams of fibre daily while the rest of the population should be looking to have 25-38 grams of fibre each day. You might want to increase your fibre slowly to avoid any unpleasant bloating and/or abdominal pain that may accompany the initial addition of fibre to our diet.
Drinking plenty of water helps ensure your bowels can be passed easier. Water is also crucial to prevent dehydration during your pregnancy and also to improve your milk production if you plan on breastfeeding your baby afterwards. Consider drinking 2 to 3 litres (8-12 cups) of water daily to improve your overall health during and after your pregnancy.
Gentle/moderate exercise has been shown to help your bowels to move. If you have not been exercising, consider walking each day for 20 minutes. Check with your healthcare provider before starting a new exercise routine to make sure it is right for you.
When the above methods do not ease your constipation, you may wish to try some treatments that are safe for you during your pregnancy.
- Docusate is often tried but there is little evidence to support its use. Though it is safe to take during pregnancy, it doesn’t appear to be as effective as many hoped it would be
- Lactulose is safe and effective but may cause bloating and gas
- PEG (polyethylene glycol) is also safe and effective but may give you abdominal cramps
- Milk of magnesia can be tried but may pose a risk during mid to late pregnancy due to it causing sodium retention
- Some options that family and friends may encourage you to try as they may used it themselves are mineral oil and castor oil. Since mineral oil can impair the absorption of fat soluble vitamins and castor oil may actually induce labour, we do not recommend these choices for pregnant women. Thankfully there are many better options available to try.
If the above regimens have failed, consult your healthcare provider for other options.
Hemorrhoids may result during pregnancy if constipation and the resulting strained bowel movements are not adequately treated. As well, the increased pressure your enlarged uterus puts on your body increases your risk of developing hemorrhoids. Thus, it should not be surprising to learn that 25-35% of pregnant women complain of hemorrhoids.
Pregnancy alone can lead to some unpleasantness as the baby grows and hemorrhoids, which can be extremely painful, can add to that discomfort. It is best to be proactive to reduce your risk by ensuring you have an adequate amount of fibre in your diet and a sufficient intake of fluid. You may wish to have a sitz bath 3-4 times daily to provide some relief. If you find yourself suffering from hemorrhoids, don’t be shy and suffer quietly. Consider making an appointment with your pharmacist as they may be able to assess and prescribe a suitable treatment.
For more information on this or any other topic, contact your pharmacist.
