In the movies, the first clue a woman is pregnant is when she darts out of bed, clutches her stomach and runs for the bathroom. But there are many lesser known pregnancy symptoms that rival morning sickness - which, by the way, doesn't only strike in the morning.
"I've been thinking about what I've been going through that Mom never told me about," says Erika Shapiro, an administrative assistant who is expecting her first child. Three months into her pregnancy, she has already experienced plenty of surprises. "I've heard of morning sickness, but nobody ever told me that brushing my teeth would bring it on," she tells WebMD. "I want to make sure all my friends hear the truth when they get pregnant."
WebMD is here to help. We checked with the experts to create an uncensored list of pregnancy symptoms you might not be expecting:
"All Day" Sickness
Morning sickness is probably the best known of the early pregnancy symptoms, but many people don't realize the term is inaccurate. "Morning sickness can strike at any time of day," says Michael K. Lindsay, MD, MPH. Lindsay heads Emory University's Division of Maternal Fetal Medicine. He tells WebMD nausea may be more common in the mornings because stomach acids build up overnight. But most women who get morning sickness also feel nauseous at other times of day.
Even before the nausea kicked in, Shaprio developed "an extremely-heightened sense of smell." Scents were so over-powering, the Shapiros avoided cooking for several weeks, relying instead on bland take-out. "Pizza, teriyaki chicken, and eggs were just some of the foods that were too much for my nose to handle," Shapiro says.
"Massive changes in all body systems can cause overwhelming tiredness," says midwife Elizabeth Stein, CNM, owner of Ask Your Midwife, PC. She points to higher levels of progesterone, along with changes in blood production, metabolism, heart rate and breathing. The sense of exhaustion can be so intense that concentration suffers, Stein tells WebMD.
Shapiro knows the feeling. "I'm usually very organized... This morning [my boss] had a meeting, and I completely forgot to print the documents he needed. It's embarrassing to think about."
Fatigue tends to be most common in the first trimester, Lindsay says, but often occurs later in pregnancy as well. Carrying around all that extra weight can make you tire easily in the third trimester. In addition, you may have trouble sleeping if your growing belly makes it hard to get comfortable. Lindsay recommends that expectant moms with severe fatigue be evaluated for anemia and depression.
Frequent urination is another early pregnancy symptom most expectant moms know all too well. The culprit is often hormonal in the earlier stages. Later in the pregnancy, frequent bathroom breaks are often caused by an enlarged uterus (and the rapidly growing baby inside) putting pressure on the bladder.
Many women find they gain a bra size or two during their pregnancy. (For better or worse, the change is usually not permanent.) The swelling, which signals an increase in fat reserves and milk gland size, may be accompanied by soreness.
Here's one pregnancy symptom your mom may not have warned you about - you're likely to get constipated, especially in the late second and third trimesters. According to Lindsay, constipation may result from a number of factors:
- Changes in digestion caused by the hormone progesterone
- Increased water absorption in the large intestines
- Iron supplements
- Pressure of the uterus on the rectum
Also common in the second and third trimesters is heartburn, a burning sensation between the breastbone and the throat. Lindsay says progesterone is once again to blame. The hormone relaxes the sphincter at the bottom of the esophagus, allowing gastric acid to come up. Lindsay's tips for easing heartburn:
- Avoid spicy foods
- Don't eat immediately before lying down
- Elevate the head of the bed -- try blocks under the head of the mattress
- Take antacids (Check with your doctor or midwife first.)
Seasonal allergies and asthma may become unpredictable during pregnancy. Stein tells WebMD some women see their symptoms improve, while others notice the opposite. She says expectant moms with asthma generally should continue using their inhalers. "If you don't breathe, your baby won't either."
Changes in Balance
In the third trimester, many women find they are perpetually off-balance. "This change happens later in pregnancy, but I notice very few women expect it," Stein tells WebMD. While a growing belly tends to throw off your center of gravity, there's more to it than that. "A hormone called relaxin kicks in toward the end of pregnancy," Stein explains. "Its main purpose is to loosen the pelvic joints so they are more flexible during labor. But this hormone also works on the hips, knees and ankles. This makes [expectant mothers] more wobbly and achy and likely to fall."
Abnormal Pregnancy Symptoms
With so many changes taking place in your body, you may be tempted to dismiss any new discomfort as normal during pregnancy. But certain symptoms could signal a serious problem:
- Bleeding or spotting - According to Lindsay, "bleeding or spotting is never felt to be normal during pregnancy." Spotting is common in the first trimester and probably not a cause for alarm. However, in the second and third trimester, bleeding could provide advance warning of a serious complication, such as preterm labor or problems with the placenta. Always report any bleeding or spotting to your doctor or midwife.
- Severe itching - In the late second and third trimester, severe itching may signal a rare liver problem that sometimes develops during pregnancy, known as intrahepatic cholestasis. "This condition requires increased fetal surveillance and early delivery," Lindsay says.
- Blurred vision, severe headaches and pain in the right side of abdomen - These symptoms, whether they occur alone or in combination, may indicate severe preeclampsia - the medical term for dangerously high blood pressure during pregnancy. "Women who experience any of these symptoms should contact their health care provider immediately," Lindsay advises. Early delivery may be necessary "to avoid life-threatening maternal and fetal complications."
Next Time Around
You may be wondering whether your pregnancy will be similar the next time around. Stein says you are no more or less likely to experience troubling pregnancy symptoms when a second or third child is on the way. But you may be too busy to dwell on the little things, she adds, "Since you'll be taking care of one child and growing another."