Pregnancy and parenthood can be akin to being on an emotional rollercoaster with twists, turns and highs and lows aplenty. This article looks at some of the challenges expectant mothers can face and how to overcome them

In the run up to childbirth and becoming a mum, a woman faces a huge learning curve in a very short space of time. There is much to learn and many changes to accommodate as well as the prospect of childbirth to prepare for. And while much of the focus during pregnancy tends to be on giving birth, this is just the beginning of the 24/7 business of being a mother. A newborn baby is a thing of wonder, for sure, but it also represents a seemingly never-ending challenge.

Physically, there is a lot for women to cope with when they are pregnant. A rapidly changing body, along with morning sickness, constipation, indigestion, cramp and tiredness, are just some of the minor conditions that can take their toll. Then there is the rollercoaster of emotions about bringing a new life into the world and caring for a new baby. It’s no surprise that mums can feel overwhelmed and consumed with worry about staying healthy during pregnancy as well as the life-changing responsibility of becoming a parent.

An informed choice

The thought of childbirth makes many pregnant women feel afraid, says Elizabeth Duff, senior policy adviser for the National Childbirth Trust. “Worrying about giving birth is normal – every pregnant woman, even the most confident, has some degree of concern about what it will feel like, how she will manage, and what might happen. The more a woman finds out about pregnancy, the less likely she is to worry needlessly.”

Elizabeth says women can prepare themselves and their partners by going to antenatal classes, where they will get information about all aspects of pregnancy, childbirth and looking after a baby. Physically, they can prepare by looking after their health, eating a balanced diet, cutting out alcohol and smoking, and taking regular exercise. Beverley Beech, honorary chair of the Association for Improvements in the Maternity Services, says:

“I think women are very worried about childbirth. These days it’s seen as a risky thing and very painful – this is what the images on TV programmes like One Born Every Minute show them.” She says home birth rates have barely risen above two per cent in recent years, indicating that still too many women are being encouraged to have their babies in hospital where epidural rates are high and a quarter of babies are born by caesarean section.

Beverley recommends that women carefully research the type of birth they want on reputable websites like the Which? BirthChoice website, created in partnership with BirthChoiceUK and supported by the Royal College of Midwives. This site gives expectant mothers information to help them plan the birth they want.

Research conducted by Which? prior to launching the site found that half of mothers knew nothing or not much about the different types of maternity units available to them and a third said the same about the amount of choice they had about where to give birth. Elizabeth adds: “The more choice a woman has about the birth, the more she will feel in control of the event. If she can choose where she’s going to give birth, who’s going to be there, what sort of pain relief she can have, etc, then she is far more likely to feel confident about the birth itself.”

Anxious and lonely

After the birth, many new mums feel isolated because they don’t have the traditional network of friends and family to support them. Mervi Jokinen, practice and standards professional advisor at the Royal College of Midwives, says: “The loss of these support networks is a potentially serious problem, both practically and emotionally for women. Our research shows that many new mothers do not get the level of postnatal care they need and this is having a negative impact.”

Feeling isolated can cause postnatal depression, a fact supported by half of 1,500 mums who had suffered from depression during or after pregnancy and over 2,000 health professionals surveyed for a report published last year by the Netmums website. Julia McGinley, director of support at Netmums, says: “Isolation is definitely an issue for new mums. Many of them now log on to our forums to share problems that in the past they would have shared with their mum or granny. Sadly some of them post comments like ‘I don’t like being a mum as much as I thought I would do’. They want to know if their feelings are normal.”

Around one in 10 new mothers develop postnatal depression. It often starts within one or two months of giving birth and symptoms include low mood, feeling unable to cope and difficulty sleeping.

Postnatal depression tends to be a temporary condition and women usually recover with treatment such as talking therapies, cognitive behavioural therapy and/or antidepressant medication. Self-help measures include getting plenty of rest, taking regular gentle exercise, eating regularly to prevent blood sugar levels falling, abstaining from alcohol and eating a healthy, balanced diet.

Alison Baum, chief executive of the charity Best Beginnings, which provides resources to ensure families have the information and support they need to protect their children’s health, says new mums can feel anxious. “Pharmacy assistants have a hugely important role in acting as sounding boards for support and reassurance, and for suggesting helpful treatments for minor ailments both for pregnant women and in the early months of caring for their new babies,” she says.

Pregnancy problems

Pregnancy can come along with a number of common conditions. While often not serious, these can cause discomfort, pain and tiredness.

Constipation

Hormonal changes can cause constipation in pregnancy, particularly in the early months. Symptoms include abdominal discomfort, tummy cramps and wind in addition to pain when passing stools. To prevent and ease constipation, women should eat foods high in fibre, drink plenty of water and exercise gently.

If dietary and lifestyle changes do not work, a laxative may help. Laxatives that are usually safe to use during pregnancy include lactulose and macrogols, which are not absorbed by the digestive system and therefore do not affect the baby. However, pregnant customers should speak to the pharmacist or GP before trying any laxative. If these products do not work, the GP or pharmacist may recommend a small dose of bisacodyl or senna (not in the third trimester), which are stimulant laxatives.

Morning sickness

Nausea and vomiting in pregnancy, also known as morning sickness, afflicts many women in early pregnancy. Mums can be reassured that it doesn’t harm their baby, and usually clears up between weeks 12 and 14 of pregnancy.

If the sickness is severe, a GP or midwife may prescribe antisickness medication, but in most cases, morning sickness does not need any specific treatment. Some women, such as the Duchess of Cambridge, get a very severe form of nausea and vomiting called hyperemesis gravidarum, which needs specialist treatment, sometimes in hospital.

Self-help advice includes: get plenty of rest; eat dry toast or a plain biscuit before getting up if sickness occurs first thing in the morning; drink plenty of fluids and eat small, frequent nongreasy meals that are high in carbohydrate, such as bread, rice and pasta, and avoid smells that trigger nausea.

Indigestion

As many as eight out of 10 women suffer from indigestion during pregnancy. This is commonly due to acid reflux – when acid from the stomach leaks up into the oesophagus causing irritation. During pregnancy, indigestion can be triggered by hormonal changes, the lower oesophageal muscle relaxing, and in later pregnancy by the growing baby pressing on the stomach.

Symptoms include heartburn, discomfort, belching, bloating, regurgitation, nausea and vomiting.

Advise avoiding foods such as peppermint, tomatoes, chocolate, fatty and spicy foods, fruit juices, and hot drinks. Eating, smaller, more frequent meals may help. An antacid or alginate can also be recommended by a pharmacist.

If symptoms are troublesome the GP may prescribe ranitidine or omeprazole which are acidsuppressing medicines.

Cramp

Many women suffer from cramp in their legs during late pregnancy, usually at night. This is probably due to fluid retention and many women tend to have swollen legs too. Cramp causes sudden pain as the muscles in the leg suddenly become tight and painful. Stretching and massaging the muscle to undo the cramping will relieve the pain and stretching the calves before going to bed may help as well.

Baby’s first year: a whistle stop tour

A baby’s first year is often dramatic, full of milestones and will flash by in whirl of changes that will see them go from a tiny, helpless bundle to a mobile little person.

In the first four weeks of life, babies look at faces and start to recognise their parents, at four to six weeks they begin to smile, and by 12 weeks they should be able to lift their heads. At two to three months they will start to roll over and by three to five months will start to reach for objects.

At four to six months babies start to make noises, at five months can hold objects and at six months they develop hand-to-mouth coordination and should be starting to eat solids. Many babies are able to sleep through the night by four to six months and at around five to six months can sit up with support. At six to nine months teething starts and by eight months they are likely to be crawling.

Babies are ready to start feeding themselves by between nine and 12 months as they develop better control over their hands and fingers. They will start to pull themselves up at around eight months and by 11-12 months will begin to stand without support and will quickly progress to taking small steps while holding on to furniture or other objects. Some babies will be able to walk by their first birthday although the range for this milestone is anywhere from nine to 17 months.

The first year of a baby’s life will be full of memorable milestones

Pharmacy assistants have a hugely important role in acting as sounding boards for support and reassurance and for suggesting helpful treatments for minor ailments

Baby conditions

Babies are susceptible to a number of conditions:

Colic

Colic is the term for excessive, frequent crying in a baby who appears to be otherwise healthy and well fed. It is a poorly understood condition which usually begins within the first few weeks of life, but often stops by the time the baby is four months old, and by six months at the latest.

The baby will cry intensely for several hours, their face may become flushed and they may clench their fists, draw their knees up to their tummy, or arch their back.

Tips for soothing a colicky baby include: hold the baby during a crying episode; bathe the baby in a warm bath; gently massage the baby’s tummy; take the baby for a car or pram ride, and put on some background or ‘white’ noise.

Gripe water or a medicine containing simeticone can be recommended. If mum is breastfeeding, dietary changes may help, or if bottle-feeding, a change in milk is sometimes suggested. Mums should speak to the pharmacist for more information. 

Cradle cap

Cradle cap is a type of skin inflammation which mainly affects the scalp and face of babies. Symptoms include greasy, yellow, scaly patches on the scalp. Some babies may develop a rash on other areas of the skin.

Treatment is not usually needed, as the condition does not cause any discomfort and usually clears on its own after a few months. However, the scales can be softened through daily washing with a baby shampoo or baby oil gently rubbed into the child’s head followed by gentle brushing with a soft brush or sponge.

Eczema Eczema in babies is common and often starts between the ages of two and four months. Most babies will grow out of it. The symptoms are patches of red, dry and itchy skin on the face or behind the ears and in the creases of the neck, knees and elbows. It may be very itchy and can become infected if the baby scratches it.

An emollient cream can be applied to the skin several times a day to prevent the skin from becoming dry, and an emollient wash can be recommended for washing and bathing, instead of soap. Advise the parent to keep the child cool, avoid soap, baby bath and bubble bath, and to stick to cotton garments.

If the problem is more serious, a GP may prescribe a steroid cream.

Nappy rash

Most babies develop nappy rash at some time in their first 18 months. Nappy rash is a skin condition which can be caused by prolonged contact with urine or stools irritating the skin. There may be red patches on the baby’s bottom, or the whole area may be red.

The skin may look sore and feel hot to touch, and there may be spots, pimples or blisters.

Recommend using a treatment cream to clear the rash and a barrier cream at each nappy change to prevent it recurring.

Other tips for preventing nappy rash include: leave the nappy off as much as possible; change the nappy often; use cotton wool and water or baby wipes for sensitive skin to clean the skin; make sure the baby’s bottom is properly dry after washing, and do not use talcum powder.