context: You will be visited with various kinds of discomforts during pregnancy -- some fleeting, some more permanent. Some may occur in the early weeks, while others emerge closer to the time of delivery. Others may appear early and then go away, only to return later. Every woman's pregnancy is unique, so you may not experience all of the changes described in this article. As always, if you notice any changes that concern you, mention them to your health care provider. The pains listed below are considered a normal part of pregnancy. Most pregnant women will feel some changes in their breasts. Your breasts will increase in size as your milk glands enlarge and the fat tissue enlarges, causing breast firmness and tenderness typically during pregnancy's first and last few months. Bluish veins may also appear as your blood supply increases. Your nipples can also darken, and sometimes a thick fluid called colostrum may leak from your breasts. All of these changes are normal. Recommendations: Wear a bra that provides firm support. Choose cotton bras or those made from natural fibers. Get a bigger bra as your breasts become larger and fuller. Your bra should fit well without irritating your nipples. Try maternity or nursing bras, which provide more support and can be used after pregnancy if you choose to breastfeed. Try wearing a bra during the night. Tuck a cotton handkerchief or gauze pad into each bra cup to absorb leaking fluid. You can also buy nursing pads in the drugstore or maternity/baby store that fit into your bra. Make sure to change these pads as needed so your skin doesn't get irritated. Wash your breasts with warm water and mild soap that will not cause dryness. Feeling tired? That might be because your growing baby requires extra energy. Sometimes, it's a sign of anemia (low iron in the blood), which is common during pregnancy. Recommendations: Get plenty of rest; go to bed earlier and take naps. Keep a regular schedule when possible. Pace yourself. Balance activity with rest. Moderate exercise daily boosts your energy level. Ask your health care provider to test your blood routinely for anemia. It's very common -- and normal -- to have an upset stomach when you're pregnant. Chalk it up to pregnancy's hormonal changes. It usually happens early in pregnancy, while your body is adjusting to the higher hormone levels. Good news: Nausea usually disappears by the fourth month of pregnancy (although in some cases it can persist throughout the pregnancy). It can happen at any time of the day but may be worse in the morning, when your stomach is empty (that why it's called "morning sickness") or if you aren't eating enough. Recommendations: If nausea is a problem in the morning, eat dry foods like cereal, toast or crackers before getting out of bed. Try eating a high-protein snack such as lean meat or cheese before going to bed (protein takes longer to digest). If you are hungry but extremely nauseated, try the BRAT (bananas, rice and tea) diet as well as bland foods. Seabands offer some pregnant women comfort. Ginger may combat nausea. Eat small meals or snacks every two to three hours rather than three large meals. Eat slowly and chew your food completely. Sip on fluids throughout the day. Avoid large amounts of fluids at one time. Try cool, clear fruit juices, such as apple or grape juice. Avoid spicy, fried, or greasy foods. If you are bothered by strong smells, eat foods cold or at room temperature to minimize or avoid odors that bother you. Talk to your doctor about taking vitamin B6. Other natural treatments and prescription medications can provide relief. Contact your health care provider if your vomiting is constant or so severe that you can't keep fluids or foods down. This can cause dehydration and should be treated right away. Your growing uterus and baby press against your bladder, causing a frequent need to urinate during the first trimester. This will happen again in the third trimester, when the baby's head drops into the pelvis before birth. Recommendations: Don't wear tight-fitting underwear, pants, or pantyhose. If your urine burns or stings, it could be a sign of urinary tract infection. Contact your health care provider right away to treat it. Headaches can happen anytime during pregnancy. They can be caused by tension, congestion, constipation, or in some cases, preeclampsia (detected after 20 weeks). Recommendations: Put an ice pack on your forehead or the back of your neck. Rest, sit, or lie quietly in a low-lit room. Close your eyes and try to relax your back, neck, and shoulders. Over-the-counter acetaminophen like Tylenol may help. But if your headaches don't go away, are severe, make you nauseous, or affect your vision, tell your doctor. You may not have expected pregnancy to affect your mouth. But your blood circulation and hormone levels can make your gums tender and swollen, and you may notice they bleed more easily. You may also develop nose bleeds. Recommendations: Get a dental checkup early in your pregnancy to make sure your teeth and mouth are healthy. See your dentist if you notice a particular problem. Brush your teeth, floss regularly and rinse daily with an antiseptic mouthwash. Constipated? It can happen during pregnancy for a couple of reasons. Your hormones, as well as vitamins and iron supplements, may cause constipation (difficulty passing stool or incomplete or infrequent passage of hard stools). Pressure on your rectum from your uterus may also cause constipation. Recommendations: Add more fiber (such as whole grain foods, fresh fruits, and vegetables) to your diet. Drink plenty of fluids daily (at least 6-8 glasses of water and 1-2 glasses of fruit or prune juice). Drink warm liquids, especially in the morning. Exercise daily. Avoid straining when you have a bowel movement. Discuss the use of a laxative or stool softener with your health care provider. Dizziness can occur anytime during middle to late pregnancy. Here's why it happens: The hormone progesterone dilates blood vessels so blood tends to pool in the legs. More blood is also going to your growing uterus. This can cause a drop in blood pressure, especially when changing positions -- and that can make you dizzy. If your blood sugar levels get too low, you may feel faint. Recommendations: Move around often when standing for long periods of time. Lie on your left side to rest. This helps circulation throughout your body. Avoid sudden movements. Move slowly when standing from a sitting position. Eat regular, small meals throughout the day to prevent low blood sugar. Drink plenty of water. Finding a comfortable resting position can become difficult later in pregnancy. Recommendations: Don't take sleep medication. Try drinking warm milk at bedtime. Try taking a warm shower or bath before bedtime. Use extra pillows for support while sleeping. Lying on your side, place a pillow under your head, abdomen, behind your back and between your knees to prevent muscle strain and help you get the rest you need. You will probably feel better lying on your left side; this improves circulation of blood throughout your body. Heartburn is a burning feeling that starts in the stomach and seems to rise up to the throat. During pregnancy, changing hormone levels slow down your digestive system, weaken the stomach sphincter, and your uterus can crowd your stomach, pushing stomach acids upward. Recommendations: Eat several small meals each day instead of three large meals. Eat slowly. Drink warm liquids. Avoid fried, spicy, or rich foods, or any foods that seem to give you indigestion. Don't lie down right after eating. Keep the head of your bed higher than the foot of your bed. Or, place pillows under your shoulders to prevent stomach acids from rising into your throat. Don't mix fatty foods with sweets in one meal, and try to separate liquids and solids at meals. Try heartburn relievers such as Tums, Maalox, Titralac, Mylanta, Riopan, or Gaviscon. Hemorrhoids are swollen veins that appear as painful lumps on the anus. During pregnancy, they may form as a result of increased circulation and pressure on the rectum and vagina from your growing baby. Recommendations: Try to avoid constipation. Constipation can cause hemorrhoids and will make them more painful. Avoid sitting or standing for long periods of time; change your position frequently. Don't strain during a bowel movement. Apply ice packs or cold compresses to the area or take a warm bath a few times a day to provide relief. Avoid tight-fitting underwear, pants, or pantyhose. If you still need more help, consult your health care provider. Pregnancy may affect your circulation, which can enlarge or swell your legs' veins. Recommendations: Although varicose veins are usually hereditary, here are some preventive tips: Avoid standing or sitting in one place for long periods. It's important to get up and move around often. Avoid remaining in any position that might restrict the circulation in your legs (such as crossing your legs while sitting). Elevate your legs and feet while sitting. Exercise regularly. Wear support hose but avoid any leg wear that is too tight or constraining. Pressure from your growing uterus can cause leg cramps or sharp pains down your legs. Recommendations: Be sure to eat and drink foods that are rich in calcium (such as milk, broccoli or cheese). Wear comfortable, low-heeled shoes. Try wearing support hose, but avoid any leg wear that is too tight. Elevate your legs when possible; avoid crossing your legs. Exercise daily. Stretch your legs before going to bed. Avoid lying on your back, since the weight of your body and the pressure of your enlarged uterus can slow the circulation in your legs, causing cramps. Gently stretch any muscle that becomes cramped by straightening your leg, flexing your foot, and pulling your toes toward you. Massage the cramp or apply heat or a hot water bottle to the sore area. You may have a stuffy nose or feel like you have a cold. Pregnancy hormones sometimes dry out the nose's lining, making it inflamed and swollen. Recommendations: Apply a warm, wet washcloth to your cheeks, eyes, and nose to reduce congestion. Avoid using nasal sprays unless prescribed by your doctor because they can aggravate your symptoms. Drink plenty of fluids (at least 6-8 glasses of fluids a day) to thin mucus. Elevate your head with an extra pillow while sleeping to prevent mucus from blocking your throat. Use a humidifier or vaporizer to add moisture to the air. Take a warm shower or bath. Shortness of breath can happen due to increased upward pressure from the uterus and changes in physiologic lung function. Recommendations: When walking, slow down and rest a few moments. Raise your arms over your head (this lifts your rib cage and allows you to breathe in more air). Avoid lying flat on your back, and try sleeping with your head elevated. If prolonged shortness of breathing continues or you experience sharp pain when inhaling, contact your health care provider. You could have a pulmonary embolism (blood clot in the lungs). Stretch marks are a type of scar tissue that forms when the skin's normal elasticity is not enough for the stretching that occurs during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks or thighs. Though they won't disappear completely, stretch marks will fade after delivery. Stretch marks affect the surface under the skin and are not preventable. Recommendations: Be sure that your diet contains enough sources of the nutrients needed for healthy skin (especially vitamins C and E). Apply lotion to your skin to keep it soft and reduce dryness. Exercise daily. Pressure from your growing uterus on the blood vessels carrying blood from the lower body causes fluid retention. The result is swelling (edema) in the legs and feet. Recommendations: Try not to stay on your feet for long periods of time. Avoid standing in one place. Drink plenty of fluids (at least 6-8 glasses of fluids a day). Avoid foods high in salt (sodium). Elevate your legs and feet while sitting. Avoid crossing your legs. Wear loose, comfortable clothing; tight clothing can slow circulation and increase fluid retention. Don't wear tight shoes; choose supportive shoes with low, wide heels. Keep your diet rich in protein; too little protein can cause fluid retention. Notify your health care provider if your hands or face swell. This may be a warning sign of preeclampsia. Rest on your side during the day to help increase blood flow to your kidneys. Normal vaginal secretions increase during pregnancy due to greater blood supply and hormones. Normal vaginal discharge is white or clear, isn't irritating, is odorless, and may look yellow when dry on your underwear or panty liners. Recommendations: Choose cotton underwear or brands made from natural fibers. Avoid tight-fitting jeans or pants. Do not douche. Douching can introduce air into your circulatory system or break your bag of waters in later pregnancy. Clean the vaginal area often with soap and water. Wipe yourself from front to back. Contact your health care provider if you have burning, itching, irritation or swelling, bad odor, bloody discharge, or bright yellow or green discharge (these symptoms could be a sign of infection). Backaches are usually caused by the strain put on the back muscles, changing hormone levels, and changes in your posture. Recommendations: Wear low-heeled (but not flat) shoes. Avoid lifting heavy objects. Squat down with your knees bent when picking things up instead of bending down at the waist. Don't stand on your feet for long periods. If you need to stand for long periods, place one foot on a stool or box for support. Sit in a chair with good back support, or place a small pillow behind your lower back. Also, place your feet on a footrest or stool. Check that your bed is firm. If needed, put a board between the mattress and box spring. Sleep on your left side with a pillow between your legs for support. Apply a hot water bottle or heating pad on low setting to your back, take a warm bath or shower, or try massage. Perform exercises, as advised by your health care provider, to make your back muscles stronger and help relieve the soreness. Maintain good posture. Standing up straight will ease the strain on your back. Contact your health care provider if you have a low backache that goes around your stomach and does not go away within one hour after you change position or rest. This might be a sign of premature labor. Sharp, shooting pains on either side of your stomach may result from the stretching tissue supporting your growing uterus. These pains may also travel down your thigh and into your leg. Recommendations: Change your position or activity until you are comfortable; avoid sharp turns or movements. If you have a sudden pain in your abdomen, bend forward to the point of pain to relieve tension and relax the tissue. Apply a hot water bottle or heating pad to your back, or take a warm bath or shower. Try a massage. Make sure you are getting enough fluids. Take Tylenol (acetaminophen) occasionally. Contact your health care provider if the pain is severe or constant or if you are less than 36 weeks pregnant and you have signs of labor. ( Signs of labor include repetitive cramping like contractions.) The uterine muscles will contract (tighten) starting as early as the second trimester of pregnancy on. Irregular, infrequent contractions are called Braxton- Hicks contractions (also known as "false labor pains"). These are normal during pregnancy. Recommendations: Try to relax Change positions. Sometimes this can ease the contractions. Call your doctor if they do not go away.