Pregnancy is an exciting time—and there’s a lot to know. For those who wanted, planned and made it happen, it’s an amazing thing when that double line appears. And throughout the 36 remaining weeks, there are a lot of “shoulds” around your feelings.

One of the biggest? That through it all—during the nausea, heartburn, shortness of breath, leg cramps, varicose veins and so many other uncomfortable side effects of growing an entire person—you should feel grateful to be pregnant. Well, you can certainly feel grateful and frustrated by the bodily discomforts that are mostly out of your control. But knowing which are normal can give you a little peace of mind and make them (hopefully) easier to tolerate.

Common symptoms in the first trimester of pregnancy (weeks 1-13)

By the time you miss your period, you’re already four weeks pregnant since the start of pregnancy is measured from the first day of your last period. Symptoms may have even given it away before you confirmed it with a test.

What are the symptoms of first trimester pregnancy?

  • Sore breasts – With increased levels of estrogen and progesterone, the enlargement of breast tissue and heightened sensitivity can cause breast tenderness even before a missed period. This indicates your body is adapting to support the developing pregnancy.

Relief: Wear a supportive (likely larger) bra, preferably without underwire. Applying warm or cold compresses can also provide relief.

  • Nausea – Elevated hormone levels, especially human chorionic gonadotropin (hCG), are the likely culprit behind “morning sickness” because of their effect on the digestive system. For many, nausea and food aversions (which can occur any time, contrary to popular belief) peak around week nine and often subside by the second trimester.

Relief: Eat smaller, more frequent meals (even when you really don’t want to eat) and stay hydrated. If you have severe nausea, your provider may be able to prescribe a medicine to help.

  • Fatigue – Increased progesterone levels create a sense of drowsiness that can make getting through the day feel like passing through a thick fog. Fatigue in pregnancy is incredibly common and sometimes debilitating.

Relief: For coping with fatigue, nap as much as you can, drink plenty of water and maintain a balanced diet with essential nutrients. But really, sometimes it’s just riding it out.

  • Headaches – Headaches are a natural result of the hormonal changes your body experiences, with fatigue, tension, increased hunger or stress increasing the frequency. If you have a headache that is different from your usual headache or is accompanied by visual changes or high blood pressure, call your provider.

Relief: Aspirin, ibuprofen and most migraine medications aren’t recommended during pregnancy; however, you can take Tylenol (acetaminophen) if that helps. Follow the dosing recommended by your provider during pregnancy. Also try to avoid fatigue, dehydration and low blood sugar by getting plenty of rest and having water and snacks handy. Try including a little protein in your snacks and applying a compress to the forehead or base of the skull or taking a cool shower.

  • Constipation – Elevated levels of progesterone slow down bowel movements, leading to increased water absorption and firmer stools, aka, making it harder to go.

Relief: Stay hydrated, eat fiber-rich foods and consider gentle exercises. Try not to…push it. Too much straining can increase the risk of hemorrhoids. You can also try a fiber supplement, such as Metamucil or Fiber Con (psyllium), stool softeners such as Colace (docusate), Milk of Magnesia (MOM), polyethylene glycol (Miralax), or glycerin suppositories. Read product directions for dosing.

  • Hormonal mood changes – Fluctuating levels of estrogen and progesterone throughout pregnancy greatly impact mood regulation. Tears feel close to the surface, alongside irritability, making big feelings of all kinds common and sometimes surprising, even to you.

Relief: Accept and recognize this as a normal part of pregnancy and seek support from loved ones (or alone time) when you need it.

Common symptoms in the second trimester of pregnancy (weeks 14-28)

For many, the second trimester can feel like the “honeymoon phase” of pregnancy as first-trimester symptoms subside. But that doesn’t mean symptoms disappear altogether, and new ones show up, too. Symptoms from the first trimester that can continue to make an appearance into the second include headaches, constipation and hormonal mood changes.

What are the symptoms of second trimester pregnancy?

  • Heartburn – Heartburn in pregnancy is primarily caused by increased progesterone, which relaxes the lower esophageal sphincter, allowing stomach acid to reflux into the esophagus. Growing pressure from the expanding uterus also contributes, which is why you may have heartburn throughout the entirety of your pregnancy.

Relief: For heartburn relief, eat smaller meals, avoid trigger foods (such as spicy or fried foods) and sit upright after eating. You can also use over-the-counter medications like Tums (calcium carbonate); liquid antacids (Mylanta, Mylicon, Riopan); Pepcid (famotidine); or Tagamet (cimetidine). Read product directions for dosing.

  • Frequent urination – Increased blood flow to the kidneys and an expanding uterus that presses on the bladder cause pregnant people to pee more often and lead to the “urge to go” even if not much comes out.

  Relief: Use the bathroom! While many like to poke fun, remember your organs are literally shifting to make room for a small human, so use the bathroom frequently without fear of judgment.

  • Pelvic pain – Cramp-like pain without bleeding–as though your period is about to begin–is likely the uterus expanding and increasing pressure on the pelvic floor. The hormone relaxin also contributes to joint and ligament laxity. If the pain does not resolve or is accompanied by bleeding, call your provider.

Relief: Some tips for pelvic pain include maintaining good posture (tucking your belly in while walking), using a support pillow while sitting and practicing gentle stretches. Warm baths, prenatal yoga and wearing a pelvic support belt can also provide relief.

  • Back pain – As the belly grows, the lower spine curls to accommodate extra weight. The expanding uterus also shifts your center of gravity forward, which puts more pressure on your spine. Sometimes back pain in pregnancy can be indicative of preterm labor. So if you are having intermittent or crampy back pain, and rest and hydration don’t make it better, call your provider.

Relief: Heating pads and warm (but not hot) baths can help you deal with back pain during pregnancy. For prevention, wear shoes with proper arch support, avoid heavy lifting, or lift with your knees to avoid any injuries. Massage, physical therapy, acupuncture and chiropractic adjustments are safe during pregnancy, and you can also try acetaminophen.

  • Abdominal aches and itchiness – Sometimes referred to as growing pains, the ligaments supporting the uterus can cause aches and sharp pains on one or both sides of the abdomen as the uterus grows. Unless fever, bleeding, light-headedness, vaginal discharge or chills accompany this pain, it’s a normal part of pregnancy. Itchiness along the abdomen is also common from your skin drying out as it expands. If you experience sudden weight gain in other parts of your body, those areas are likely to itch, as well.

Relief: Gentle exercises and stretching, and bending into the sudden pangs, can bring relief. Keeping hydrated and relaxing in warm baths also helps. For itchiness, apply a moisturizer after toweling off, avoiding those that contain alcohol and fragrance.

Common symptoms in the third trimester of pregnancy (weeks 29-40)

The final months of pregnancy include rapid growth as the fetus triples in size or more, causing new symptoms as your body adjusts to make room. Heartburn, frequent urination, constipation, pelvic pain and back pain from the second trimester can also continue and worsen.

What are the symptoms of third trimester pregnancy?

  • Shortness of breath – Your growing uterus displaces the diaphragm and reduces your lung capacity. Combine that with the 45% increase in your body’s blood volume, making your heart work even harder, and it’s no wonder you get winded going up a couple of steps.

Relief: Practice good posture, take breaks and discuss persistent or severe symptoms with your provider.

  • Swelling – Swelling during pregnancy is due to a normal accumulation of fluids and commonly appears in the legs, ankles and feet. If you experience sudden swelling in your face and hands, call your provider right away, as this can be a sign of preeclampsia.

Relief: The best remedy for swollen feet might seem counterintuitive: drink plenty of water. Also, avoid salty foods and eat those that are natural diuretics (like asparagus, Brussels sprouts, beets, oats, cabbage, carrots, lettuce and tomatoes). Keeping cool and propping up your feet also helps.

  • Spider veins, varicose veins and hemorrhoids – Increased blood volume and pressure from the growing uterus, along with hormonal changes, contribute to vein relaxation—a nice-sounding term for a range of discomfiting physical changes.

 Relief: Regular exercise and elevation may help manage these usually-temporary conditions, but know that those like varicose veins may be genetic.

  • Difficulty sleeping – Lovingly referred to as “pregnancy insomnia,” a restful night’s sleep is hard to accomplish in pregnancy thanks to discomfort from the growing belly and increased urination frequency. Stress and anxiety about becoming a parent or welcoming another child don’t help either.

Relief: To sleep better during pregnancy, try establishing a relaxing bedtime routine and using supportive pillows under your bump, behind your back and/or between your knees.

  • Braxton Hicks contractions – These “practice” contractions feel like a pressure and tightening of the pelvis. Usually sporadic and rarely painful, Braxton Hicks contractions are sometimes associated with dehydration. They also may involve only portions of the uterus, rather than the entire belly. Unless you feel more than four contractions per hour for two hours, they should be considered normal.

Relief: Managing Braxton Hicks contractions is annoyingly good practice for labor. Stay hydrated, change positions and practice your breathing.

  • Vaginal pain – Sharp, piercing and sudden vaginal pain can often be a sign that your cervix is dilating—and that your baby is on the way! This pain can occur several weeks or just hours before labor, and it should be considered normal unless accompanied by pain in the lower abdomen. These jolts can be among the most painful you experience before labor, but they mean the end of your pregnancy is near.

Relief: Similar to Braxton Hicks contractions, now’s your time to practice labor breathing exercises to get through the painful moments. A warm shower may also offer relief.

This, unfortunately, is not an exhaustive list of every symptom, ache and pain you may experience throughout pregnancy, but it captures some of the most common ones. Every body and every pregnancy is different. So when it comes to what to expect, the answer may be…anything. What you experience in one pregnancy may be very different from what you experience in a subsequent pregnancy, inspiring many an after-hour call to the doctor’s office.

This is why if you’re pregnant or planning to become pregnant, we at Women’s Healthcare Associates want to make the experience as comfortable for you as possible by providing the information you need to best manage the symptoms you can–or at least take comfort in knowing what’s normal. Find an OB/GYN physician or certified nurse-midwife provider to join you on your journey here. We also have your back during the postpartum period, too.