Common Concerns for First-Time Mothers at 20 Weeks Pregnant

Questions of a First-Time Mother

I am currently 20 weeks pregnant, and the prenatal check-up indicated that I am having a baby boy.
The doctor mentioned that the baby weighs 346 grams, but I still have many questions that I don't quite understand.
I would like to ask the doctor for clarification:
1.
I am experiencing pain in my lower abdomen.
Could this be due to sitting for long periods?
2.
I often have soreness in my lower back, and sometimes when I massage it, I feel nauseous, which can lead to vomiting the next day, usually expelling yellow liquid (I have had two previous vomiting experiences, but I thought it was due to eating contaminated food, and I typically vomited undigested food).
3.
How can I differentiate between "uterine contractions" and "fetal movements"? I read online that noticeable uterine contractions could lead to preterm labor.
In my younger years, due to financial instability, I had three abortions within a month; could this make me more susceptible to preterm labor?
4.
Besides avoiding stimulants like cigarettes, alcohol, and coffee, what other foods should I avoid during pregnancy? A friend mentioned that I shouldn't eat cooling foods or chives, and I'm unsure about what I should be eating.
5.
Does taking prenatal vitamins affect digestion? Sometimes I go two to three days without a bowel movement; could it be that I'm not eating enough vegetables?
6.
Do I need to change my bed? Sometimes when I lie on my side for too long, I feel pain in my abdomen.
Is this because I'm pressing on the baby? I am currently sleeping on a mattress on the floor; could this impact the baby's development?
I kindly ask the doctor to take the time to respond.
Thank you, doctor!

Xiao Bei, 20~29 year old female. Ask Date: 2004/02/16

Dr. Zhan Deqin reply Obstetrics and Gynecology

1.
During pregnancy, it is common to experience discomfort or pain due to the enlargement of the uterus.
If the pain is severe or occurs regularly, it is best to consult your obstetrician.
2.
Lower back pain is also common because of the increased load on the back.
3.
Fetal movement is felt as the baby kicking, while uterine contractions are characterized by the uterus (belly) becoming very hard and painful.
If you place your hand on your belly and feel it hard or a lump, that indicates uterine contractions.
Multiple miscarriages can sometimes cause damage to the uterus.
4.
Maintain your usual diet, and also ensure you are consuming fruits and vegetables.
Occasional walks can help alleviate constipation, and it is advisable to limit tobacco, alcohol, coffee, and strong tea.
6.
If you have been lying on your side for a long time, it is important to change positions or switch sides.
Changing beds is not necessary, as the pressure is on the mother's pelvis and blood vessels, not directly on the fetus.

Reply Date: 2004/02/16

More Info

Congratulations on reaching the 20-week mark in your pregnancy! This is an exciting time as you begin to feel more connected to your baby. However, it’s also common to have concerns and questions, especially for first-time mothers. Let’s address your questions one by one.

1. Lower Abdominal Pain: Experiencing some discomfort in your lower abdomen can be quite normal during pregnancy. This pain is often due to the stretching of the ligaments that support your uterus as it grows. Prolonged sitting can contribute to discomfort, so it’s important to take breaks, stretch, and move around periodically. If the pain becomes severe or is accompanied by other symptoms like bleeding, you should contact your healthcare provider.

2. Lower Back Pain and Nausea: Lower back pain is also common during pregnancy due to the added weight and changes in posture. If you notice that massage triggers nausea or vomiting, it could be due to the pressure on your stomach or a reaction to the massage itself. If this continues, it might be worth discussing with your doctor to rule out any underlying issues.

3. Differentiating Between Contractions and Fetal Movement: It can be challenging to distinguish between Braxton Hicks contractions (practice contractions) and fetal movements, especially if you are experiencing both. Generally, fetal movements feel like gentle flutters or kicks, while contractions can feel like tightening or cramping in the abdomen. If you experience regular contractions before 37 weeks, it’s important to seek medical advice as this could indicate preterm labor. Your history of previous abortions does not necessarily increase your risk of early labor, but it’s always good to discuss your concerns with your healthcare provider.

4. Dietary Restrictions During Pregnancy: In addition to avoiding alcohol, caffeine, and tobacco, it’s advisable to steer clear of raw or undercooked meats, fish high in mercury (like shark and swordfish), unpasteurized dairy products, and certain soft cheeses. While some cultures advise against "cooling" foods, scientific evidence does not strongly support these claims. Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. If you have specific concerns about certain foods, consult your healthcare provider.

5. Impact of Sodium and Digestion: If you are experiencing constipation, it may be due to hormonal changes during pregnancy, which can slow down digestion. Increasing your intake of fiber-rich foods (like fruits, vegetables, and whole grains) and drinking plenty of water can help. If you’re concerned about sodium intake, it’s best to limit processed foods and focus on fresh ingredients.

6. Sleeping Position and Comfort: It’s common to feel discomfort when lying on your side for extended periods. If you’re feeling pain, it may be due to pressure on your abdomen or the weight of your growing uterus. Consider using pillows for support, such as placing one between your knees or under your belly. Sleeping on a firm mattress is generally recommended, but if you’re comfortable on the floor, it should not negatively impact your baby’s development. However, ensure you have adequate support to avoid back pain.

In summary, while many of your concerns are common among pregnant women, it’s essential to maintain open communication with your healthcare provider. They can provide personalized advice and reassurance based on your specific situation. Remember to take care of yourself, listen to your body, and don’t hesitate to reach out for help when needed. Wishing you a healthy and happy pregnancy!

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