What to expect when you're expecting (61 page)

“Certain foods that I’ve always loved taste strange now. Instead, I’m having cravings for foods that I never liked. What’s going on?”

The pregnancy cliché of a harried husband running out in the middle of the night, raincoat over his pajamas, for a pint of ice cream and a jar of pickles to satisfy his wife’s cravings has definitely played out more often in the heads of old-school sitcom writers than in real life. Not many pregnant women’s cravings carry them—or their spouses—that far.

Still, most expectant moms find their tastes in food change somewhat in pregnancy. Most experience a craving for at least one food (most often ice cream, though usually without the pickles), and more than half will have at least one food aversion (poultry ranks right up there, along with vegetables of all varieties). To a certain extent, these suddenly eccentric (and sometimes borderline bizarre) eating habits can be blamed on hormonal havoc, which probably explains why they’re most common in the first trimester of first pregnancies, when that havoc is at its height.

Hormones, however, may not tell the whole story. The long-held theory that cravings and aversions are sensible signals from our bodies—that when we develop a distaste for something, it’s usually bad for us, and when we lust after something, it’s usually something we need—often does seem to stand up. Like when you suddenly can’t face the morning coffee you once couldn’t face your morning without. Or when a glass of your favorite wine sips like vinegar. Or when you can’t gobble down enough grapefruit. On the other hand, when you call “fowl” at the sight of chicken, or your beloved broccoli becomes bitter, or your cravings launch you into a full-fledged fudge frenzy—well, it’s hard to credit your body with sending the smartest signals.

The problem is that body signals relating to food are always hard to read when hormones are involved—and may be especially tough to call now that humans have departed so far from the food chain (and now that so many food chains sell fast food). Before candy bars were invented, for instance, a craving for something sweet might have sent a pregnant woman foraging for berries. Now it’s more likely to send her foraging for M&M’s.

Do you have to ignore your cravings and aversions in the name of healthy pregnancy eating? Even if that were possible (hormone-induced food quirks are a powerful force), it wouldn’t be fair. Still, it’s possible to respond to them while also paying attention to your baby’s nutritional needs. If you crave something healthy—cottage cheese by the crateful or peaches by the pile—don’t feel like you have to hold back. Go for the nutritious gusto, even if it means your diet’s a little unbalanced for a while (you’ll make up for the variety later on in pregnancy when the cravings calm down).

If you crave something that you know you’d probably be better off without, then try to seek a substitute that
satisfies the craving (at least somewhat) but also satisfies a nutritional requirement (and doesn’t fill you up with too many empty calories). chocolate frozen yogurt instead of a frozen chocolate bar; a bag of trail mix instead of a bag of jelly beans; baked cheese puffs instead of the kind that turn your fingers orange. If substitutes don’t fully satisfy, adding sublimation to the mix may be helpful. When MoonPies at the 7-Eleven howl your name, try doing something that takes your mind off them: taking a brisk walk, chatting with friends on a pregnancy message board, checking out maternity jeans online. And, of course, completely giving in to less nutritious cravings is fine (as is enjoying them, so leave that side of guilt off the menu when you indulge), as long as they don’t include something risky (such as an alcoholic beverage) and as long as your indulgences don’t take the place of nutritious foods in your diet on a regular basis.

Most cravings and aversions disappear or weaken by the fourth month. Cravings that hang in there longer may be triggered by emotional needs—the need for a little extra attention, for example. If both you and your spouse are aware of this need, it should be easy to satisfy. Instead of requesting a middle-of-the-night pint of Chunky Monkey (with or without the sour dills), you might settle for an oatmeal cookie or two and some quiet cuddling or a romantic bath.

Some women find themselves craving, even eating, such peculiar non-food substances as clay, ashes, and paper. Because this habit, known as pica, can be dangerous and may be a sign of nutritional deficiency, particularly of iron, report it to your practitioner. Craving ice may also mean you’re iron deficient, so also report any compulsion to chew ice.

“I have unsightly blue lines all over my breasts and belly. Is that normal?”

Not only are these veins (which can make your entire chest and belly look like a road map) normal and nothing to worry about, they are a sign that your body is doing what it should. They’re part of the network of veins that has expanded to carry the increased blood supply of pregnancy, which will be nourishing your baby. They may show up earliest and be much more prominent in very slim or fair-skinned women. In some women, particularly those who are overweight or dark-skinned, the veins may be less visible or not noticeable at all, or they may not become obvious until later in pregnancy.

“Since I became pregnant I’ve got awful-looking spidery purplish red lines on my thighs. Are they varicose veins?”

They aren’t pretty, but they aren’t varicose veins. They are probably spider nevi, commonly dubbed “spider veins,” for obvious reasons. There are a few reasons why spider veins might choose to spin their web across your legs. First, the increased volume of blood you’re carrying can create significant pressure on blood vessels, causing even tiny veins to swell and become visible. Second, pregnancy hormones can do a number on all your blood vessels, big and small. And third, genetics can predispose you to spider veins (thanks, Mom).

If you’re destined to have spider veins, there’s not much you can do to avoid them altogether, but there are ways to minimize their spread. Since your veins are as healthy as your diet is, try eating enough vitamin C foods (the
body uses it to manufacture collagen and elastin, two important connective tissues that help repair and maintain blood vessels). Exercising regularly (to improve circulation and leg strength) and getting into the habit of not crossing your legs (which restricts blood flow. will also help keep spider veins at bay.

Prevention didn’t do the trick? Some, though far from all, spider veins fade and disappear after delivery; if they don’t, they can be treated by a dermatologist—either with the injection of saline (sclerotherapy) or glycerin, or with the use of a laser. These treatments destroy the blood vessels, causing them to collapse and eventually disappear—but they aren’t recommended during pregnancy. In the meantime, you can try camouflaging your spider veins with flesh-toned concealers specifically designed for that purpose.

“My mother and grandmother both had varicose veins during pregnancy. Is there anything I can do to prevent them in my own pregnancy?”

Varicose veins run in families—and they definitely sound like they have legs in yours. But being genetically predisposed to varicose veins doesn’t mean you have to be resigned to them, which is why you’re wise to be thinking now about bucking your family tradition with prevention.

Varicose veins often surface for the first time during pregnancy, and they tend to worsen in subsequent pregnancies. That’s because the extra volume of blood you produce during pregnancy puts extra pressure on your blood vessels, especially the veins in your legs, which have to work against gravity to push all that extra blood back up to your heart. Add to that the pressure your burgeoning uterus puts on your pelvic blood vessels and the vessel-relaxing effects of the extra hormones your body is producing, and you have the perfect recipe for varicose veins.

The symptoms of varicose veins aren’t difficult to recognize, but they vary in severity. There may be a mild achiness or severe pain in the legs, or a sensation of heaviness, or swelling, or none of these. A faint outline of bluish veins may be visible, or serpentine veins may bulge from ankle to upper thigh. In severe cases, the skin overlying the veins becomes swollen, dry, and irritated (ask your practitioner about moisturizers that can help). Occasionally, superficial thrombophlebitis (inflammation of a surface vein due to a blood clot) may develop at the site of a varicosity, so always check with your practitioner about varicose vein symptoms.

To give your legs a leg up against varicose veins:

Keep the blood flowing. Too much sitting or standing can compromise blood flow, so avoid long periods of either when you can—and when you can’t, periodically flex your ankles. When sitting, avoid crossing your legs and elevate them if possible. When lying down, raise your legs by placing a pillow under your feet. When resting or sleeping, try to lie on your left side, the best one for optimum circulation (though either side will do).

Watch your weight. Excess poundage increases the demands on your already overworked circulatory system, so keep your weight gain within the recommended guidelines.

Avoid heavy lifting, which can make those veins bulge.

Push gently during bowel movements. Straining can be a strain on those
veins. Staying regular (see
page 173
) will help keep things moving.

Wear support panty hose (light support hose seem to work well without being uncomfortable) or elastic stockings, putting them on before getting out of bed in the morning (before blood pools in your legs) and taking them off at night before getting into bed. While neither will contribute to your sexiest pregnancy moment, they help by counteracting the downward pressure of your belly and giving the veins in your legs a little extra upward push.