Wonderful and dramatic things happen to a woman before, during, and after the birch of a child. She becomes a different person. She looks different, she feels different, she even thinks differeddy. Yet these changes develop so slowly and subtly that few wives (and even fewer husbands) realize what is going on. Many of these changes are mediated through the hormones produced by the placenta. This remarkable structure becomes an efficient factory and by the end of pregnancy is producing large amounts of several different hormones.
There is hardly any part of the body that is not involved in these changes. In the development of a new life the body must adjust to increased stress and strain, but so perfect is this adjustment that any woman free of serious health handicaps can go through repeated pregnancies with hardly any inconvenience or risk.
The work’ performed by•the heart increases in pregnancy by roughly one-fourth. Women with serious heart disease need strict medial supervision in pregnancy and must curtail other activities to prevent heart failure. Formerly abortions were sometimes performed on pa-tients with serious heart disease, but modern medical care brings almost all these women through pregnancy safely. Obstetricians are seeing more and more women who have recovered from heart surgery. The experience with these patients has been gratifying. There are even a few who have undergone heart surgery in pregnancy. While this is possible, pregnancy is certainly not the ideal time for cardiac surgery. and unless it is a matter of life or death the cardiac surgery is best performed between pregnancies
. One of the most common changes in the circulatory system in preg-nancy is the occurrence of varicose veins of the legs. Increased pressure
in the veins of the lower extremity, a condition of pregnancy, is the cause. There does seem to be a strong heredity factor too. Any girl whose mother has had much trouble with varicose veins has two strikes against her when she becomes pregnant.
Often the varicose veins are much worse on one side than on the other. This condition is due to the arrangement in the pelvis of the large arteries and veins that supply the legs. On one side the artery crosses over the veins, while on the other side it does not.
A certain amount of nasal congestion goes with pregnancy. Often the ears feel plugged up. Women feel in summer that they have suddenly developed an allergy, and in winter they seem to have a cold that will not go away. Because of this congestion, nosebleeds are quite common. Women predisposed to sinus infections are likely in pregnancy to have acute flare-ups. Many women notice breathlessness in the middle and latter parts of pregnancy. We are uncertain about the cause of this condition. In spite of the enlarged abdomen, pregnancy does not reduce the capacity of the lungs to perform the functions necessary to life.
Gastrointestinal Symptoms Nausea, vomiting, and constipation in the early stages are such common changes in pregnancy that they have already been referred to as symptoms. In addition, the emptying time of the stomach is delayed in pregnancy: women with gastric ulcers frequently are relieved of their symptoms because food in the stomach keeps the ulcer quiet. In the middle and latter parts of pregnancy, many women have severe heart-burn, which results from the pushing up of a nubbin of the stomach where the esophagus (the tube connecting the mouth and stomach) passes through the diaphragm.
This condition is known as hiatus hernia. The discomfort is often worse at night or when lying flat. Sitting or sleeping with the head elevated gives relief. The condition goes away promptly with delivery. There is also a sluggishness in the flow of bile in pregnancy.