Blame it on your uterus

I just finished 12 pages of module notes on the common discomforts of pregnancy and non-pharmacological ways to alleviate them, and I noticed a common theme: almost everything seems to be caused by the pressure/weight/size of the enlarging uterus. Varicose veins during the 2nd and 3rd trimester? The enlarging uterus increases the pressure on pelvic veins when standing, which thereby impairs venous circulation and increases venous pressure in the lower extremities. This compression then leads to dereased blood return to the heart, which then leads to congestion of blood in the peripheral veins, and voila, you’ve got varicosities. Hemorrhoids? Same thing. Pedal edema? Same thing, with the added caveat that the increased peripheral congestion leads to increased fluid building up in the cells of your lower extremities. Low back pain? The weight of the enlarging uterus strains the lumbar vertebrae and supporting back muscles, especially if the abdominal muscles are weak. Round ligament pain? The poor ligaments are stretched to their utmost to accompany the enlarging uterus. Heartburn? The enlarging uterus has compressed the functional capacity of the stomach, and deplaced it upward (of course, high amounts of progesterone also contribute to relaxation of the cardiac sphincter, and decrease gastic motility, which then leadsto increased reflux). Leg cramps? Enlarged uterus imparing circulation on blood vessels and pelvic nerves as they travel to the lower extremities (that’s one theory, anyway). Hyperventilation and shortness of breath? The enlarged uterus has compressed the diaphragm and elevated it 4 cm by the end of the 3rd trimester, and although your thoracic diameter widens slightly during pregnancy, it can’t quite compensate. Supine hypotension? Avoid lying flat on your back, because the weight of your enlarging uterus will compress the inferior vena cava and abdominal venous tree, and many women pass out from the resulting arterial hypotension. Increased urinary frequency? You guessed it. Me large uterus, me crush puny bladder beneath me. Mwuahahahaha!

Yes, it’s true: our organs, bones, ligaments, muscles etc. etc. are all carefully designed to support a pregnancy, but you know what? Just barely. I didn’t realize how “just barely” all of it was. By the third trimester, it seems that a woman’s body has pretty much been stretched to its absolute maximum. It’s hard, hard work to carry an extra 30 pounds of concentrated weight right out in front of you for the three interminable, uncomfortable months at the end of your pregnancy. And I’m sure your response to this post will be: well of course, duh. And yes, of course, duh. But wow. Thank goodness babies are born at the end of the 3rd trimester! If there was a 4th trimester, I’m not sure women’s bodies would make it (which is of course why they’re born at the end of the 3rd trimester). But seriously, wow. Can you think of a more perfectly designed system? Really, it just absolutely blows me away, the more I learn about it.

If my mother were still alive, I’d go find her and give her a hug right now, just for getting through that third trimester with me.

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