Managing Symptoms

Nausea is very common affecting almost 90% of women and usually affects you from week 6 -14, but can last the whole pregnancy.  You can manage some of these symptoms by ensuring you are:

• Properly hydrated – make sure you drink little and often, water can be given with a straw during cases.
• Properly nourished:
  • Keep a stash of your preferred snack in clinic and theatre.
  • Ginger ale/nuts - ginger is a natural anti-emetic.
• You should also make sure that you can control your temperature:
  • Have a fan in your clinic room/ward area.
  • Cold spray on your ankles or neck is a close second during a case.
• If you are struggling it is ok to medicate and definitely seek help if you can’t hold anything down. For hyperemesis see RCOG guideline: www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg69.

Tiredness is a very real issue during pregnancy. So you should:

• Sit in theatre wherever possible – you can still do a surprising amount on a perching stool and there are opportunities in most cases for a proper moment to rest.
• Avoid heavy physical cases – where possible lists should be planned to avoid this, but if not if it often possible to swap cases with another trainee.
• Try to give yourself little to do in the evenings and weekends.
• DO NOT swap your on-calls for later on in pregnancy or after – this is not necessary, if you are not managing then speak to occupational health and stop on-call.

Fainting is a very common symptom. You can help avoid this by ensuring that you are:

• Properly hydrated – make sure you drink little and often, water can be given with a straw during cases.
• Wearing flight socks or TED stockings can also help.
• Taking regular little walks or on the spot marches.

Heartburn is a very common symptom. You can help avoid this by ensuring that you:

•    Avoid spicy foods and acid drinks.
•    Don’t lean on your belly in theatre it increases (even further) the intra-abdominal pressures.
•    Eat and drink little and often.
•    Use over the counter remedies: tablets can be slipped in to your mask.
•    Medications.​​​​​​

Many women discover a new world of smell, unfortunately many hospital and theatre smells can be extremely nauseating.

• Avoid smells which bother you if you can!
• Put something you find pleasant to smell on the inside of your mask – lip balm/ Friars balsam.

Pregnancy can also – understandably – lead to back or pelvic pain. You should:

• Try to see a specialist maternity physio early in your pregnancy.
• Consider using pelvic support belts.
• Use a perch stool in theatre.
• Reduce walking, for example you can ask nurses to bring clinic patients to you, and take your lunch to clinic.

It has been shown that the brain and cognition undergo real changes during pregnancy. Couple that with sleep deprivation, distractions and stress of pregnancy and child rearing – it is therefore completely normal to feel a brain fog. Strategies that may help:

• Write EVERYTHING down.
• To do lists/ bullet journals – lots of systems out there find what works for you.
• Orthobullets/ orthomate/ traumapaedia for last minute swotting up/ reminders.
• Change up your study technique – further info can be found here.

Unfortunately, hemorrhoids can occur especially in the mid-second to third trimesters of pregnancy:

• Drink plenty of water.
• If you can arrange to be involved in shorter cases so you are standing for less time.
• While it is not an easy issue to discuss, you could try approaching the subject slightly obliquely: “I have an issue to today which is very sore, but completely non-threatening that I don’t want to talk about – you’ll just have to forgive me if I am distracted!”
• More information can be found at: www.nhs.uk/pregnancy/related-conditions/common-symptoms/piles.