The journey to motherhood has begun. You feel a mixture of anticipation, joy, hope, excitement, and perhaps a little apprehension. Unfortunately, these euphoric moments may be punctuated with episodes of nausea, constipation, and back pain. How do you get through the rest of the pregnancy without these nagging discomforts?

During pregnancy a woman's body goes through some major changes to meet the demands of her growing baby. These changes are initiated by the sex hormones estrogen, progesterone, and the other hormones of pregnancy, and are often accompanied by numerous discomforts. These normal side effects, which vary among women and pregnancies, are not the same as complications. (Complications of pregnancy include hypertension, anemia, gestational diabetes, pre-eclampsia, and vaginal bleeding.) Here are some common pregnancy discomforts and tips on how to manage them.

Fatigue is especially common during the first 8-10 weeks due to metabolic changes in your system. Fatigue may also be related to poor nutrition, being overweight, lack of regular exercise, and insomnia.

What may help: Take frequent naps and rest whenever you can. Cut back on your work or daily activities, but engage in regular moderate activity ( eg, walking). Eat small, frequent meals to keep energy levels even.

You may feel like you are on an emotional roller coaster—excited and euphoric, but also full of doubt and anxiety. You may cry easily and worry about any number of things, such as your pregnancy, the health of your baby, giving birth, your relationship with your partner, and your future.

What may help: Keep in mind that it is normal to have these feelings. Talk openly with your partner, family, friends, and supportive others. Join groups or classes for expectant mothers. You will find that sharing experiences is very helpful.

What may help: Eat plenty of high fiber foods such as whole grains, fruits, and vegetables. Make sure you drink plenty of fluids and get regular exercise.

Varicose veins in the anus cause itchiness and pain, triggered by internal pressure from the baby and constipation.

What may help: Eat a high-fiber diet with whole grains, raw fruit, and vegetables; drink plenty of water; exercise regularly. Creams are available to soothe the burning and itching.

Inflammation and swelling of the gums is often caused by poor oral hygiene. During pregnancy, however, the gums may bleed easily as the result of increased progesterone and expanded blood supply which softens the gums. This situation increases the risk of food collecting at the base of the gums, which could lead to tooth decay and gum disease.

What may help: Practice good oral hygiene. Brush teeth several times per day, especially after eating, and use dental floss. Make sure you visit the dentist during your pregnancy.

Dark purplish, swollen veins may develop in the lower leg, causing aching and itching. These can be due to pregnancy hormones, the weight of the baby, increased blood volume, and heredity.

What may help: Do not stand for long periods of time or sit with your legs crossed. You can also try elevating your legs on a pillow when lying down. When sitting, keeping your legs raised. Try support stockings before getting out of bed.

Indigestion and heartburn are most common during the last trimester due to increased pressure on the stomach, which causes a reflux of gastric juices into the esophagus.

What may help: Avoid fried, spicy, or acidic foods and drinks. Eat small, frequent snacks rather than several large meals. Avoid lying down after eating. Elevate your head with propped up pillows when you go to bed. Talk to your doctor about which medicines are safe for you to take.

You may have difficulty sleeping due to discomfort, sweating, leg cramps, the baby kicking, or the need to urinate.

What may help: Try to unwind before going to bed with a warm bath, relaxing music, stress-relieving exercises, and comfortable bed clothing.