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Third Trimester of Pregnancy
Changes in Your Body
You could still be having some of the same discomforts you
had in your second trimester, but now you will notice that
you may have to go to the bathroom more often or that you
find it even harder to breathe. This is because the baby is
getting bigger and it is putting more pressure on your organs.
Don't worry, your baby is fine and these problems will lessen
once you give birth. You also might have some of these changes:
Heartburn
As your baby gets bigger, your uterus pushes on your stomach
and can cause heartburn, especially before bedtime or right
after you eat. Continue to avoid greasy, fried foods and eat
six to eight smaller meals instead of large meals. You also
can take small sips of milk or eat small pieces of chipped
ice. If your heartburn is severe and doesn't improve with
these tips, talk with your health care provider. Also talk
with your health care provider before taking an antacid medication.
Swelling
As you near the end of your pregnancy, you might notice more
swelling than you had before, especially in your ankles, fingers
and face. Continue to drink lots of fluids (water is best)
and rest when you can with your feet elevated. If you notice
sudden, extreme swelling in any of these areas, or have a
rapid significant weight gain, call your health care provider
right away. This could be a sign of preeclampsia or toxemia.
Hemorrhoids
You might begin to experience more discomfort from hemorrhoids
now from the increased pressure of your growing baby on the
veins in your rectum. You might also be constipated, which
makes hemorrhoids worse because you might strain for a bowel
movement. Try to avoid hemorrhoids by drinking lots of fluids
and eating plenty of whole grains, raw or cooked leafy green
vegetables, and fruits. Try not to strain for bowel movements,
and always talk with your health care provider before taking
a laxative.
Tender Breasts
Your breasts have most likely increased in size and fullnesss
as your pregnancy has advanced. As you near the end of your
pregnancy, hormones in your body cause your breasts to increase
even more in size, to prepare for breastfeeding. Your breasts
can feel full and heavy, and they might be tender or uncomfortable.
Wearing a well-fitting maternity or nursing bra will help
you be more comfortable, because these types of bras offer
extra support. Some pregnant women begin to leak colostrum
in the third trimester. Colostrum is the first milk that your
breasts produce for your baby. It is a thick, yellowish fluid
that contains antibodies that protect new babies from infections.
If leaking becomes a problem for you, you can purchase disposable
or cloth nursing pads (that you can use when nursing your
newborn) to place inside your bra.
Now and after delivery, it is a good idea to only wash your
nipples with water instead of soap. Soap might cause the skin
of your nipples to become dry, irritated and crack. If you
do have skin cracks, which can be sore and painful, use a
heavier cream that contains lanolin for extra moisture.
Changes in Your Baby
Your baby is still growing and moving, but now it has less
room in your uterus. Because of this, you might not feel the
kicks and movements as much as you did in the second trimester.
During this final stage of your pregnancy, your baby is continuing
to grow. Even before your baby is born it will be able to
open and close its eyes and might even suck its thumb. As
your body starts to prepare for the birth, your baby will
start to move into its birth position. You might notice the
baby "dropping," or moving down lower in your abdomen.
This can reduce the pressure on your lungs and rib cage, making
it easier to breathe or not to get out of breath so fast.
As you near your due date, your cervix becomes thinner and
softer (called effacing). This is a normal, natural process
that helps the birth canal (vagina) to open during the birthing
process. Your health care provider can check your progress
with a vaginal exam. And, your visits to your provider may
increase the month before you give birth. The average baby
is about 20 to 22 inches long and weighs approximately 7 1/2
pounds at birth, but anywhere between 5 lbs., 11 1/2 ounces
and 8 lbs., 5 3/4 ounces is a healthy range for newborns.
Prenatal Care
Visits and Tests
Be sure to continue to visit your health care provider, and
ask him or her to answer your questions and address your concerns
about labor and delivery. As the birth of your baby gets closer,
you and your health care provider will discuss what kind of
delivery you will have. Some women need to have a cesarean
section (c-section), in which a surgical incision is made
in the abdomen and uterus to remove the baby. If you are able
to plan on a non-surgical, vaginal birth, you may want to
have your baby naturally, without medications, and you may
want to take a childbirth class. Many women find childbirth
classes very helpful, even if they have already had a baby.
And, women also bring their partners or a friend or relative
to these classes, particularly if this person will be with
them to offer support and coaching during the birth of their
baby.
Inducing Labor
It's helpful to know that only five percent of babies are
actually born on their due dates. This is very normal and
does not mean anything is wrong. Sometimes, though, there
are problems or your health care provider has concerns about
the baby's and/or your health, and labor needs to be induced.
Inducing labor means that your health care provider will start
your labor through artificial means. Most health care providers
will wait one to two weeks after a woman's due date before
considering inducing. There are other reasons why a woman
might need to have labor induced. She might have a chronic
illness like high blood pressure or diabetes that threatens
the health of the baby, or the baby might not be growing or
thriving in the uterus. Sometimes, the uterus can become unhealthy
for the baby. A woman also might have the membranes that surround
the fetus rupture (or have her "water break") without
going into labor naturally within a reasonable amount of time.
Labor can be induced during a vaginal exam - your health care
provider might rupture or strip the membranes surrounding
the fetus or insert a gel or suppository containing a hormone
to stimulate contractions. A drug called Pitocin can also
be given intravenously (put into your body through a vein
in your arm or hand) to start contractions.
Deciding to Breastfeed or Bottle Feed
If you haven't thought about whether you will breastfeed
or bottle feed your baby, this is the time to learn more about
both, and make a decision about what you plan to do. Breastfeeding
has many more advantages over formula for your health and
your baby's health. But it is best to discuss it with your
health care provider, and then make a decision that is right
for you. Click here to learn more about the benefits of breastfeeding,
how to make it work best for you, and for tips on breastfeeding
after returning to work.
When to Call Your Health Care Provider
Before your due date, make sure to talk with your health
care provider about how to reach him or her if you go into
labor. It's also helpful to be familiar with the hospital
or birthing center, where you should park, and where to check
in ahead of time. Know that sometimes you can think you're
in labor, but really are not (called false labor). This happens
to many, many women, so don't feel embarrassed if you go the
hospital certain that you are in labor, only to be sent home!
It's always better to be seen by a health care provider as
soon as possible once labor has begun. Here are the signs
of true labor:
Contractions at regular and increasingly shorter intervals
that also become stronger in intensity.
Lower back pain that doesn't go away. You might also feel
premenstrual and crampy.
Your water breaks (can be a large gush or a continuous trickle)
and you have contractions.
A bloody (brownish or blood-tinged) mucous discharge. This
is the mucous plug that blocks the cervix. Labor could be
at any time, or days away.
Your cervix is dilating (opening up) and becoming thinner
and softer (also called effacement). During a pelvic exam,
your health care provider will be able to tell if these things
are happening.
Caring For Yourself
Make sure to continue for these last three months the healthy
behaviors that you learned in your first trimester. Many pregnant
women feel great in their last trimester and still have lots
of energy. But, your energy may lessen as you enter your 9th
month and you may begin to slow down. This is completely normal.
It's important to get enough rest now, even though it might
seem difficult to sleep as you get larger. Your baby's stretching
movements, having to urinate often, and an increase in your
body's metabolism might interrupt or disturb your sleep. And,
if you are having any leg cramping, this can affect your sleep
as well. You might have a better night's sleep if you try
to avoid eating large meals three hours before going to bed.
You can also try some mild exercise like walking, which can
help relieve stress and may improve sleep. Avoid long naps
during the day. If you can't sleep because you are anxious
about becoming a mother or about your labor and delivery,
try talking with your partner or friends who've been through
this before. You can also talk with your health care provider.
Weight Gain
Everyone gains weight at different rates, but on average, it
is normal to gain about one pound per week, or three to four
pounds per month, during this trimester. By the end of your
pregnancy you should have gained, on average, about 25 to 30
pounds. About 7 1/2 pounds of that weight should be the baby.
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