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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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