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3rd Trimester of pregnancy

What Is the Third Trimester of Pregnancy and What can you expect?

The third trimester is the last phase of your pregnancy. It lasts from weeks 28 to 40 weeks, or months 7, 8, and 9. Although you only have a few weeks to go before baby is born, these weeks can be the most challenging.

Fetal Development during the 3rd trimester

As your baby grows, his or her movements will become more obvious. In the third trimester, your baby keeps growing. By the end, a full-term baby usually is between 48 and 53 cm long and weighs between 2.6 and 4 kg.

Your baby begins to turn itself head-down to get ready for delivery. At week 36, the baby’s head should begin to move into your pelvic area, and it will stay in this down-facing position for the last 2 weeks of your pregnancy.

Your baby develops in other important ways in the third trimester. During this phase, it’s able to:

  • Open its eyes and see
  • Hear
  • Suck on its thumb
  • Cry
  • Smile
  • Your baby’s brain continues to develop.
  • Its lungs and kidneys mature.
  • It gains muscle tone and about 16% body fat.
  • The bones at the top of its skull are soft to ease delivery.
  • If it’s a boy, the testes have descended into the scrotum.
  • During the third trimester, the vernix caseosa, a protective coating, covers your fetus’ skin.

What changes to your body can you expect?

  • Braxton-Hicks contractions. You might start to feel mild irregular contractions or tightness in your belly, which are warm-ups to prepare your uterus for the real labor to come. Braxton-Hicks contractions often aren’t as intense as real labor contractions, but they may feel a lot like labor and can eventually progress to it. These contractions also tend to occur more often and become stronger as you approach your due date. One main difference is that real contractions gradually get closer and closer together — and more intense. Contact your Midwife if the contractions become regular and steadily increase in strength.
  • Abdominal achiness. As your baby grows, it takes up more room in your abdomen. This can cause you to have some aches and discomfort. You may find it hard to get comfortable when you’re in bed at night trying to go to sleep.
  • Backache. Pregnancy hormones relax the connective tissue that holds your bones in place, especially in the pelvic area. These changes can be tough on your back, and often result in discomfort during the third trimester. When you sit, choose chairs with good back support. Get regular exercise. Wear low-heeled — but not flat — shoes with good arch support. At night, sleep on your side with a pillow tucked between your legs. If you have severe or persistent pain, contact your Midwife.
  • Bleeding. Some light bleeding toward the end of your pregnancy might be a sign that labor is starting. But spotting may sometimes be a sign of a serious problem, including placenta previa (the placenta grows low and covers the cervix), placental abruption (separation of the placenta from the uterine wall), or preterm labor. Call your Midwife as soon as you notice any bleeding.
  • Breast enlargement and leaking. Make sure you’re wearing a supportive bra so your back doesn’t suffer. Close to your due date, you may start to see a yellowish fluid leaking from your nipples. This substance, called colostrum, will nourish your baby in the first few days after birth.
  • Vivid dreams. It’s common to have more vivid dreams or nightmares in your third trimester. This can disrupt your sleep. Your wild dreams are likely caused by changes in hormone levels from pregnancy.
  • Clumsiness. You may feel clumsy or out of balance during the third trimester.
  • Discharge. You might see more vaginal discharge during the third trimester. If the flow is heavy enough to soak through your panty liners, call your Midwife. Close to your delivery date, you might see a thick, clear, or slightly blood-tinged discharge. This is your mucus plug, and it’s a sign that your cervix has begun dilating in preparation for labor. If you experience a sudden rush of fluid, it may mean that your water has broken (although only about 8% of pregnant women have their water break before contractions begin). Call your Midwife as soon as possible after your water breaks.
  • Fatigue. You might have been feeling energetic in your second trimester, but are weary now. Eat healthy food and get regular exercise to give yourself a boost. When you feel tired, try to take a nap, or at least sit down and relax for a few minutes. You need to reserve all your strength now for when your baby arrives and you’re really not getting any sleep.
  • Frequent urination. Now that your baby is bigger, its head may be pressing down on your bladder. That extra pressure means you’ll have to go to the bathroom more frequently — including several times each night. To relieve the pressure and prevent leakage, go to the bathroom whenever you feel the urge and urinate completely each time. Wear a panty liner to absorb any leakage. Let your Midwife know if you have any pain or burning with urination. These can be signs of a urinary tract infection.
  • Heartburn and constipation. They’re caused by extra production of the hormone progesterone. To relieve heartburn, try eating more frequent, smaller meals throughout the day and avoid greasy/fried, spicy, and acidic foods (like citrus fruits) and chocolate. For constipation, increase your fiber intake and drink extra fluids to keep things moving more smoothly. If your heartburn or constipation is really bothering you, talk to your Midwife about what medications may be safe for you to take for symptom relief.
  • Spider veins, varicose veins and haemorrhoids. Increased blood circulation might cause tiny red-purplish veins (spider veins) to appear on your face, neck and arms. Redness typically fades after delivery. You might also notice swollen veins (varicose veins) on your legs. Painful, itchy varicose veins in your rectal area (haemorrhoids) are another possibility. To ease swelling, exercise and elevate your legs frequently, include plenty of fiber in your diet and drink lots of fluids. For haemorrhoid relief, soak in a warm tub.
  • Nerve pain. Nerve pain that shoots from your lower back to your buttocks and down your leg is more likely in the third trimester.
  • Shortness of breath. As your uterus expands, it rises up until it sits just under your rib cage, leaving less room for your lungs to expand Exercising can help with shortness of breath. You can also try propping up your head and shoulders with pillows while you sleep.
  • Stretch marks. You may develop stretch marks on your breasts, butt, tummy, or thighs. Stretch marks are a type of scar that happens when your skin stretches during pregnancy.
  • Swelling. Your rings might be feeling tighter these days, and you may also notice that your ankles and face are looking bloated. Mild swelling is the result of excess fluid retention. To reduce swelling, put your feet up on a stool whenever you sit for any length of time, and elevate your feet while you sleep. If you have sudden onset of swelling though, contact your Midwife immediately as it may be a sign of preeclampsia, a dangerous pregnancy complication
  • Your emotions. As anticipation grows, fears about childbirth might become more persistent. How much will it hurt? How long will it last? How will I cope? The reality of parenthood might begin to sink in as well. You might feel anxious, especially if this is your first baby. It’s helpful to plan ahead. If you’ll be breast-feeding, you might get a nursing bra.

Red Flag Symptoms

Any of these symptoms could be a sign that something is wrong with your pregnancy. Don’t wait for your regular prenatal visit to talk about it. Call your Midwife right away if you experience:

  • Severe abdominal pain or cramps
  • Severe nausea or vomiting
  • Bleeding
  • Severe dizziness
  • Pain or burning during urination
  • Rapid weight gain (more than 6.5 pounds per month) or too little weight gain

Antenatal care

During the third trimester, your Midwife will require you to come in every 2 weeks between weeks 28 and 36, from 36 weeks you will have an antenatal consultation every week.  At around 32 weeks, you will also have an ultrasound with our in-house Sonographer.

Like previous visits, your health care provider will check your weight, blood pressure, and ask about any signs or symptoms you’re experiencing.

You will also need screening tests for iron deficiency anaemia. Iron deficiency anaemia occurs when you don’t have enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Anaemia might cause you to feel very tired. To treat anaemia, you might need to take iron supplements.

Your Midwife will also check your baby’s size and heart rate and near the end of your pregnancy, she will check your baby’s position and ask about your baby’s movements. As your due date approaches, keep asking questions. Knowing what to expect can help you have the most positive birth experience.

It’s likely, that labor will start a couple of weeks earlier or later — in fact, about 30 percent of all babies linger past the 40-week mark. If that’s the case, your Midwife will give you to naturally induce labor on your own, but once you reach around week 41 or 42, you’ll likely be considered overdue. At that point your Midwife may decide to induce labor if it doesn’t begin on its own. 

Signs of Labor

It’s the event you’ve been happily (and nervously) anticipating for months: your baby’s birth! Here are some labor symptoms to watch out for.

Every birth is different, so it’s hard to predict the answers to all those questions. But knowing the signs of labor to look out for will help provide clues that it’s almost time to meet your baby, including:

  • Strong, frequent contractions – True labor contractions are spaced at regular intervals and become more frequent as time goes on. Real labor contractions last for 30 to 70 seconds each and they get stronger over time and don’t ease up, even when you change positions. You may not be able to walk or talk through labor contractions once they’ve progressed.
  • Bloody show – You may notice the loss of your mucus plug — the cork sealing off your uterus from the outside world. It can come out in one large or lots of little ones, though you may not get a glimpse of it at all (and some women don’t lose it before delivery).
  • Belly and lower back pain – You may feel like you’re having strong menstrual cramps, stomach upset or lower abdominal pressure. You could also have pain in your lower back that radiates down into the legs. This pain won’t go away if you change positions. 
  • Water breaking – For most women, membranes rupture and amniotic fluid leaks after other labor symptoms have already begun. And you won’t necessarily lose it all in one big gush, either — for some women, water breaking feels more like a trickle.  Your water breaking is actually one of the final signs of labor most women experience — and it happens naturally in only around 15 percent of births or fewer. So don’t count on it as a definite sign of labor.
  • Diarrhoea – Just as the muscles in your uterus are relaxing in preparation for birth, so too are other muscles in your body — including those in the rectum. And that can lead to pre-labour. Though annoying, it’s completely normal. Just be sure to stay hydrated!

 

Am I going into labor? Should I call the Midwife?

Still feel like you won’t know when it is time – don’t stress about it. You’ll be seeing your Midwife frequently now, and she will help you spot all the important clues.

Labor contractions won’t all be exactly spaced, but if they’re becoming pretty consistent, more painful and longer (usually around 30 to 70 seconds each), it’s time to check in with your Midwife. If you think you might be in labor but aren’t sure, call your Midwife, can explain what’s going on and have you come in if there’s any uncertainty.

You should always call Midwife if:

  • You experience any bleeding or bright red discharge (not brown or pinkish).
  • Your water breaks — especially if the fluid looks green or brown. This could be a sign that meconium, or your baby’s first stool, is present, which can be dangerous if your baby ingests it during birth.
  • You experience blurred or double vision, a severe headache or sudden swelling. These can all be symptoms of preeclampsia, which is characterized by pregnancy-induced high blood pressure and requires medical attention.

 

What is preterm labor?

Most pregnancies — about 90 percent — make it to week 37 of pregnancyPreterm labor is when labor occurs before week 37. Call your practitioner if you haven’t yet reached your 37th week and you’re experiencing labor symptoms.  

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