The last months of pregnancy are filled with excitement for things to come. No amount of preparation and enthusiasm can eliminate the difficult physical changes that are a part of the third trimester, however. It is important for any woman to familiarize herself with the many regular symptoms of late pregnancy; this knowledge may not reduce all of her physical discomfort, but her mind will rest easier knowing that it is all a part of bringing baby into the world.
Edema, or water retention, is a very common complaint in the last trimester of pregnancy. It can affect any part of the body, but is most noticeable in the extremities. Shoes may become tight, and rings may not fit. Edema is most often a normal and non-threatening condition of pregnancy due to the increase of fluids in the woman’s body to support the fetus. However, if sudden swelling occurs accompanied by high blood pressure, vision changes, dizziness, headaches, or severe abdominal pain, it is important to contact a physician. These symptoms in the last months of pregnancy can be signs of a more serious condition called preeclampsia.
Back pain in the third trimester is caused by added weight, changing posture, and the hormone relaxin. Relaxin is found primarily in pregnant women. It loosens the joints and ligaments in her body to prepare it for giving birth. A pregnant woman may want to sleep on her side in the last trimester, as sleeping on her back will not only cause pain, but reduce blood flow as the baby rests on the vena cava. Other methods of reducing back pain include having good posture, wearing low-heeled shoes with arch support, and doing pelvic tilts. Pelvics tilts involve rocking the pelvis back and forth while on all fours and may reduce back strain from prolonged positioning in the last trimester.
With the increasing weight of the fetus pressing against the bladder, it is no surprise that frequent urination is a concern in the third trimester of pregnancy. This increases as the baby moves further down into the pelvis. It can result in multiple trips to the bathroom during the night, or even urine leakage: especially when coughing, sneezing, or laughing. Although this is a troublesome issue, it is important to maintain fluid intake during the last trimester for the health of both mother and baby.
Increasing progesterone levels cause the muscle at the top of the stomach to relax. It also causes food to empty from the stomach at a slower rate. This, coupled with an enlarged uterus that pushes the stomach upward during the third trimester, makes heartburn a very real possibility for any pregnant woman. To reduce heartburn in the last months of pregnancy, one can safely take digestive enzymes with meals, eat smaller portions throughout the day instead of three large meals, and avoid any trigger foods: spicy foods, fried foods, and citrus juices are a few. Drink plenty of water, but in between meals. Mixing fluids with food dilutes natural enzymes and stomach acid, which can increase heartburn in the third trimester.
Constipation, like heartburn, is caused by a slower moving digestive tract and displaced organs as the uterus grows larger. It is unfortunately one of the most common physical complaints of the last trimester, but may be greatly reduced by eating a healthy diet rich in fiber and drinking plenty of water. Exercise also works well, as activity causes a sluggish digestive system to begin moving again.
Stretch Marks and Itching
Stretch marks are very common in the third trimester. They most often appear on the stomach, but are also common on the breasts, hips, and thighs. The chance of a woman getting stretch marks during the last trimester increases with high weight gain, large babies, or a multiple pregnancy. This stretching can also cause itchy skin. These conditions are not always preventable, but keeping skin well moisturized may help with both stretch marks and itching. Vitamin E and cocoa butter are two simple stretch mark emollients that are safe to use during pregnancy. If itching is severe and accompanied my many numerous small welts, or large patches of red skin, it may be a pregnancy skin condition known as PUPPS.
Shortness of Breath
Shortness of breath becomes an issue when the growing uterus pushes the diaphragm upward in the last trimester of pregnancy, out of its normal resting place in the body. Though it only moves about an inch and a half, this is enough to cause a disturbance during routine physical activities such as going for a walk or climbing stairs. This does not mean pregnant women should reduce the amount they exercise in the third trimester, however. The opposite is true. Light exercise routines can improve this condition. Sleeping propped up to relieve pressure from the lungs may help, too. This condition often resolves itself in the final weeks of pregnancy, as the baby drops down further in preparation for birth.
Varicose Veins and Hemorrhoids
Varicose veins often appear in the last trimester due to increased pressure from the size and weight of the fetus. These are veins that have enlarged or twisted over time. Varicose veins in the legs are often painless, but hemorrhoids, which are varicose veins located in the rectum, can be quite painful. To reduce the instance of varicose veins in the legs, wear support stockings, or elevate the legs frequently. Hemorrhoids may be avoided in pregnancy if one maintains a high fiber diet and drinks plenty of water.
Leg and Foot Cramps
Leg and foot cramps are also quite common in the third trimester. Though the causes are uncertain, it is known that moving and stretching the calf muscles and toes regularly may help to prevent them. A warm bath may also help. These can happen at any time, but are most noticeable at night, when going to bed.
Breast Growth and Colostrum Leakage
The rapid growth of breast tissue may be a continued annoyance in the last trimester of pregnancy. Nipples may be tender, and breasts may be sore. There is also the added discomfort of colostrum leakage for many women at this time. Making sure that all bras are the right size is very important, and nursing pads prevent the visible leakage that sometimes occurs as labor nears.
Braxton Hicks Contractions
Braxton Hicks contractions, also called “practice contractions,” may begin in the third trimester. They can begin as early as the second trimester for some women, but this is not common. Braxton Hicks have many triggers and may begin when mother or baby are particularly active, when the woman’s bladder is full, after sex, or with dehydration.
Braxton Hicks may be discerned from true labor contractions by their intensity and frequency. They are irregular, infrequent, and to not become closer together over time as real contractions do. They may also be alleviated by drinking plenty of fluids, changing positions, or sitting in a warm bath. Though these early contractions can be unsettling, they are often painless and believed to help prepare the woman’s body for real labor.
Though vaginal discharge changes throughout pregnancy, it may still come as a surprise to many women just how much it can increase of the third trimester. It can be an inconvenience which may require a pantyliner at times, but it is usually normal. Regular vaginal discharge is thin, white, and odorless. A doctor should be contacted if the woman seems to be leaking clear fluids consistently, as this may be a compromised amniotic sac. Premature water breaking has a few causes, including infection, injury, and cervical issues. Also contact a physician if the discharge contains mucous or blood before thirty-seven weeks, as this “bloody show” may be a sign of premature labor.
Even if mood swings disappeared in the second trimester, they often return for the third. Part of this is hormones, but it is also due to the physical changes that happen at this time, and the increased anxiety about labor and parenting that may surface. It can be difficult for any pregnant woman to deal with this all at once. Taking naps when possible is important if sleep is lacking, as is continued light exercise every day, and a healthy diet.
With all of these physical changes, it is no wonder that many women find it very difficult to sleep during the third trimester of pregnancy. Pillows on either side of the body may help when lying down. There are pillows made specifically for pregnancy as well. These wrap around the entire body, helping the woman to stay in place on her side through the night. If this doesn’t work, staying propped up may be more comfortable, as in a recliner. Of course, even being comfortable cannot guarantee a peaceful nights sleep, as nothing may stop the endless trips to the bathroom or the intense dreams that can come with the last trimester of pregnancy.
Though all of these conditions can be very trying for any pregnant woman, they are usually normal, healthy signs that the body is getting closer to labor. It may seem like a long wait at the time, but birth is approaching steadily. Once the baby is born, many of these struggles will seem a distant memory as all attention is focused on caring for the new little bundle.