Congratulations, you’ve reached the home stretch. As your fetus continues to grow, you should prepare for the delivery of the baby. You may feel a little uncomfortable as you continue to gain weight and your false labor contractions continue. It is a good idea to start taking childbirth classes and breastfeeding classes around this time. Included below is a list of some of the changes and symptoms you can expect during this, your final trimester:
As your fetus continues to grow, he/she will radiate heat, causing you to feel hotter. Also, your basal metabolic rate can increase to greater than 20 percent of normal. You may find that in addition to feeling overheated you may also perspire more, especially at night.
Try some of the following tips on staying cool:
- Dress lightly in breathable fabrics, like cotton
- Avoid exercising outside in the heat of the day. Take your strolls before breakfast or after dinner, or attend exercise classes in an air-conditioned facility.
- Stay out of the sun as much as possible, especially on very hot days.
- Take a cool shower or bath.
- Go for a swim
- Stay air-conditioned when possible. If you have no air-conditioning at home, spend time at the library, a museum, or mall.
- Drink lots of fluids; at least eight glasses of water a day, more if you’re exercising or perspiring a lot.
- Avoid caffeine and alcohol, which can dehydrate you.
The increased frequency of the bladder
As your fetus grows, there is increased pressure being placed on the bladder, causing an increase in urinary frequency. Make sure you don’t cut back on fluids in an attempt to cut back on your trips to the bathroom. Also, as before, whenever you feel the urge to empty your bladder, do it.
As you near the end of your pregnancy, you might notice more swelling than you had before, especially in your ankles, fingers and face. This is called edema and due to you retaining more fluids. Continue to drink lots of water and rest when you can with your feet elevated.
Some other things that you can do to battle swelling in your ankles and feet include:
- Avoid extended periods of standing
- Elevate your legs when you’re sitting
- Lie down for brief periods when you can, preferably on your left side
- Wear comfortable shoes or slippers
- Avoid elastic-top socks or stockings
- Take regular, practitioner-approved exercise breaks throughout your day
- Support panty hose may also bring relief
- Paradoxically, drinking at least eight to ten glasses of water a day can help avoid water retentikon by flushing out waste products
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. Preeclampsia (also known as toxemia or pregnancy-induced hypertension) is characterized by high blood pressure, fluid retention that first shows up in the second half of pregnancy, and protein in the urine. It can be either mild or severe, and in more serious cases can restrict blood flow to the placenta. Should the blood flow to the placenta be restricted it could seriously harm your baby. It is more likely to occur in first pregnancies and beyond the 20th week of gestation. Although preeclampsia is a rare pregnancy complication, if you ensure that you are getting all the right prenatal care and keeping all of your prenatal appointments the chances that your health care provider will pick up the problem early enough to treat it.
Increased circulation and metabolism caused by pregnancy hormones nourish your skin very well. You may notice that hair is beginning to grow at a faster rate and on your arms, legs, and face due to increase hormone stimulation of hair follicles. You may also find that your hair may feel coarser. The good news is that most of this excess hair will disappear within six months after birth.
Breast tenderness and colostrum
Colostrum, a fluid in the breasts that nourishes the baby until the breast milk becomes available, may begin to leak from the nipples. 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.
Your breasts have most likely increased in size and fullness 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.
Since you are carrying around more weight than before, you may be having trouble sleeping at night, and you may have responsibilities other than carrying and nurturing for you new baby, fatigue is an issue during the third trimester. The fatigue you are experiencing is a signal from your body that you should slow down. Make sure that you get enough rest and try to cut back on nonessential activities. By relaxing and resting you will ensure that you have all your strength for labor and delivery.
You may also find that you experience periods of shortness of breath. This is because your body is trying to take in more oxygen to use with the development of your child. This will be particularly evident in the last trimester when the expanding uterus presses against the diaphragm and crowds the lungs. You might that you can obtain relief by sitting up straighter rather than slumping, avoiding overexertion, and sleeping in a semi-propped-up position with two or three pillows.
If your fatigue is extreme and doesn’t ease up with extended rest, make sure to report it to your doctor. This may be a sign of anemia which can sometime strike at the beginning of the third trimester. Anemia is an iron deficiency in your body, but you needed worry to much about your baby as he/she will ensure that they get enough iron from you. You will in fact run short of iron long before your baby does. Your baby will really start to draw on your iron reserves around week 20. Your baby may only suffer from anemia if the situation is ignored. It is when you don’t get enough iron to keep up with your body’s demands that you may develop iron-deficiency.
A woman’s libido (sexual drive) may decrease.
Braxton Hicks contractions (false labor)
These may begin to occur at irregular intervals in preparation for childbirth. These uterine contractions at begin sometime after the 20th week of pregnancy and usually feel as painless tightening of your uterus that last about fifteen or thirty seconds. As you near your delivery, the Braxton Hicks contractions become more frequent and intense and are even confused for the beginning of labor by some women.
To relieve any discomfort during these contractions try changing your position and moving around. Many women find that they can use this time to practice their breathing exercises in preparation for the delivery. If you find that the contractions are very frequent or are accompanied by pain or vaginal discharge, report them immediately.
Continuation of previous symptoms:
- Leg cramps may become more frequent.
- The increased pressure of your growing baby on the veins of your rectum may cause or worsen your hemorrhoids. You might also be constipated which will worsen your hemorrhoids. 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.
- Dry, itchy skin may persist, particularly on the abdomen, as the skin continues to grow and stretch.
- Skin pigmentation may become more apparent, especially dark patches of skin on the face.
- Heartburn may worsen as your baby gets bigger and your uterus pushes on your stomach. Remember to avoid greasy and fried foods and eat six to eight smaller meals instead of larger meals.
- Increased white-colored vaginal discharge (leukorrhea) which may contain more mucus.
- Backaches may persist and increase in intensity.
- Varicose veins in the legs may persist and increase in severity
Revision date: June 20, 2011
Last revised: by Jorge P. Ribeiro, MD