Advice From an OB/GYN

It’s week 28 and you’ve officially started the third trimester of your pregnancy.

Gone are the days of the first trimester’s morning sickness. By second trimester, nausea and mood swings typically subside. The exciting third trimester brings signs of life, but also potential for heartburn, shortness of breath and skin problems.

Your little peanut is now the size of an eggplant, weighing approximately 2 to 2 1/2 pounds, but will almost double in the eighth month of your pregnancy. With this rapid growth, you might begin to feel discomfort like lower back pain or have difficulty sleeping. Thus, this time period can be physically and emotionally challenging. Darby E. Murphy, MD, OB/GYN at Northwestern Medicine Woodstock Hospital, shares her advice for moms-to-be as they navigate the third trimester.

Back Pain and Other Discomfort

With this time of growth comes added pressure on your joints and ligaments. One of the common things you can expect is musculoskeletal discomfort, such as lower back pain and hip discomfort. As the baby grows, your center of gravity shifts, which can cause additional strain on your back.

“I recommend using a heating pad on the lower back, stretching, and taking an over-the-counter medication, like Tylenol, in moderation,” says Dr. Murphy. For pelvic pressure, she suggests maternity support binders that help take pressure off of the pubic bone.

More severe pain, like shooting pain down the legs, may require additional treatment such as physical therapy or a trip to a specialized chiropractor. “I usually start with physical therapy, but a lot have seen relief with a chiropractor who is familiar with working with pregnant women,” Dr. Murphy explains.

Managing weight can also be beneficial. “Try to have the appropriate weight gain in pregnancy, as excessive weight gain can make symptoms worse,” says Dr. Murphy. Normal weight gain is approximately 25 to 35 pounds, or 15 to 25 pounds for someone who is overweight.

Swelling and Weight Gain

During pregnancy, your body typically maintains extra fluid, which explains swelling in your hands, feet and face. This might cause your feet to ache. One option is trying compression stockings to decrease the swelling. You can also try to limit standing for long periods of time if possible. In the evening, elevate your feet and legs to promote blood flow.

Heartburn

“Heartburn during pregnancy is very normal. Some things make it worse, like coffee, cola, citrus or fatty foods,” says Dr. Murphy. Since heartburn worsens when you lie down, try to avoid eating right before bedtime. If problems persist, over-the-counter antacids can be taken.

Constipation and Hemorrhoids

Unfortunately, these problems might plague you throughout pregnancy, as your elevated progesterone levels cause smooth muscle to relax, which slows the passage of food through your intestines. In order to avoid constipation, Dr. Murphy recommends high-fiber foods and drinking plenty of water. Stool softeners are also safe to take. In order to avoid hemorrhoids, avoid constipation and straining, which can increase your risk. If they do develop, over-the-counter cream can provide comfort.

Difficulty Sleeping

You might have plenty of restless nights ahead, but it’s important to maximize your sleep and give your body time to rest. “With getting up to use the washroom, heartburn, restless legs and lower back pain, a lot of women will have fragmented sleep,” says Dr. Murphy.

To improve your chances of a good night’s sleep, Dr. Murphy recommends decreasing your fluid intake before bed to help reduce the nighttime trips to the bathroom. When settling down for the night, get in a comfortable position with strategically placed pillows, specifically between the knees or behind the back. During the day, try to work in exercise, like yoga, walking or light weightlifting, which also help improve sleep.

Light Bleeding

In the third trimester, bleeding and light spotting can happen around 35 to 36 weeks. This can happen for a number of reasons, such as a cervical exam in the office or light spotting after sex. Dr. Murphy says light spotting after such events is usually not cause for alarm. However, she warns, “If you have any heavy bleeding, you should call your doctor.” Although sex is natural and normal, as a general precaution, some physicians might recommend that you stop having sex in the final weeks of your pregnancy. Consult your physician to see what is right for you.

Nesting

Ready to clean house? Nesting, or the urge to prepare a home for baby, is common during the third trimester. Some speculate it’s often part of the excitement for your little one to arrive. As you’re getting ready for baby, avoid lifting heavy objects and using any harmful chemicals, such as bleach. Seek additional help for tasks that require getting on ladders, as your growing belly may affect your balance.

Is It Time?

As your due date approaches, you’ll begin experiencing contractions. That doesn’t necessarily mean you should head to Labor and Delivery. Braxton Hicks contractions feel like tightening or mild cramping and do not occur regularly. “As it becomes late in your pregnancy, you might have them several times a day for a couple hours,” explains Dr. Murphy. These types of contractions don’t mean you’re in labor. Labor contractions are strong enough and close enough to make the cervix start to dilate, and will be progressively more painful, says Dr. Murphy.

Dr. Murphy recommends pregnant women attend prenatal classes, which will cover what to expect during labor, how to navigate breastfeeding and common questions about your newborn.

Of course, don’t forget to pack your bag and get ready for the big day!