Health & Fitness Pregnancy

See how you can maintain your health during the third trimester (week 28 – end of pregnancy)

The third trimester is from week 28 to week 40, which means 7th, 8th, 9th months of your pregnancy. Your feelings at this stage of pregnancy tend to go from tiredness and worry to the excitement of seeing the baby within a few months. Your baby continues to grow, and as the third trimester progresses they’ll have a better chance if they’re born early. You’ll have more visits to the doctor in the third trimester, because keeping an eye on your health and your baby’s health is more important. 

This is the final stretch of pregnancy and the curiosity and fear increase in this period. Some of the physical symptoms you may experience during the last 3 months include shortness of breath, hemorrhoids, urinary incontinence, varicose veins, and sleeping problems. Many of these symptoms arise from the increase in the size of your uterus, which expands from approximately 2 ounces before pregnancy to 2.5 pounds at the time of birth. 

What changes may occur in the third trimester?

  • Shortness of breath

Breathing difficulties occur when your uterus gets larger. It grows higher in your abdomen, and presses on your diaphragm, which makes breathing difficult. You might be unable to make it up a flight of stairs without getting winded. The best thing to do is just to take it easy, move more slowly, and stand up or sit up straight so your lungs have more room to expand. If you experience dramatic breathing changes, or if you have a cough or chest pain, contact your healthcare provider right away. Once your baby drops down into your pelvis and is ready to come out or be born, the pressure is taken off your lungs and breathing will become a little easier.

                  Tips:

  • Get plenty of rest.
  • Use good posture.
  • Try taking deep, slow breaths through the mouth.
  • Wear loose clothing.
  • Frequent urination

You may find yourself needing to pee more often when you enter the final weeks of your pregnancy. This is because as your baby moves further down into your pelvis, she may press on your bladder too. You may also find that you leak a little, especially when you laugh, sneeze, bend, or lift. If this bothers you, wear a panty liner. However, if you feel a gush or trickle of watery fluid, it could be your water breaking, in which case contact your healthcare provider as this is a sign that labor is beginning.

                     Tips:

        • Pee regularly.
        • Avoid caffeine.
        • Do pelvic floor exercise 
  • Swollen feet and ankles

Many pregos notice a type of swelling, called edema, in their ankles and feet because of extra fluid retention, hormonal changes, and weight gain. If you notice this, it could help to elevate your legs whenever you can and to soak your feet in cool water. To help you feel more comfortable, you may need to buy bigger shoes. The swelling in your body may also press on nerves, causing tingling and numbness. This can happen in your legs, arms, and hands. The skin on your belly may feel numb because it is so stretched out. Tingling and numbness in the hands usually occur because of carpal tunnel syndrome. That is caused by pressure on a nerve in the wrist. You may be able to get rid of these symptoms by wearing wrist splints overnight. Otherwise, the problem usually ends after pregnancy.

  • The contractions in third trimester

You may experience the false contractions, in the last months. These “practice contractions” are useful for your body because they help your muscles prepare for labor. Braxton Hicks contractions may start out quite mild and feel like a tightening of your abdomen, but as your due date nears they can become more painful. Essentially, the contractions come irregularly and often go away if with changing your position; true labor contractions get more regular over time and don’t go away.

 

  • Aches and pain

Your growing baby is starting to get cramped in your belly, so you might start feeling more kicks and other movements. A growing fetus can cause more body aches for you because of the extra weight you’re carrying. Aches and pains in the back, knees, and neck are common during the third trimester. Rest and put your feet up when you can, and alternate between ice packs and heating pads to ease the pain.

 

  • Heartburn

Indigestion and heartburn are more common during the third trimester because the growing uterus puts pressure on the intestines and the stomach. The pressure on the stomach may also push contents back up into the esophagus. 

                 Tips to cure:

  • Eat small and frequent meals.
  • Do not bend or lie down immediately after a meal. 
  • Do not wear tight waistbands.
  • Avoid fried, fatty, and spicy foods.
  • Drink lots of liquids between meals.
  • Elevate your head and shoulders while resting.

General disturbance and insomnia during the third trimester of pregnancy:

 

You may feel a disturbance in general well being throughout the pregnancy period, but it increases in the second and third trimesters.  Many pregnancy sleep struggles come from just not being able to find a comfortable position to sleep in. Inveterate stomach-sleepers find that they eventually can’t sleep in this position anymore. Meanwhile, back sleepers also have to search for a new path to slumber, since back-sleeping isn’t advised past the first trimester. When you lie flat on your back, your circulation may be compromised. Because, the weight of your growing uterus presses on the main vein carrying blood from your lower body back to your heart. 


Tips to sleep well: 

  • Sleep on your left side. This allows for the best blood flow to the fetus and to your uterus and kidneys. Try to avoid lying on your back for extended periods of time.
  • Try using a special “pregnancy” pillow to help you sleep better.
  • If you are experiencing leg cramps you may want to avoid carbonated sodas and drinks.
  • If you start snoring, have your blood pressure and urine protein checked—especially if you have swollen ankles and headaches.
  • If you develop Restless Legs Syndrome, you may want to talk to your health care physician about an iron deficiency.
  • If you can’t sleep, don’t lie in bed forcing yourself to sleep. Get up and read a book, write in a journal or take a warm bath.
  • If you get a cramp in your leg, straighten your leg and flex your foot upwards. Try doing this before going to bed several times to help ward off future cramps.

What skin changes may occur during the third-trimester pregnancy?

No doubt, you’ve got the pregnancy glow, but you may also experience unpleasant skin changes during the third trimester of your pregnancy. For some women, pregnancy is a time when the skin improves and acne subsides. But most women experience at least some itching and redness, as well as potentially long-lasting skin changes, such as stretch marks.

A change in diet and lifestyle can help, but it’s also important to accept that some changes like those stretch marks, are long-lasting. It is to be said that, “stretch marks are the stripes of a tiger mama. Embrace them and be confident.”

  • Stretch marks

They are very common in pregnancy. Typically, they are red or white marks on your skin, and are most often found on the breasts, belly, and upper thighs. Your skin has fibers that allow your skin to stretch and grow. However, growth that happens too quickly can break these fibers. Stretch marks usually are purple or red when they first appear because the blood vessels in the dermis are showing. They usually fade after delivery, but it may be difficult to eliminate them completely. Some women never lose their stretch marks. However, after birth, the marks will gradually change from red or purple to tan or white and will be harder to see.

 

  • Varicose vein:

These are bluish, swollen, sometimes painful veins beneath the surface of the skin. They often show up on the backs of the calves or the inside of the legs. Varicose veins are caused by,

 

  • Pressure your growing uterus puts on the large veins behind it, which slows blood circulation.
  • Pregnancy hormones, which cause the walls of veins to relax and possibly swell.
  • Constipation, which makes you strain to pass hard bowel movements.
  • Increased fluid retention.
  • Hemorrhoids

    Hemorrhoids are varicose veins in the rectum. They may stick out of the anus and cause itching, pain, and sometimes bleeding. 

              Tips:

  • Avoid constipation and straining.
  • Do pelvic floor Exercise. 
  • Rest and sleep on your side with a pillow between your legs. Do not lie flat on your back.
  • Try not to sit or stand for long periods of time, change positions, or walk around.
  • For relief, apply ice wrapped in a cloth to the affected area.

 

Skin Eruption:

Sometimes called PUPPP (pruritic urticarial papules and plaques of pregnancy), the characteristic lesions are red, raised, and itchy. The rash tends to be located in stretch marks, though it can also make an appearance on thighs, buttocks, or arms. Its cause is unknown, but it isn’t dangerous to you or your baby.

         Tips:

  • If you use soap, try one made with glycerin.
  • Avoid long, hot baths.
  • Apply oils or lotions to keep your skin moisturized, especially after a bath or shower.
  • Calamine lotion may relieve the itching.
  • Severe itching can be a sign of a serious liver condition. If your itching is severe, talk with your healthcare provider. 

 What bodyweight changes may occur?

Your body will go through significant changes during the third trimester of pregnancy to support your growing fetus. Your baby changes rapidly during this period. You may experience some of the same changes and symptoms you had during your first and second trimesters, but they get worse in the third trimester, as you get closer to your baby’s arrival.

During the final months of pregnancy, your baby gains the most weight. In fact, a fetus weighs around 2 pounds at 27 weeks, 4 to 4 ½ pounds by 32 weeks, and grows up to between 6 ¾ pounds to 10 pounds, if you have a full-term delivery. Your baby will also grow an average of six more inches during the third trimester.

In addition to baby weight, your body will also gain weight from:

  • fluids
  • more blood
  • amniotic fluid
  • a larger uterus
  • the placenta
  • fat stores

All of these will add a few extra pounds. That’s one reason why doctors stress that women try not to gain too much weight during the first two trimesters of pregnancy.

While you certainly don’t want to lose weight during the third trimester, it’s also important not to give in to unhealthy food cravings and to be as active as possible. Doing both will help you prevent unnecessary weight gain. The total amount of weight you should gain depends on how much you weighed pre-pregnancy. Complications of too much weight gain can show up during the third trimester, and may include:

  • gestational diabetes
  • high blood pressure
  • premature birth 
  • heavy birth weight

Gestational Diabetes:

During the period of pregnancy, some women develop a high sugar level, which is a medical language known as Gestational diabetes mellitus (GDM). GDM or gestational diabetes mostly develops in the 24th to 28th week of pregnancy but it may last till the end of pregnancy. It can affect the mother as well as the baby’s health. Gestational diabetes usually goes away after you have your baby. As we know, the placenta supports the baby and helps to grow. Hormones from the placenta help the baby develop and get nourished. But these hormones also block the action of the mother’s insulin in her body. This problem is known as insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin, which ultimately leads to hyperglycemia and results in GDM.

Who is more likely to have gestational diabetes mellitus?

  • Mother older than 25
  • the overweight or obese person
  • the one who had a history of GDM with past baby
  • may have a polycystic ovarian syndrome
  • Prediabetes At this stage person’s blood glucose levels are higher than normal but not high enough to be diabetes.
  • Positive Family history

Can GDM cause problems in pregnancy? If yes then what are those? 

The first and most common problem is seen cesarean birth which is commonly known as C- Section. Women can have a normal vaginal delivery, but the ratio of NVD is lesser in women with GDM as compared to normal to women.

  • High blood pressure: 
  • High blood pressure (hypertension), i.e, the force of blood against the walls of the blood vessels, is too high. It can stress the mother’s heart and can cause heart problems. When pregnant women develop hypertension may give the signs that some of the organs like kidneys may not be working properly. In medical language, Preeclampsia is another name for hypertension during pregnancy.
  • Signs of preeclampsia:
  • high protein in the urine
    • vision problems
    • Headache.
    • Edema ( swelling )
    • This can increase the risk of premature birth.
  • Premature birth: 
  • The birth before the 37 weeks is considered a premature birth, which may need to have a c-section if you have complications during pregnancy, and may need to have labor induced before your due date. Inducing labor means your provider gives you medicine or breaks your water (amniotic sac) to make labor begin.
  • Heavy birth weight:
  • This term is used to describe a newborn who’s much larger than average. Also known as “fetal macrosomia.”
  • A baby who weighs more than 8 pounds, 13 ounces regardless of his or her gestational age, is called a heavy birth weight baby. About 9% of babies worldwide weigh more than 8 pounds, 13 ounces.
  • Risks associated with fetal macrosomia increase greatly when birth weight is more than 9 pounds, 15 ounces. Fetal macrosomia may complicate vaginal delivery and can put the baby at risk of injury during birth. Fetal macrosomia also puts the baby at an increased risk of health problems after birth.
  • Postural deviation in the third trimester:
  • In the thirds trimester of pregnancy, women go through different changes. From the beginning of a pregnancy, the hormone relaxin (which causes ligamentous laxity) has been flowing through the prego’s body, allowing for essential skeletal shifts that allow for the baby’s growth. However, the presence of relaxin can also lead to exaggerated shifts as a woman moves through her third trimester. The increased weight she is likely carrying can cause an anterior pelvic tilt (lordosis), which may lead to prominent low-back pain. The anterior weight shift also occurs at the breasts throughout pregnancy, profoundly more so in the third trimester. This pull adds to increased kyphosis at the cervical and thoracic spine. Kyphosis pulls her out of a neutral spine position, which may lead to neck and upper back pain, as well as diminished power and range of motion when she is operating out of the proper posture.
  • How can you keep your posture maintained?
  • Much of the back pain experienced throughout pregnancy is related to the strain on your back from the weight of your growing baby. Using proper posture can help prevent and even relieve some of the pain. Here are some tips to help you maintain good posture in various positions.
  • What is proper posture during pregnancy?
  • You can imagine a straight line running from your ears to your shoulders and your hips and knees. When your body is in alignment or when you use proper posture, choose supportive shoes with low heels and good arch support. You may need to buy a larger size, as many women find their feet grow or swell with pregnancy. So large shoes are preferable for the prego’s comfort.
  • Pregnancy hormones cause the ligaments to relax. These changes may make you feel uncomfortable, even in a lying position. 
  • Here are tips to help you cope:
  • It’s best to avoid lying on your back, especially in late pregnancy, when the weight of the heavy uterus can press on the large blood vessels in your belly.
  • When lying on your side, keep your body in line, with your knees bent slightly, and avoid twisting.
  • Use pillows for support behind your back, between your legs and under your belly. Most women find that a firm mattress with a good pad provides the best support.
  • To get out of bed, raise your upper body with your arms and hands to a sitting position then move your legs over the side of the bed.  Stand up slowly, using your leg muscles.
  • If you are in a sitting position, proper posture is important. Here are tips to help you practice good posture while sitting:
  • Keep your body in alignment while sitting, and try not to slump or slouch. Use a sturdy chair with low-back support and tilt your pelvis forward to avoid the swayback position. Your knees should be slightly lower than your hips, and your feet should touch the floor.
  • Choose a chair with soft armrests that allow your shoulders to relax and your elbows to be near your body.
  • Be careful with chairs on wheels as they may move as you try to sit down or stand up.
  • It’s also helpful to get up every hour or so and walk around. Try not to cross your legs while seated, as this can impair circulation.
  • Here are tips to help you use good posture when standing:
  • It’s best to avoid standing for long periods. Try to vary your position often.
  • When you do have to stand, keep your feet slightly apart and avoid locking your knees. Remember to keep your pelvis tucked in.
  • If you have to stand in one place for a long time, place one foot on a small step stool. This takes some of the weight off your lower back. 
  • Good posture can help you look and feel better and may prevent some of the discomforts that can happen later in pregnancy.
  • Which exercises are recommended in the third trimester of pregnancy?
  • Exercising in pregnancy is very beneficial for the mother, and it increases the chances of normal safe delivery. It also helps to prevent weight gain, improve circulation and keeps the heart rate stable throughout the pregnancy, helps to reduce labor pain, improves stamina and makes the mom more flexible, reduces the chance of high blood pressure and gestational diabetes also being active in your pregnancy helps you recover quickly after the delivery.
  • Tips for a safe workout during pregnancy: 
  • Wear Loose and Comfortable Clothing: This helps to prevent obstruction in blood circulation. 
  • Control the Room Temperature: A room that is too hot or too cold can affect your body temperature and harm the baby.
  • Drink Plenty of Water: it is always important to stay hydrated.
  • Wear Comfortable Footwear: This provides stability.
  • Warm-up with Stretches: Initially doing some stretching exercises helps prevent aches and
  • Don’t Exert Yourself: Don’t exercise if you are too tired.
  • Avoid Standing Still For Long Periods: This may lead to pooling of blood and resultant swelling in the lower limbs.
  • Recommended exercises are;
  1. Walking: This is the simplest, most accessible exercise in pregnancy. Make sure to wear a comfortable and supportive pair of shoes while walking. Visit a running shoe store to get a free consultation on the specific kind of support you need for your feet and how you walk. A trained sales associate will be able to tell you if you need more of an arch or a flat shoe. If you find that your lower back or pelvis hurts during a walk, try wearing a back or pelvis brace for extra support. For severe back or pelvic pain, see a prenatal physical therapist to determine what kind of support and strengthening exercises are needed. Walking every day for about 30 to 40 minutes ensures that your body is not sedentary and also keeps your heart healthy. Carry on in a comfortable and consistent speed, and do not forget to sway your arms and enjoy the activity.
  2. Swimming or water aerobics: Swimming, besides feeling amazing during pregnancy, is a great exercise because the water takes the weight and stress off your joints and ligaments, allowing you to move with little or no discomfort. Swimming laps or doing water aerobics, on your own or in a class, is a great way to safely and comfortably raise your heart rate.
  3. Prenatal yoga or Pilates: Yoga and Pilates are ideal during pregnancy, not only because of the gentle pregnancy-friendly movements, but also because of their focus on strengthening your core and pelvic floor, which helps with stability, comfort, and labor and birth. If you’re searching for a good class to attend, be sure to look for a pregnancy-specific class with instructors who are certified in teaching prenatal classes.
  4. Body exercises and toning work If you’re looking to tone muscles and improve strength, simple exercises like squats, arm lifts with low-weight dumbbells, wall pushups, lunges, leg lifts, etc. are great because they are low impact and can be done easily at home.

What are the yoga tips that may help you to get normal delivery?

Butterfly Pose Yoga widens your hips and eases pain in the lower back.

Steps:

 

  • Sit on the ground and bring the soles of your feet together, with the knees pointing outwards.
  • Grasp your ankles (or feet) and draw your heels as close to your body as comfortable.
  • Lean forward, hold the position, and breathe deeply.

Pelvic Stretches:

When you are preparing for labour pelvic floor muscles exercises are highly recommended. Kegel exercises for a normal delivery focus on strengthening the pelvic floor muscles. To isolate and exercise these muscles, try stopping the flow of urine without using your abdominal muscles, thighs or buttocks. For slow Kegel exercises, start by sitting with a straight back comfortably on the workout ball.

Steps:

  • Slow Kegel exercise: hold the contracted muscles for 3-10 seconds for 10 sets.
  • Fast Kegel exercise: Contract and relax the pelvic floor muscles 25-30 times before relaxing for five seconds, and perform four sets of exercises

Yoga during pregnancy for normal delivery is highly recommended for expecting mothers and there are plenty of forms and aasanas that can help increase the flexibility and endurance in an expecting mother. Some aasanas that can be done include:

Yastikasana (Stick pose):

  • Lie down with your arms stretched above your head and keep your legs straight.
  • Keep the arms and legs as close to each other as possible.
  • Hold for as long as it is comfortable.

Vakrasna (Twisted pose):

  • Sit on the floor with your legs stretched in front of you.
  • Bend your left knee, placing the left foot near the right knee.
  • Inhale and raise your arms to shoulder height.
  • Exhale and twist as much as you can comfortably, and grasp your right knee with the right hand. Hold for a while.
  • Do the exercise in reverse.

Squats:

they are important, as they help in the contraction and loosening of the pelvic muscle and help reduce delivery pain. Taking position with the support of a gym ball or holder will give a good pressure to the pelvic area and thighs.

Steps for squats:

  • Breathe and bend down to acquire a sitting position.
  • Wait for a second, and return to your starting position.
  • Repeat the squat, now keeping your elbows placed inside your thighs, and gently try to open your hips by pushing them back.
  • Slowly return to the standing position with feet well supported.

Don’t forget that, exercise for about half an hour is adequate and recommended. An expectant mother must stop when she feel fatigue or any of the following is observed:

Pre-existing blood pressure problems, asthmatic conditions, cardiac disorder, diabetes etc.

Vaginal bleeding

History of a preterm delivery or wasted delivery

Experience augmented contractions shortly after exercising.

What are the nutritional requirements in the third trimester?

Don’t eat too much, but it is important to eat healthy during pregnancy days. Gone are the days when women were advised to eat for two to fulfill their nutritional needs. The latest focus is on what we eat rather than how much we eat, especially as your pregnancy progresses.

During the third trimester of your pregnancy, you need sufficient energy to keep up with the routines throughout the day. Rely on the right diet so that you and your baby get all the required nutrition.

  • DHA, which is a docosahexaenoic acid, is a type of omega-3 fat. It is important for proper development of the fetal brain and retina during the third trimester. Its requirement increases from 100 to 200mg per day.
  • Calcium, 1000mg daily, is essential to build bones and teeth in your baby. Milk and other dairy products, such as cheese and yogurt, are the best sources of calcium.
  • Vitamin D 15 µg per day, is needed for the bones to absorb calcium.
  • Folic acid is essential to avoid neural defects in the baby. Your intake can go up to 800µg per day.
  • You need additional 26g a day of protein in the third trimester as it is required to maintain maternal tissues and fetal growth.
  • The options for food containing, Magnesium rich foods  are Dark green leafy vegetables, nuts, whole grains, avocados 
  • Protein rich foods are Eggs, milk, yogurt, tofu, all meats
  • Calcium rich foods that are essential to take, Broccoli, watercress, cheese, seafood, dried peas, and beans
  • Folic acid rich foods include: Lentils, beans, Brussels sprouts, oranges, eggs
  • And the iron rich foods are, breads and pastas, beans, beets, raspberries, strawberries, red meat, dry fruits like apricots, prunes
  • Perhaps the most significant changes you’ll have towards the end of your pregnancy are contractions. Unlike Braxton Hicks contractions, true labor progresses by contractions becoming longer, stronger, and closer together. 
  • Congratulations!! You’re gonna see your baby within few days, the contractions are your cue to call your midwife or birth center to prepare for the arrival of your baby!
  • Sign up for and attend childbirth classes to help you get ready for the big day, prepare yourself mentally and physically to grow a child.
  • Prepare a birth plan, if you want one
  • Choose a good pediatrician for the future.
  • Get prepared for your little one’s arrival by stocking up on baby gear like diapers and wipes, clothes, and nursery essentials to avoid any hurdles.

Postpartum care:

  • Well, postpartum care is as important as the pregnancy care. The postpartum period lasts six to eight weeks, beginning right after the baby is born. 
  • Although this is the great time because you have your baby in your lap and you can touch, feel his cute and soft hands and face. But the mother, during this period, goes through many physical and emotional changes. Postpartum care involves getting proper rest, nutrition, and vaginal care.

Getting Enough Rest

  • Rest is crucial for new mothers who need to rebuild their strength after the pregnancy period. To avoid getting fatigue, as a new mother, you may need to:
  • sleep when your baby sleeps
  • keep your bed near your baby’s crib to make night feedings easier
  • allow someone else to feed the baby with a bottle while you sleep so you can fulfill you sleep requirement.

Getting proper nutrition:

  • Eating properly and getting enough nutrition in the postpartum period is important to over-come the changes your body went through during pregnancy and labor.
  • The weight that you gained during pregnancy helps make sure you have enough nutrition for breast-feeding. However, you need to continue to eat a healthy diet after delivery.
  • Experts recommend that breast-feeding mothers eat when they feel hungry. Make a special effort to focus on eating when you are actually hungry  not just busy or tired.
  • avoid high-fat snacks
  • focus on eating low-fat foods that balance protein, carbohydrates, and fruits and vegetables
  • drink plenty of fluids

Vaginal Care

New mothers should make vaginal care an essential part of their postpartum care. You may experience:

  • vaginal soreness f you had a tear during delivery
  • urination problems like pain or a frequent urge to urinate
  • discharge, including small blood clots
  • contractions during the first few days after delivery
  • Schedule a checkup with your doctor about six weeks after delivery to discuss symptoms and receive proper treatment. 

About the author

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Khurram Jamil - Digital Marketer By Profession & Blogger By Passion. Food Lover By Choice

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