Symptoms from A to Z – Third Trimester
As you get to the third trimester of pregnancy, things begin to change again and you may be feeling simply - more pregnant.
Your baby and your uterus become heavier, your breasts are fuller and your blood volume is at its maximum, you are feeling very different from before. Some of the symptoms have followed you from the first trimester, and a few new ones are joining them.
•Backache is a pretty obvious symptom at the end of pregnancy. Your belly is growing and pushing forward, your breasts are full and heavy, your centre of gravity is shifting. The ligaments in your pelvis are getting softer to prepare for birth and your back has that much extra weight to carry. Some women find that regular massage, chiropractic or osteopath adjustments from an experienced practitioner are helpful. Some other tips can include
• Generally, be aware when changing positions
• When you’re lying back, roll over on your side and push up with your hands to sit up instead of just sitting up
• Avoid standing or sitting in one position for long periods of time - stand up and take a quick walk, or do some hip circles every twenty to thirty minutes
• if you are lifting something, lift from your legs and not your back
• Tuck pillows between your knees and under your belly when you’re lying down and sleeping
•Braxton-Hicks are “practice” contractions that your uterus does before labour. You can tell they are BH contractions because they are irregular and don’t intensify over time. Sometimes, a warm shower or bath can help slow or stop them. In fact, your uterus contracts from early pregnancy onwards, it’s just that you don’t usually feel it.
•Breathlessness happens because you are breathing for two and because your uterus is putting more pressure on your lungs. Take breaks when you’re out of breath and don’t feel bad - this is a normal
part of pregnancy.
•Fatigue is a topic we have already written about. It tends to get worse in the third trimester, and you are likely to need a nap in the afternoon. Since most labours begin at night, it’s a good idea to get to bed early in the third trimester - if you go to bed at 9pm and are woken up by contractions at 3am, at least you’ve had a good chunk of sleep.
•Heartburn happens as your growing uterus puts more and more pressure on your stomach. Hormonal changes also cause the valve at the top of your stomach to relax and more stomach acid can back up into the oesophagus, causing heartburn. You can curb this by avoiding foods that trigger you, avoiding eating before bed, drinking a glass of milk before a meal or eating a few almonds when you feel the burning begin. If it is severe, ask your midwife or doctor if they can help you with a prescription medication.
•Haemorrhoids tend to get worse late in pregnancy. You can ease them by avoiding straining when pooing, by raising your legs or using a stool under your feet so you are in a squat position when pooing.
Other things that can help are avoiding sitting on hard surfaces, keeping the area around your anus clean (use unscented, undyed toilet paper and wash gently after each poo). You can also use witchhazel pads to ease irritation. If they are severe, talk to your midwife or doctor about medicated creams you can try.
•Hip soreness happens because of the softening ligaments in your pelvis. Try doing light hip stretches, circles and yoga to make the pain go away.
•Itchiness is inevitable considering how much your skin is stretching and growing. Find a good quality moisturiser with simple ingredients (cocoa butter, olive oil, shea butter are some examples) and give your skin a good rub-down once a day, paying special care to your belly. If your itchiness is severe, especially if your palms are itchy, talk to your midwife or doctor.
•Insomnia can happen throughout pregnancy, but especially during the third trimester when it’s harder to sleep because of your big belly and because you’re probably waking up to pee at least once at night. You can make sleep easier by limiting your caffeine intake, avoid drinking a lot before bed and skipping late-night snacks, going to bed at a regular time and watching the number and length of naps you take during the day. Exercise can help you sleep, as can taking some time to relax and unwind before bed. Make sure your bedroom is a comfortable temperature and that you have enough pillows to support you when sleeping - some women like having a pillow under their belly and one between their knees. Another great position for sleeping is being on your side and having
your top leg bent at the knee and raised above your lower leg.
•Leg cramps tend to happen in the middle of the night, causing extreme pain in the muscle between your knee and your foot, especially if you tend to stretch out at night. When stretching, be careful to stretch by pushing your heel downward – don’t stretch by pushing your toes forward. Consider taking some magnesium or calcium supplements, as leg cramps can be a sign that you’re deficient in these minerals. If you get a leg cramp, try massaging your calf or getting up to walk around, this usually helps the pain go away.
•Linea nigra is a line that appears on the bellies of some women during pregnancy, stretching from the belly button down. It disappears after you give birth.
•Mask of pregnancy or chloasma are brown patches of skin that can appear on a pregnant woman’s face and neck. These can be lessened by avoiding direct sun exposure and disappear after birth.
•Perineal aching, or when the area between your vagina and your anus starts to ache, is common in late pregnancy. You are holding a very heavy weight in your pelvis, and as your baby’s head descends for birth, this can cause pain in your perineum. Light exercise can be helpful.
•Pubic bone pain can intensify in the third trimester. It happens as pregnancy progresses because your ligaments soften to make room for a growing baby and to be more flexible for birth. This can cause pain for some women, especially in the areas where the pubic bones meet (where the ligaments are). This eases slowly after you give birth, as the ligaments tighten again.
•Restless leg syndrome can best be described as any unpleasant sensation in your legs, that is usually most annoying at night. It can even cause leg twitching. RLS is often a sign that you are deficient in
magnesium - be weary, it takes a few days for the magnesium to build up enough in your body to make RLS better. Exercise and avoiding caffeine can also help.
•Rash in pregnancy or PUPP (Pruritic urticarial papules and plaques of pregnancy) causes red bumps to form in the creases of stretch marks, usually on the abdomen. It’s likely caused by stretching of the skin plus an immune response to pregnancy. In most cases, it goes away a few days after birth. It’s best to avoid scratching, touching or irritating the skin (as hard as that is), apply cool compresses or ice, moisturise the area and apply soothing creams that include oatmeal and chamomile or other substances known to ease itching.
•Sciatica is the pain, tingling or numbness you can feel in your lower back, bum, legs or thighs during pregnancy. It happens when baby’s head rests itself on a particular nerve, sending a shooting sensation into your body. Changing positions often during the day, stopping to do some stretches occasionally, swimming and relaxing and water therapy (shower or bath) can provide relief. Chiropractic and osteopathic care can also be helpful.
•Separation of abdominal muscles during pregnancy (or diastasis recti) happens to many women as their abdominal muscles move apart to accommodate a growing baby. Ask your midwife or doctor to
have a look at your belly if you are concerned about your muscles and talk about how to help.
•Stretch marks can happen at any time during pregnancy but are most common towards the end. These can appear on your belly but also on your breasts, thighs and other body parts. They begin as red lines and slowly fade to silvery-white but rarely disappear completely. Special creams and lotions are not likely to help you avoid stretch marks, but your skin will be more elastic and stretch more easily if you keep your skin well-hydrated on the outside with lotions, and on the inside by drinking more water.
•Increased sweating and generally feeling hot are common in the final trimester. Your body will work to keep you cool, which means you will be sweating more often. Wear loose clothing made of breathable materials and dress in layers so you can adjust your clothing depending on how you feel. It may also be a good idea to carry around an extra bottom layer (t-shirt or undershirt) in case you soak through yours in an extreme situation.
•Swelling and oedema are a very important part of pregnancy – the extra fluid you are retaining helps keep your blood pressure up after you give birth, protecting you from problems if you experience above average bleeding after birth. Increasing your fluid intake can help make your swelling go down, as can exercise or resting your swollen ankles in an elevated position. Avoiding salt is not helpful, and for some women avoiding carbohydrates (see chapter two on nutrition) can help. If you suddenly become very swollen or have severe swelling, let your midwife or doctor know as soon as possible.
•Urination is something you’re very familiar with by now. More pressure on your bladder from a heavier baby and uterus means that you are feeling the urge to pee more often. Your bladder is also being squished and can hold less urine.
•Tightness in your uterus (painful or not) can happen when you’re exercising and is usually normal. It usually stops when you’ve stopped exercising, after you have a glass of water or have rested for at least half an hour. Contact your midwife or doctor if they continue longer than that or if you have more than four contractions (tightening) in an hour.
•Varicose veins happen when extra blood pools around your veins. They tend to run in families - if your mum or sister had them, chances are you will too. They tend to happen in your legs and can become painful and swollen. They can also happen in your outer labia (labia majora) - this may look frightening but is normal. Speak to your midwife or doctor on how to ease varicose veins. Avoid kneading or massaging them, as this can make them worse. If you notice a red, swollen tender area that seems infected, lift your leg and call your midwife or doctor immediately.