The third trimester of pregnancy can be tiring and uncomfortable. Here's help relieving symptoms — and anxiety — as your due date approaches.By Mayo Clinic Staff
The third trimester of pregnancy can be physically and emotionally challenging. Your baby's size and position might make it hard for you to get comfortable. You might be tired of pregnancy and eager to move on to the next stage. If you've been gearing up for your due date, you might be disappointed if it comes and goes uneventfully.
Try to remain positive as you look forward to the end of your pregnancy. Soon you'll hold your baby in your arms! Here's what to expect in the meantime.
As your baby grows, his or her movements will become more obvious. These exciting sensations are often accompanied by increasing discomfort and other third trimester pregnancy symptoms.
Continued breast growth
By your due date, you might have an additional 2 pounds (nearly 1 kilogram) of breast tissue. As delivery approaches, your nipples could start leaking colostrum — the yellowish fluid that, if you breast-feed, will nourish your baby during the first few days of life.
If you had a normal BMI before pregnancy, you might gain 25 to 35 pounds (about 11 to 16 kilograms) before giving birth. Your baby accounts for some of the weight gain, but so do the placenta, amniotic fluid, larger breasts and uterus, extra fat stores, and increased blood and fluid volume.
Braxton Hicks contractions
These contractions are warm-ups for the real thing. They're usually weak and come and go unpredictably. True labor contractions get longer, stronger and closer together. If you're having contractions that are painful or regular, contact your health care provider.
As your baby continues to gain weight, pregnancy hormones relax the joints between the bones in your pelvic area. These changes can be tough on your back.
When you sit, choose chairs with good back support. Apply a heating pad or ice pack to the painful area. Ask your partner for a massage. Wear low-heeled — but not flat — shoes with good arch support. If the back pain doesn't go away or is accompanied by other signs and symptoms, contact your health care provider.
Shortness of breath
You might get winded easily as your uterus expands beneath your diaphragm, the muscle just below your lungs. Practice good posture to give your lungs more room to expand.
To keep heartburn at bay, eat small meals and drink plenty of fluids between meals. Avoid fried foods, citrus fruits or juices, and spicy foods. If these tips don't help, ask your health care provider about antacids.
As your growing uterus puts pressure on the veins that return blood from your feet and legs, swollen feet and ankles might become an issue. Swelling in your legs, arms or hands can place pressure on nerves, causing tingling or numbness.
To reduce swelling, frequently prop up your legs and don't sit with your legs crossed. If you have to stand for long periods, try to move around often.
Spider veins, varicose veins and hemorrhoids
Increased blood circulation might cause tiny red veins, known as spider veins, to appear on your skin. You might also notice blue or reddish lines (varicose veins) beneath the surface of the skin, particularly in the legs. Varicose veins in your rectum (hemorrhoids) are another possibility.
If you have painful varicose veins, elevate your legs frequently and wear support stockings. To prevent hemorrhoids, avoid constipation. Include plenty of fiber in your diet and drink lots of fluids.
As your baby moves deeper into your pelvis, you'll feel more pressure on your bladder. You might find yourself urinating more often. This extra pressure might also cause you to leak urine — especially when you laugh, cough or sneeze. If you're worried about leaking urine, panty liners can offer a sense of security.
Continue to watch for signs of a urinary tract infection, such as urinating even more than usual, pain during urination, fever or backache. Left untreated, urinary infections increase the risk of pregnancy complications.
Potentially heavy vaginal discharge is common at the end of pregnancy. If you saturate a panty liner within a few hours or wonder if the discharge is leaking amniotic fluid, contact your health care provider.
As anticipation grows, fears about childbirth might become more persistent. How much will it hurt? How long will it last? How will I cope?
If you haven't done so already, consider taking childbirth classes. You'll learn what to expect — and meet other moms-to-be who share your excitement and concerns. Talk with women who've had positive birth experiences, and ask your health care provider about options for pain relief. Tell yourself that you'll simply do the best you can. There's no right or wrong way to have a baby.
The reality of parenthood might begin to sink in as well. You might feel anxious and overwhelmed, especially if this is your first baby. To stay calm, revel in the experience of being pregnant and think about the joy that will come from loving a new human being. Consider:
- Writing your thoughts in a journal
- Talking to your baby
- Taking photos of your pregnant belly to share with your child one day
It's also helpful to plan ahead. If you'll be breast-feeding, you might get a nursing bra or a breast pump. If you're expecting a boy — or you don't know your baby's sex — think about what's right for your family regarding circumcision. Consider who'll be your baby's principal health care provider. Make plans for your first few weeks together.
During the third trimester, your health care provider might ask you to come in for more frequent checkups — perhaps every other week beginning at week 28 or 32 and every week beginning at week 36.
Like previous visits, your health care provider will check your weight and blood pressure and ask about any signs or symptoms you're experiencing. Regardless of your vaccination status, one dose of Tdap vaccine is recommended during each pregnancy — ideally during the third trimester. This can help protect your baby from whooping cough before he or she can be vaccinated. You also might need screening tests for various conditions, including:
- Gestational diabetes. This is a type of diabetes that sometimes develops during pregnancy. Prompt treatment and healthy lifestyle choices can help you manage your blood sugar level and deliver a healthy baby.
- Anemia. Anemia is an abnormally low level of red blood cells or hemoglobin, a protein in red blood cells that contains iron. Severe anemia can slow your baby's growth. To treat anemia, you might need to take iron supplements.
- Group B strep. Group B strep is a type of bacteria that can live in your vagina or rectum. It won't make you sick, but it could cause a serious infection for your baby after birth. If you test positive for group B strep, your health care provider will likely recommend antibiotics while you're in labor.
Your health care provider will also check your baby's size and heart rate. Near the end of your pregnancy, vaginal exams can help your health care provider determine your baby's position inside your uterus. He or she might also check your cervix to see whether it's begun to soften or dilate in preparation for birth — although cervical exams aren't a reliable way to predict when labor will begin.
If you have specific desires or preferences for labor and birth — such as laboring in water or avoiding medication — you might want to define your wishes in a birth plan. Review the plan with your health care provider ahead of time to prevent any misunderstandings.
As your due date approaches, keep asking questions. How can I tell the difference between false labor and the real thing? When do I need to go to the hospital? Could I be too late for an epidural? Remember, there's no silly question. Understanding what's happening can help you have the most positive birth experience.
May 05, 2014
- Hill CC, et al. Physiologic changes in pregnancy. Surgical Clinics of North America. 2008;88:391.
- You and your baby: Prenatal Care, Labor and Delivery, and Postpartum Care. Washington, D.C.: American College of Obstetricians and Gynecologists; 2011.
- Lockwood CJ, et al. Prenatal care (second and third trimesters). http://www.uptodate.com/home. Accessed Jan. 6, 2014.
- Stages of pregnancy. Office on Women's Health. http://www.womenshealth.gov/pregnancy/you-are-pregnant/stages-of-pregnancy.cfm. Accessed Nov. 20, 2013.
- Frequently asked questions. Pregnancy FAQ169. Skin conditions during pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq169.pdf?dmc=1&ts=20140106T1519409256. Accessed Jan. 6, 2014.
- Frequently asked questions. Gynecologic problems FAQ050. Urinary tract infections. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq169.pdf?dmc=1&ts=20140106T1519409256. Accessed Jan. 6, 2014.
- Frequently asked questions. Labor, delivery and postpartum care FAQ004. How to tell when labor begins. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq169.pdf?dmc=1&ts=20140106T1519409256. Accessed Jan. 6, 2014.
- Frequently asked questions. Pregnancy FAQ115. Easing back pain during pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq169.pdf?dmc=1&ts=20140106T1519409256. Accessed Jan. 6, 2014.
- Pregnancy — Body changes and discomforts. Office on Women's Health. http://www.womenshealth.gov/pregnancy/you-are-pregnant/body-changes-discomforts.html. Accessed Jan. 10, 2014.
- Pregnancy — Staying healthy and safe. Office on Women's Health. http://www.womenshealth.gov/pregnancy/you-are-pregnant/staying-healthy-safe.html. Accessed Nov. 20, 2013.
- American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth Month to Month. 5th ed. Washington, D.C.: American College of Obstetricians and Gynecologists; 2010:139.
- Group B Strep (GBS) — Prevention in newborns. Centers for Disease Control and Prevention. http://www.cdc.gov/groupbstrep/about/prevention.html. Accessed Jan. 10, 2014.
- SL Schrier, et al. Treatment of the adult with iron deficiency anemia. http://www.uptodate.com/home. Accessed Jan. 6, 2014.
- Laughlin-Tommaso SK (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 4, 2014.
- Protect babies from whooping cough (pertussis). Centers for Disease Control and Prevention. http://www.cdc.gov/Features/Pertussis. Accessed Feb. 5, 2014.