During the third trimester of pregnancy, you’re probably focused on preparing for labour, delivery and your new baby. Here, I’m going to run through some solutions to common challenges you may face at this time and the things you should know before you prepare for your birth.
Recently, I’ve noticed that a lot of women are confused about normal movement towards the end of pregnancy. So, I wanted to start with informing you on what is normal and ensuring the common old wives tale ‘babies don’t move much at the end of pregnancy because they don’t have enough room’ is disregarded. Your baby’s movement may not be as vigorous due to the lack of room but the frequency of movement should remain unchanged. As per the second trimester, monitor the pattern and frequency of your baby’s movements. You should be feeling regular, frequent movements right up until labour. If their regular frequency or the pattern changes, you need to see your midwife to have a Cardio Toco Graph (CTG). This will monitor your baby’s heart rate to ensure they are receiving enough oxygen.
2. Conflicting advice
I’ve also noticed that women often get conflicting advice from friends or family, making it difficult for mums to be to know who and what is right. I would like to share some useful authorising body’s clinical guidelines. These have been more than sufficiently researched and developed with maternal and neonatal health at the forefront. This therefore removes individual opinion and gives you the factual advice you need. So, if you aren’t sure and want some scientific facts, take a look at the below:
- National Institute for Health and Care Excellence (NICE)
- World Health Organisation (WHO)
- Association of Women’s Health, Obstetrics and Neonatal Nursing and the National Association of Neonatal Nurses
- National Centre for Biotechnology Information (NCBI)
- The Nursing and Midwifery Council (NMC)
- Royal College of Obstetrics and Gynaecology (RCOG).
Swelling is common and you may notice significant swelling around your ankles in the third trimester. This is due to gravity, increased blood volume and plasma. Try to elevate your legs with pillows in bed. When you’re on the sofa, pop your legs up to reduce further swelling and ask for a foot rub! If you’re sitting for long periods and can’t elevate your legs, then make sure you gently circle your ankles to encourage circulation.
If your baby’s due in the summer, you may want to invest in some comfortable shoes or sandals to accommodate any swelling. Some women have been known to go up a whole shoe size. Flip flops may seem like an easy option but they’re not supportive and you can slip in them. Sandals with adjustable straps are good and can still be used after the birth as the swelling gradually goes down. If you notice swelling on your hands, face or neck and have headaches, visual disturbances or epigastric pain (high abdominal pain), then you may need blood tests to rule out pre-eclampsia. Contact your midwife if you have any concerns.
4. Sleeping during the third trimester
As your bump grows, getting to sleep and having a full night’s sleep can be difficult. Pregnancy pillows really do help with comfort and are worth investing in. They can also come in handy whilst breastfeeding because they facilitate the weight of your baby’s head and help maintain a good position for feeding. It’s best to sleep on your left side but your right is fine, if it’s more comfortable.
Avoid sleeping on your back unless you are well propped up. If you struggle to get to sleep then remove any electrical light and devices like phones, iPads and laptops. Make make sure your bedroom is as dark as possible and slightly cool. Feeling hot during the night sometimes wakes women up but if your room is slightly cooler this may help you to sleep through the night. Even if you wake try to rest with your eyes closed and focus on your breathing to conserve energy.
5. Backache and pelvic pain
Backache and pelvic pain are probably the most common symptoms in the third trimester. Good posture and a support belt may help to elevate some of the discomfort. You can get a good support belt online. Yoga, Pilates or swimming may also help to elevate the discomfort so keep attending the classes you already go to.
6. Take breaks
Still working? Make sure you’re getting restful breaks and feel well at work. Numerous studies suggest that women with high stress levels can go into premature labour and grow smaller babies. Although you may have work commitments, don’t underestimate the value of taking restful breaks or even days off, if you need to. This is one of the most challenging times for your body so look after yourself.
It’s nearly time for the arrival of your baby, here are some useful things to bear in mind as you prepare:
7. Newborn skin
Your baby’s skin is five times more permeable than ours. It takes a newborn 4 – 6 weeks to build up their natural enzymes and skin barriers. Therefore, no products should be marketed as ‘safe for newborn’ because the physiology of the skin is extremely complex. Rubbing any chemicals, alcohol or perfumes into the skin only disrupts the natural process and increases the risk of eczema (UK rates of childhood eczema are among the highest in the world) and psoriasis and can even be carcinogenic. So, don’t go stocking up on washes, creams or lotions just yet as plain water is the safest option.
8. Washing your baby’s clothes
Baking soda is a natural product and has uses that go beyond the kitchen. If you want to pre-wash your delicate baby’s clothes with a chemical-free, non-toxic and natural product, baking soda is all you need. It brightens colours and whites, removes odours from clothing, gets rid of stains and cleans away everyday dirt. It’s also a lot cheaper and kinder to newborn skin. I’d also recommend adding a few drops of essential lavender oil for a calming natural scent.
9. Packing your hospital bag
It’s recommended that you pack a hospital bag by 36 weeks, even if you’re planning a home birth, (in case you need to go into hospital at some point).
10. Preparing to be at home with a newborn.
Cook some hearty and healthy meals now you have the time to and freeze them in preparation for when you get home. A lot of new mums, especially if breastfeeding, eat whatever is quick and easy which is usually without any nutritional value. You probably won’t have the time or energy to prepare healthy meals caring for a newborn. If you have someone around that can cater for you, excellent! Unless that person is going to be with you for a few weeks, then do some preparing yourself now. Get lots of healthy snacks in that you can grab them during and between feeds. It’ll make life a little more convenient and healthy.
11. Breastfeeding and expressing
If you’re planning on breastfeeding, then you can express breastmilk from 36 weeks and your milk can be stored in a freezer for up to six months. This can be so handy especially if your baby is born slightly early or has low blood sugars and needs top-ups. Ask you midwife to provide you with the required equipment to do this safely.
12. Optimal foetal positioning
The best position for your baby to be in throughout labour and delivery is occiput anterior (OA). This means that your baby is head first, looking towards your back and the smallest part of the head is presenting. You can encourage your baby to adopt this position through your positioning such as all fours, sitting upright with your back supported and sitting on a birthing ball with your legs more than shoulder width apart. Avoid slouching back into a chair with your pelvis bent forward. As tempting as it might be, this encourages the reverse of what you want – occiput posterior (OP).
13. Pelvic floor muscles
Keep these in as good shape as possible. They lie like a hammock across the base of your pelvis and your baby will pass through these muscles when he or she is born. The fibres run in a double figure of eight pattern to surround your urethra, vagina and anus. Gentle squatting or half-kneeling, half-squatting movements are good to practice for stretching but avoid full squatting if you have haemorrhoids, varicosities or a cervical stitch. If your baby is breech (bum/legs first) after 34 weeks, avoid squatting altogether.
14. Naturally encouraging labour
From my experience, I’ve seen poor results from eating pineapples, mixed results with raspberry leaf tea and the best results from sex, hot curry, walking upstairs, nipple stimulation and stretch and sweeps (vaginal examination performed by a midwife/Doctor only – ask your midwife about this). It’s entirely up to you what you prefer to try but combining them all within a few days may just give your body that little natural push it needs to go into labour.
15. Your waters go and you aren’t in labour
The most important thing for you to note in this scenario is the colour of the fluid you are losing. If you have a low risk pregnancy and the fluid is clear or pinkish that’s fine and you just need to let your midwife know within 12 hours, as you may need an induction if they have gone and you do not labour naturally. If the fluid is brown, green, yellow or smelly then you need to contact your midwife as soon as possible because this may indicate that your baby is distressed or an unknown infection.
16. Going into labour
If you think you are going into labour, monitor the frequency and length of your contractions. Most hospital protocols will invite you in for an assessment if you are having three contractions in 10 minutes, each lasting 45 seconds. According to the NICE Guidelines, you’re considered to be in established labour once you are contracting 3:10 and are 4cm dilated. If everything is normal and you have a low risk pregnancy, try to stay at home for as long as possible.
Relax between contractions, have a nice warm bath, take deep breaths, up to 1g of paracetamol and keep well hydrated. If you have any complications or are GBS+, call the hospital for advice if you think you’re going into labour.
17. Not going into labour
There’s a slightly higher incidence rate of most maturity (overdue) if this is your first baby. Only 3% of babies arrive on their due date. You should be offered an induction of labour (IOL) before you are 41 weeks plus five days. IOL is recommended because there is a wealth of research suggesting the placenta doesn’t work as well after this date, meaning there is concern your baby will not be well oxygenated. Different hospitals have different first line drug choices, discuss this with your midwife and the options available to you to make an informed decision.
18. Sometimes things don’t go according to birth plan
Most women have a birth plan written and ready, but as labour progresses things can change. Rather than hold onto your original plans try and just go with it. Several women that I have looked after have been adamant about not wanting pain relief or an epidural. One woman stands out in my mind, it was her first baby and at 5cm dilated, she became very distressed. She kept talking about ‘letting everyone down’ because she now wanted an epidural. She felt guilty about changing her mind as she had set herself a rule: no epidural. Eventually she had one but was crying with self-disappointment and I think it tainted her experience and self-esteem.
Try not to rule anything out, especially with your first baby. Take it as it comes, allow things to change and do what is right for you at the right time. That way you won’t feel bad, guilty or upset about any changes that occur along your journey.
19. The baby’s cord
After you have had your baby the cord will need to be clamped and cut. The cord needs to be allowed to continue to pulsate until it naturally stops. This provides oxygen rich blood to your baby which clamping and cutting the cord at birth stops. The World Health Organisation (WHO) suggests that delayed cord clamping is recommended for improved maternal and infant health, nutrition and reduces childhood anaemia. Optimal cord clamping can also decrease the risk of you bleeding heavily after birth. Write this in your birth plan or let your midwife know upon arrival.
To prepare and relax, practice deep and spinal breathing, spending time with your partner/family/friends and just having some space for yourself. Make the most of this time, to ‘just be’ and some quiet time with yourself. Everything is soon to change as you transform into a parent.
Absorb life as it is and enjoy this time before the birth.
How have you found the third trimester of your pregnancy?
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