Yellow fever

Pregnancy Third Trimester

Pregnancy is 9 months, or 40 weeks long, and is divided into three phases. The third trimester is the third and final phase, which lasts from months 7 to 9, or weeks 29 to 40. Just a few days to giving birth, this final phase can be the most challenging too. This is the time when your baby grows fully. By week 32, the bones get fully developed. In the 36th week, the baby starts to take a position to get ready for birth. This is when his/her head starts to move into your pelvic area. If this doesn't happen, and the baby is not able to take the position, your doctor will help you with it, or you might be recommended to go through a cesarean, which is a surgery in which the doctor cuts through your abdomen and uterus to deliver the baby. 

Here are the changes that happen to the baby in the third trimester:

The heart, lungs and other vital organs mature and develop fully.

Bones develop, and your baby gains muscle mass and fat.

Bones in the skull get soft to make it easier to pass through during delivery. 

Can open eyes and see

Can hear.

Can smile.

Can cry.

Can suck thumb

At the end of pregnancy, the baby gets 19-21 inches long and weighs around 3.5 kilos.

What Happens To Your Body During The Third Trimester?

This is the most challenging phase in pregnancy, and as their due date gets near, women get increasingly anxious and uncomfortable. The baby grows so big and occupies a large area in the abdominal cavity that many women find it difficult to breathe deeply. They also find it difficult to get comfortable for sleep. However, not all women feel discomfort as they anxiously await the beginning of the new chapter in their life. Here is how a woman's body changes during the third trimester:

Your abdomen aches: In the third trimester, your baby grows large and occupies a large area in the abdomen. This can cause some abdominal discomfort and aches.

Backache: You gain weight during pregnancy, which puts excess pressure on the back, leading to backache. You can use a heating pad to ease the pain. Your doctor might also prescribe a safe medicine. 

Hips discomfort: Towards the end of pregnancy, the ligaments loosen up to make your body ready for delivery. This causes discomfort in the pelvis and hip areas. To ease it, instead of giving in to the discomfort, maintain a good posture. Sit straight, and if you sit on a chair or a sofa, choose the one with proper back support. 

You get frequent leg cramps.

Sciatica pain in which you feel the pain that goes from your lower back, to your hips, and to your legs, is also common during the third trimester. To ease it, you can do Yoga, opt for physiotherapy or go for a massage. 

You might get varicose veins.

Light bleeding towards the end of pregnancy can be a sign that you are going into labour. However, spotting can indicate something serious too. It might indicate preterm labour, or placental abruption, that is the placenta has separated from the uterine wall, or placenta previa, which means the placenta is covering the cervix. These are serious conditions that need immediate medical care.

Braxton-Hicks Contractions: These are mild contractions, also called false labour, which you get close to birth. Although these are not as intense as the real one but might be confused with the real labour. You can distinguish it with the fact that real labour gets closer and closer and the intensity increases. 

Your breasts get large and close to the due date, a yellowish fluid starts to leak from nipples. This fluid is called colostrum that nourishes the baby for the first few weeks before the breasts start producing milk.

Towards the end of pregnancy, there is increased vaginal discharge that may contain mucus. If there is a sudden burst of fluids, that might mean that your water has broken.

You might get hemorrhoid during this period. 

As your baby grows large, its head presses against the bladder, which means frequent bathroom trips. Also, you might experience that urine leaks when you cough, sneeze or exercise. 

You suffer from heartburn and constipation.

Many women get stretch marks on their tummy, breasts, thighs, and hips. These are marks that form when your skin stretches. 

You feel tired often during the third trimester but get your energy back in the second one. That energy again drops in the third trimester due to weight gain, frequent urination, and anxiety over giving birth. To cope with it, have healthy foods, exercise, and rest well.

During pregnancy, your uterus expands so much that it rests right below the rib cage. This leaves lungs with little room to expand. This can cause shortness of breath.

Weight gain: You gain over 10 kilos during pregnancy. This weight comprises that of the baby, the placenta, amniotic fluids, new breast tissues, and increased fluid volume.  

Possible Complications During Third Trimester

Here are some of the complications that might occur during the third trimester:

Gestational Diabetes

In this the woman's blood sugar level spikes during pregnancy.

This happens because the pregnancy-induced hormonal changes might make it difficult for your body to use insulin. As the insulin is no longer able to bring the blood sugar level down, it leads to its spike.

Although it doesn't impact the mother in a major way, it can have an impact on the baby. 

The baby can become too large, which is known as macrosomia, due to which you might need to undergo cesarean, or there could be injuries while giving birth.

Gestational diabetes can be treated with diet, such as eating fewer carbohydrates or making lifestyle changes, such as doing light physical exercise. In some cases, your doctor might prescribe you some medicines.

Gestational diabetes goes away after giving birth, however, it increases the woman's risk of getting diabetes later in her life. 

Preeclampsia

This is a serious condition, chiefly characterised by high blood pressure, that can have a detrimental impact on both the mother and the baby.

Its symptoms include high blood pressure, protein in the urine, sudden weight gain, swelling in hands and feet, a headache that just won't go away, poor vision, abdominal pain, and shortness of breath.

If left untreated, preeclampsia can lead to seizure, kidney failure, and can even lead to the death of the mother and the child. 

Treatment chiefly depends on the severity of the condition and how far you are in your pregnancy. If you are close to your due date, delivery is the option.

Placenta Problems

Bleeding towards the end of pregnancy might be a sign that you are about to go into labour. However, if spotting occurs, that might also indicate a problem with the placenta.

There are basically two issues: placenta previa, in which the placenta blocks the cervix, and placental abruption in which it prematurely separates from the uterus. 

Premature Rupture Of Membranes (PROM)

Rupture of the membrane is the medical term for water has broken and happens during pregnancy. It is when the amniotic sac that surrounds the baby ruptures and the fluid gets out.

However, if this happens too early, called premature rupture of membranes (PROM), then it can pose a problem.

However, the exact cause is not known. An infection in the amniotic sac, or hereditary might be the possible reasons. 

Treatment options include giving antibiotics, steroids, and medicines to stop labour. If PROM occurs after 34 weeks of pregnancy, the doctor might prescribe delivery. 

Preterm Labour

This happens when a woman starts having contractions accompanied by changes in the cervix before the 37th week of her pregnancy.

There are certain risk factors behind it such as if you are pregnant with twins, excess amniotic fluids, or there is an infection in the amniotic sac, or if you had preterm delivery in the past. 

Post-term Labour

Pregnancy generally lasts for 40 weeks. But if this period gets prolonged till 42 weeks, then it's called post-term pregnancy.

Although this doesn't have any major impact on the mother, can affect the baby in a major way.

The placenta, which provides oxygen and nutrients to the baby, is designed for 40 weeks, and likely gets less effective after that. Hence, the amount of amniotic fluid around the baby gets reduced, which might compress the umbilical cord, which in turn reduces the oxygen supply to the baby.

This can even lead to the death of the baby.

In case of less amniotic fluid around the baby, or if his/her heart rate drops, the doctors might induce labour. If this is not the case, they might wait, but not for more than 42 to 43 weeks. 

Tips To Take Care Of Yourself During Third Trimester

With just a few days to your due date, it is extremely crucial to take care of yourself during the third trimester, as it is throughout the pregnancy. Here are some tips that might help:

Eat lots of fruits and vegetables

Drink plenty of water

Stay active, unless you experience aches, pains, or swelling.

Take care of your dental health, as poor dental health has been linked to preterm labour

Do Kegel exercises

Rest and sleep enough

https://www.Hopkinsmedicine.Org/health/wellness-and-prevention/the-third-trimester

https://www.Pregnancybirthbaby.Org.Au/third-trimester#:~:text=Reaching%20week%2027%20of%20your,37%20to%2042%20of%20pregnancy.

https://www.Stanfordchildrens.Org/en/topic/default?Id=third-trimester-85-P01242

https://www.Nhs.Uk/start4life/pregnancy/week-by-week/3rd-trimester/week-28/

https://www.Unicef.Org/parenting/pregnancy-milestones/third-trimester#feeling

Facing Depression During Pregnancy

With pregnancy comes joy, excitement, baby showers, and the wonder of a new life. But for some, pregnancy is clouded by depression, a condition that puts not only the mother at risk, but the child as well.

For more than 10% of pregnant women, the coming birth of a child is mingled with ongoing feelings of sadness, hopelessness, and anxiety, as well as a decreased appetite and problems sleeping.

Fortunately, expectant mothers need not suffer from this condition: Depression is treatable during pregnancy, with psychotherapy and antidepressant medication.

"During pregnancy, doctors try to keep women off antidepressants unless they have severe depression or if they have a history of relapsing if taken off antidepressants in the past," says Victoria Hendrick, MD. "Instead, other interventions, like psychotherapy, are used to help reduce the need for an antidepressant.

But if the depression is so bad that a pregnant woman is not eating or gaining weight, for instance, then it needs to be treated as aggressively as possible."

For women at risk for depression during pregnancy -- those who have battled major depression in the past or who experienced depression during a previous pregnancy -- the news is good: The risk associated with the use of antidepressants during pregnancy is small.

But what should be considered when deciding whether or not to take an antidepressant, or to try other therapies first? And, what research is available to help put an expectant mom's mind at ease?

"For mild or moderate depression, I'd rather use psychotherapy or group therapy than antidepressants," says Hendrick, assistant professor in the department of psychiatry and bio-behavioral sciences at UCLA.

But for pregnant women with major depression, the risk of a relapse after stopping antidepressant medication is greater than the risks posed by treating it with medication.

"If health behaviors are not good because of the depression, that could have a negative impact," says Hendrick. "If a woman is not eating, not sleeping, feeling stressed or anxious -- these could have an adverse impact on a developing fetus. And obviously, suicidal feelings are another adverse risk associated with depression."

Untreated depression can interfere with a woman's ability to care for themselves, impair nutrition, increase the use of tobacco, alcohol, and drugs, lead to premature labor and low birth-weight babies, and interfere with bonding feelings with an unborn child.

Untreated major depression during pregnancy may also cause infants to have an increased sensitivity to stress.

In cases of major depression, Hendrick explains to WebMD, women need both psychotherapy and antidepressant medication.

"The more multidisciplinary the treatment, the more likely they are to get better," says Hendrick. "Using both therapy and medication greatly increases a woman's chance of seeing an improvement in her symptoms."

When the symptoms of depression warrant psychotherapy as well as antidepressant medication, the good news is that certain drugs can help treat depression with little to no risk to an unborn child.

"There is no evidence to suggest that taking antidepressants during pregnancy comes with a risk of congenital defects, and that's reassuring," says Hendrick. "But it is important to keep in mind that we cannot say for sure that antidepressants are 100% safe to take during pregnancy."

According to a study published in the American Journal of Psychiatry, women who took antidepressant drugs throughout their pregnancies -- both selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft and tricyclic antidepressants -- had children with normal pre-school and early-school development.

Data also suggested that, on the other hand, depressed, untreated pregnant women and those suffering from long-term depression or multiple episodes of depression can have children with behavioral problems and delayed cognitive and language development.

A concern associated with medical treatment of depressed women during pregnancy is the possible increase risk of premature labor. A review of medical records showed women treated with SSRIs during pregnancy had a higher risk of delivering their babies early, before 36 weeks, according to a study published in the American Journal of Psychiatry.

But the women in this study who were treated with another class of antidepressants known as tricyclics had no increased risk of premature birth. Researchers stressed the risk associated with SSRIs is not overwhelming enough to warrant women not take antidepressants if their condition requires medication. Also reassuring is that the study showed no risk of birth defects associated with SSRIs.

An additional concern is whether a newborn baby whose mother took antidepressants during pregnancy will suffer from symptoms of withdrawal.

"While the SSRIs, such as Zoloft, Prozac and Paxil, are unlikely to cause a major birth defect, several, including Prozac and Paxil, have been reported to increase the risk of withdrawal symptoms in the newly born child, especially if they are used in the third trimester," says C. Neill Epperson, MD, assistant professor of psychiatry and obstetrics/gynecology at Yale University School of Medicine.

Studies that assessed the risk of SSRIs taken during pregnancy showed that Paxil could cause withdrawal symptoms, such as jitteriness, vomiting, and irritability, in infants. But researchers noted the cause of the symptoms is not entirely clear: They were not able to say definitively whether the symptoms were a result of withdrawal, the toxicity of the drugs, or another unknown factor.

The last area of concern comes when a mother gives birth and decides to breastfeed their baby while on antidepressants. Here, the news is very promising.

"Breastfeeding has been well researched in terms of antidepressants, "Hendrick tells WebMD. "And the results of research show that breastfeeding women shouldn't be told they have to stop taking an antidepressant to breastfeed."

Hendrick explains that babies are very sensitive to their mothers' moods, and there is a great deal of evidence that suggests a mother's mood can impact the child.

"The mother should not remain depressed for both her benefit and the baby's," he says. "Antidepressants can be helpful, and the exposure to a baby through breast milk is so minute, there is no reason to not take them if they would be helpful."

"Have a discussion with your doctor about the risk and benefits about being on an antidepressant if you are pregnant," says Epperson. "If you can be off a medication, of course you should be, but if you can't -- and a lot of women can't -- then antidepressants can help."

With both psychotherapy and antidepressants, a pregnant woman can overcome depression and enjoy the birth of their child, and be assured that the risk that antidepressants pose to their child is small.

A Guide To Exercises To Do During Each Trimester Of Pregnancy

Exercising during pregnancy provides a multitude of health benefits you may not even consider, like reducing pregnancy discomforts such as back pain, constipation, and leg swelling. It also helps you manage stress, sleep better, and keep your heart healthy.

Despite this, it's not always easy to get into a routine when you're pregnant. Even more, you might feel limited if you don't understand what exercises to do during each trimester of pregnancy. Learning these exercises will help you form a healthy routine you can stick to throughout your pregnancy.

Check out our informative guide to learn more about what exercises to do during each pregnancy trimester.

Exercising safely during pregnancy

While exercise is key to pregnancy health, you'll need to talk to your doctor first to ensure you're not facing a high-risk pregnancy or other factors that could limit exercise.

Exercising safely during pregnancy means avoiding contact sports that put you at risk for injury like basketball or volleyball. You should also avoid exercises that increase fall risks or generate too much momentum like horseback riding, jumping, or skipping.

You also need to stay hydrated by drinking plenty of water before, during, and after your workout. Be mindful of becoming overheated and wear supportive clothing like belly bands and sports bras.

Cardiovascular exercises

One of the most essential pregnancy exercises you can do during all three trimesters is cardiovascular exercise. Activities like swimming, walking, jogging, or riding a stationary cycle are great options with every trimester.

Current guidelines state that adults should get at least 150 minutes of moderate-intensity physical activity weekly, including at least two days of muscle-strengthening activities. You should stick to these guidelines unless your doctor recommends that you modify your physical activity levels.

If you are already doing intense exercise like running or have a high fitness level, you can usually continue activities at the same level after talking to your doctor.

First trimester exercises

In addition to cardiovascular activity, first-trimester exercises should target major muscle groups that make it easier for you to go through labor and childbirth.

These exercises also improve body awareness and prepare you for changes in posture that naturally occur as your baby grows.

Pelvic curls

Pelvic curls or tilts are perfect for this since they help with spinal mobility and strengthen your abdominal muscles, providing support as the baby grows.

For pelvic curls, you'll need to lie on your back with your knees bent, keeping your feet flat on the ground. Your feet should be approximately hip-width apart. Inhale then exhale as you tuck your hips so your spine presses against the floor.

You'll need to keep this tucked position and continue to exhale while rolling through the movements and lifting your spine from the floor one vertebra at a time. You should stop once you reach your shoulder blades and inhale once this movement is complete.

Do 12 to 15 reps at a time and remember a tilt involves the natural curve of your back. Imagining water spilling towards your abdomen as you tilt your pelvis can help.

Squats

Doing squats is a great way to strengthen the muscles in your lower body like hamstrings and glutes. Having strong muscles in these areas protects your back later in pregnancy.

To do squats, you'll need to stand in front of the couch, turning your back towards it. Place your feet slightly more than hip-width apart and squat down as if you're going to sit on the couch, but stand back up before your thighs touch.

Pace yourself so you spend five seconds going down and three to four seconds coming back up. Exhale while squatting and inhale while standing. You should aim to do two sets of 15 to 20 squats.

Second trimester exercises

Most women are over first trimester symptoms and feel much calmer and more energetic during the second trimester. This makes it easier to add more to your routine.

Since your uterus is getting bigger during the second trimester, exercising while pregnant requires a bit more care and consideration. You'll need to take care to avoid high-impact activities but can safely continue cardiovascular exercises like walking.

You should also continue with squats and pelvic curls while adding some additional exercises to focus on stability and strength like:

Incline push-ups

You'll need to stand facing a railing or ledge to place your hands at least shoulder-width apart. Step back so your body is in a standing plank position which puts your back in a straight line.

Bend your arms slowly while lowering your chest towards the ledge or railing. Straighten your arms to return to the starting position.

It's best to do at least two sets of incline push-ups with 10 to 12 repetitions daily.

Quadriceps stretch and hip flexor

The second trimester is the time to develop a stretching routine to help with continuing postural changes. Also, as your center of gravity changes, your belly begins to go forward more, shortening the hip flexor muscles.

To do this exercise, you'll need to get into a half-kneeling position on the floor while placing your right knee on the floor and your left foot in front of you. Be sure to place your left foot flat on the floor.

Keep a straight posture and lunge forward on your left foot until you feel a stretch, holding the position for 30 seconds, then repeat twice. Switch sides and repeat the stretch.

Third trimester exercises

The third trimester is a time of slowing down, and you'll certainly start noticing this feeling as the trimester progresses.

To continue a safe pregnancy, you should avoid any exercise that causes you to get off balance. Instead, focus on cardiovascular activities that help with abdominal strength and mobility like:

Walking

Pilates

Prenatal yoga

Swimming

Pelvic floor exercises

You can also do push-ups against a wall and bicep curls using light weights. Don't push yourself too much, and simply do as much as your energy allows.

Learning the exercises to do during each trimester of pregnancy

Knowing the exercises to do during each trimester of pregnancy will keep you healthy and active during each pregnancy phase.

Don't hesitate to talk to your doctor if you notice you're having trouble managing an exercise routine due to pain, fatigue, or other symptoms. Remember to take it one day at a time and before you know it, you'll have a daily workout you can stick to.

Related content

---