Pregnancy Symptoms In The Third Trimester

Introduction 

Great news, you're almost there! You're about to welcome a precious addition to your family. As you approach the final weeks, you might experience increased exhaustion and discomfort, but remember, there's plenty to eagerly anticipate!

The third trimester

Pregnancy is categorized into three separate phases, known as trimesters, each spanning three months. Upon reaching the 27th week of pregnancy, you enter the third and final trimester. Although this phase theoretically lasts until week 40, it ultimately concludes with the birth of your baby.¹

A baby born between weeks 37 and 42 of pregnancy is considered full-term, while those born before week 37 are deemed premature. If your baby has not arrived by week 42, your doctor or midwife might advise inducing labour to lower the risk of complications.¹

The importance of monitoring and understanding pregnancy symptoms during the third trimester 

The primary objective of prenatal care is to ensure the safe delivery of a healthy baby whilst minimizing any potential risks for the mother. Prenatal care is vital for preventing complications and promoting a healthy pregnancy.³

By adhering to a healthy diet, avoiding harmful substances, and managing existing conditions, women can reduce the risk of pregnancy-related problems. Taking folic acid daily and avoiding tobacco smoke and alcohol can also minimize the chances of fetal complications. Additionally, it is crucial to ensure the safety of medications by avoiding certain drugs and supplements during pregnancy. Overall, prenatal care plays a crucial role in safeguarding both the mother's and the baby's well-being.⁴

As you enter the third trimester, your healthcare provider or midwife will adjust the frequency of your prenatal visits. Instead of monthly visits, they will now be scheduled every two weeks. In the final month, you may have weekly appointments. The specific scheduling will be determined based on factors such as your medical condition, the growth and development of the fetus, and the preference of your healthcare provider or midwife.²

Physical changes and common symptoms in the third trimester 

As you enter the third trimester, you're approaching the final stages before welcoming your baby into the world. During this time, some women may experience increasing levels of discomfort as their due date draws nearer. As the fetus continues to grow and occupy more space within the abdomen, it can become difficult for expectant mothers to take deep breaths or find a comfortable position for a good night's sleep. However, it's important to note that not all women experience these discomforts.²

In this stage, you may begin to notice new symptoms emerging, including nosebleeds and indigestion. Alongside these, common signs of pregnancy during this period might encompass:⁵

• Sleeping issues 
• Development of stretch marks on your stomach, breasts, thighs, and buttocks with skin dryness and itchiness.
• Discomfort on the sides of your baby bump caused by the expanding womb 
• The fetus pressing on the main vein that carries blood back to the heart could lead to a decrease in blood pressure.
• Swollen and bleeding gums
• Headaches, backache, nosebleeds
• You may start to experience leakage of colostrum, a nourishing fluid for the baby, from your nipples.
• Irregular Braxton-Hicks contractions, also known as false labour, may commence in preparation for childbirth.
• Indigestion, dizziness and heartburn
• Bloating and constipation 
• Hemorrhoids 
• Leg cramps 
• Feeling overheated: your developing baby emits body heat, making you feel warm due to higher skin temperature. 
• The need to urinate frequently returns because the pressure on the bladder increases.
• Urinary infections, vaginal infections 
• There will be an increase in white-coloured vaginal discharge (leukorrhea), which may contain more mucus.
• Retention of fluids may cause swelling in your ankles, hands, and face, which is known as edema.
• If you have varicose veins in your legs, they may persist and worsen.
• Increased hormone activity can result in the growth of hair on your arms, legs, and face, which might feel rougher. Also thickening and increased shine in the hair.
• Darkened skin on the face or the development of brown patches, known as chloasma or the "mask of pregnancy."
• Increased oiliness and acne on the skin
• Your sexual drive (libido) may decrease.

Additionally, you may still experience symptoms from earlier weeks, such as mood swings, morning sickness, unusual cravings, a heightened sense of smell, tenderness or leakage in the breasts, a white milky discharge from the vagina, and light spotting.

Changes to the baby in the third trimester

Changes in development¹,²

During the final stage of pregnancy, the fetus continues to grow in both size and weight. The lungs are still in the process of maturing, and the fetus begins to position itself with its head facing downwards.

Usually, by the last couple of weeks, the head will turn downward, positioning itself for birth. By week 31, the lungs are more developed, but they have yet to produce surfactant, an essential substance for breathing after birth. By week 36, the baby measures approximately 47cm long and weighs around 2.6kg. The head may start to lower into the pelvis to prepare for labour, though some babies may be in the breech position (bottom first) instead of the typical head-down position. If the baby is breech, the doctor or midwife will discuss the implications for labour and explore various options for delivery. 

At this stage, the irises of the eyes are often a slate blue colour, with the permanent eye colour not appearing until after birth. The fetus can suck its thumb and cry. By 38 to 40 weeks, the fine hair (lanugo) covering the body and limbs mostly disappears, and the lungs mature completely. The baby is coated in vernix, a protective creamy substance on the skin. By 40 weeks, the baby is approximately 50 cm long and weighs around 3.4kg. Developmentally, the baby is now ready to be born.

Changes in movement⁶

During the initial weeks of the third trimester, you will experience frequent movements of your baby, such as kicking, punching, and general activity. As your baby grows bigger, you will feel more stretches and rolls rather than kicks and punches. Due to increased crowding in your uterus, you may notice a decrease in the movement of your baby. If you feel that your baby is not as active as usual, you can conduct a "kick count" by keeping a record of the number of movements within an hour. If your baby moves less than 10 times in an hour, it is advised to contact your doctor.

Self-care tips for managing third-trimester symptoms 

Nutrition

To ensure that your baby starts its life off healthy, it is crucial to consume nutritious foods throughout your pregnancy. Make sure your diet is diverse and includes a variety of fresh fruits, vegetables, protein-rich foods, as well as sources of iron and calcium. Additionally, remember to stay hydrated by consuming an adequate amount of water.

Gaining weight during pregnancy is a normal occurrence. On average, most individuals can expect to gain anywhere between 11 and 16 kg. A pregnancy weight gain calculator can be a useful tool for monitoring your weight gain during the third trimester. It is advisable to remain physically active throughout your pregnancy, even during the third trimester. While it is essential to engage in safe and gentle exercises as you approach your due date, incorporating regular exercise into your routine as part of a healthy lifestyle is highly recommended.¹

Physical discomfort

As your baby reaches full term, you may experience more discomfort compared to the second trimester. To alleviate some of this discomfort, you can try the following methods after consulting with your healthcare provider. 

For heartburn, seek advice from your healthcare provider regarding dietary and lifestyle changes. If these changes do not provide relief, antacid preparations can be used to alleviate troublesome symptoms.

To address difficulty sleeping, consider using a pillow to provide support to your entire body or specific areas that require it, which can help alleviate tension while you rest. Braxton Hicks contractions do not have a medical treatment, but there are measures you can take to ease discomfort, including:

Stay hydrated by drinking water, changing your position (if lying down, try taking a walk, and vice versa), relaxing by taking a nap, or reading a book. If these measures do not alleviate the pain and if you notice that your contractions are becoming more frequent or intense, it is important to contact your healthcare provider.⁵

Infections and disease

It is important to be aware of certain infections that can be harmful during pregnancy so that you can take steps to avoid them. Here are three measures you can take to protect your unborn baby:⁷

• Maintain proper hand hygiene by regularly washing your hands with soap and water for a minimum of 20 seconds, especially if you have contact with children or nappies, as they may carry cytomegalovirus (CMV), which can be harmful to your baby.
• If you have a pet cat, wear gloves when cleaning the cat litter tray or ask someone else to handle it for you. Cat faeces can contain a parasite that can lead to toxoplasmosis infection, which is dangerous for babies. Additionally, wear gloves while engaging in gardening activities to avoid coming into contact with animal faeces.
• Inform your doctor or midwife if you have not had chickenpox and come into contact with someone who may be contagious. Chickenpox can be transmitted from two days before the appearance of spots until all the spots have formed scabs, usually about five days after they first appear. Avoid being in close proximity to individuals with chickenpox until they no longer have new blisters or moist crusts on their spots.

FAQs

When should I seek medical assistance?

If you experience any of the following symptoms, it is crucial to contact your doctor, midwife, or hospital immediately:

• Vaginal bleeding or a consistent, clear watery vaginal discharge
• Severe nausea, vomiting, or abdominal pain
• Sudden blurry vision or a severe headache accompanied by spots or flashing lights that persist and do not dissipate.
• Abrupt swelling observed in the face, fingers, or ankles
• Presence of a fever
• Consistent and uncomfortable contractions taking place prior to reaching the 37-week mark of pregnancy
• Noticeable changes in your baby's movements:
  • Your baby is exhibiting reduced movement compared to normal.
  • You no longer feel your baby's movements.
  • There is a deviation from your baby's regular movement pattern.

It is crucial to have your baby's movements and heartbeat assessed promptly.

Do not delay; contact medical professionals immediately, even during nighttime hours.

• If your amniotic sac has ruptured and you are not experiencing contractions
• Persistent pain between contractions

How do I know that I'm giving birth? 

Delivery can begin in different ways, as every experience is unique. These are some observable signs to be aware of:

• Your water breaks.
• You are having regular, painful contractions.
• You may experience nausea, vomiting, soft stools, or diarrhoea.
• Your mucous plug may be discharged.

Summary

The third trimester of pregnancy brings about unique physical symptoms and exciting changes to the baby's development. By being aware of these symptoms and practising self-care, expectant mothers can navigate this transformative period with confidence, ease discomforts, and ensure a healthy and fulfilling pregnancy journey.