All About the Third Trimester

Our guide to the exciting last third of pregnancy

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With your due date finally just around the corner, you're eager to hold that baby in your arms—and maybe nervous about giving birth, too. You enter the third trimester filled with energy, but as your body continues to grow and change, you may start to feel tired and experience new aches and pains. How much bigger can I get? you wonder. Let's face it: You get a tad tired of being pregnant. But there are plenty of things to do to keep your mind off of your expanding figure and the annoyances that come with it. Just follow our guide to the exciting last third of pregnancy, weeks 29–40.

Your Body As you head into the final stretch, remember to keep eating right and exercising so that your baby gains the proper amount of weight and you're in the best possible shape for labor and delivery.

Eat often

You should gain one pound a week. To do this, get 300 extra calories a day from one serving each of protein and carbohydrate foods, advises Kelly Kullick, R.D., a personal trainer and the Atlanta-based owner of HealthyMoms, LLC. You may feel full halfway through meals because your uterus is pressing on your stomach. Kullick's solution: "I recommend six to eight smaller meals a day rather than three big ones." Keep in mind that you still need prenatal vitamins, at least eight glasses of water a day and 1,000 milligrams of calcium daily.

Keep moving

As long as you're not at risk for delivering a preterm baby, exercise is safe in the third trimester. But if you're used to doing moderate- or high-impact exercise, discuss with your doctor or midwife whether you should continue your routine, says Lisa Stone, a certified pre- and postnatal fitness specialist and president of Fit For 2 Inc., a fitness program for pregnant women and new moms in Atlanta. Avoid lifting heavy weights, as they can put too much stress on tendons and ligaments, which become more relaxed late in pregnancy. Whatever your exercise level, scale back if you feel dizzy or lightheaded and try prenatal yoga classes or brisk walking instead. "Pay attention to your body's signals," Stone says. "They'll let you know when you're overdoing it. "Keeping up abdominal and back exercises is important to help with postural changes and stability," she adds, "and to keep your body strong after the baby's born, when you'll have a lot of lifting to do." Since doing crunches on your back is not safe, switch to standing pelvic tilts or lying on your side or on your hands and knees; concentrate on bringing your navel toward your spine.

Rest up

Feeling uncomfortable and going to the bathroom a lot at night can leave you tired. Use a body pillow when sleeping and limit your liquid and food intake after 6 p.m. To combat fatigue during the day, take a five-minute break every hour. Sit back, relax, do deep-breathing exercises or take a walk to rejuvenate yourself.

Stay sexy

Sex and orgasms are generally safe unless you're at risk for preterm labor, but intercourse may begin to be uncomfortable. Now's a good time for you and your partner to experiment with alternate positions, such as lying on your sides.

Countdown To Delivery

Follow this timeline recommended by Rebecca Burpo, a certified nurse-midwife in Dallas, to prepare for the big day. Week 30 Start shopping for items you'll need in the hospital (nursing bras, nightgown, baby clothes, car seat) and at home (diapers, wipes, etc.).

Week 31 Attend childbirth classes. The sessions should end by week 36.

Week 32 Interview doulas or labor coaches—they book up quickly.

Week 33 Have your baby shower about two months before your due date so you'll have time to shop for items you didn't receive as gifts.

Week 34 Interview baby nurses or postpartum doulas; locate a lactation specialist in case you need one later. Research cord-blood-banking options.

Week 35 Meet with several pediatricians and choose one. Your baby will need to be checked immediately after birth.

Week 36 Pack your bag for the hospital (don't forget your phone book). A baby is considered at term three weeks before your due date, so be prepared.

Week 37 If you plan to breastfeed, read up on techniques and gather resources to have at your fingertips when you come home. Join a local La Leche League group to meet the leader and other moms; you don't want to be a stranger if you need to call them for help.

Week 38 Tour your hospital's maternity floor. Decide which family members and friends may visit you at the hospital and at home in the first few days or weeks after you give birth. If you don't, good intentions can overwhelm you: It's easier to say "This is our plan" beforehand than to reject offers on the spot.

Week 39 Many women begin maternity leave weeks before their due date. If you plan to work up until the end, post an "If I go into labor tonight" memo at work.

Two Great Toners To Keep You Strong

1. Wall Plie: Stand facing a wall, feet slightly farther than hip-width apart, knees turned out and legs straight. Place your hands on the wall. Tilt your pelvis so your tailbone points down. Bend your knees, lowering your torso toward the floor. Straighten legs, pressing upward through your heels, and repeat. Do 1–2 sets of 10–12 repetitions, resting 1 minute between sets.

2. Wall Push-Up: Stand facing a wall, feet hip-width apart. Place hands on the wall, arms straight. Pull your navel in toward your spine so your back is straight. Bend elbows, bringing chest toward the wall. Push back and repeat. Do 1–2 sets of 10–12 reps, resting 1 minute between sets.

Your Mind At some point, the energy and good mood of the second trimester may start to dip. "As women begin to experience an anticipatory anxiety, things can take a downhill slide," says Ann Dunnewold, Ph.D., a Dallas psychologist who specializes in the emotional aspects of reproductive issues. Mentally preparing for labor and delivery, as well as a newborn, can cause a great deal of uncertainty. Talk with other women who can offer realistic support for such decisions as whether to circumcise your baby or bank his cord blood. Don't listen to horror stories or read every pregnancy book. Instead, find one author whose philosophy you like and stick with him or her.

It's also easy to feel tired of being pregnant, and body-image issues are often to blame. "Many women are larger than they ever thought they'd be and feel unhappy with how they look," says Rebecca Burpo, a certified nurse-midwife in Dallas. To get past any discomfort with your weight, first confirm with your doctor that you're gaining pounds appropriately, then remind yourself that you're doing the right thing. "It's important to accept that this is what you need to weigh to make a healthy baby," Burpo says. To feel good about your looks, choose clothing that skims the body rather than bunches or billows out.

Worry about weight stems from other issues as well. "When you're pregnant, you have less control of your body," Dunnewold says. The more you can let go of any illusion of control, the better you'll feel about yourself. Spending a lot of time with your partner can help. "Often couples get closer as they try to eke out every last available minute alone together," she says.

If your partner's level of excitement and anticipation doesn't match yours, it may be that the baby hasn't become as much of a reality to him as it has to you. Involve him as much as possible in preparing for the delivery and bringing the baby home. If he's happiest in his workshop, ask him to try his hand at building a toy chest or other nursery items.

Your Baby Your doctor or midwife will want to see you every two to three weeks starting at around week 28, then every two weeks at weeks 36 and 37, and weekly at 38 weeks, says Russell Laros Jr., M.D., professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. At 36 or 37 weeks, your doctor will order a culture for Group B strep, an infection that can affect the baby. (If you do have Group B strep, you will likely be treated with antibiotics during labor.) During these last visits, your doctor will be looking for potential problems with you or the baby, including preeclampsia (pregnancy-induced high blood pressure) and indications that you might go into premature labor. Fortunately, a child born as early as 28 weeks has an excellent chance of survival.

Diary Of A Third Trimester

Writer Lu Hanessian talks about the final weeks of her pregnancy.

Week 29 Wash and fold baby clothes. Coo uncontrollably.

Week 32 Exercise to big-band music. Baby does drum solo.

Week 34 Study book of 10,000 baby names. Discover that Cameron means "crooked nose."

Week 36 Baby's head is "zero station" (right at the cervix). OB predicts early delivery. Pack hospital bag, stash in car trunk. Install infant car seat.

Week 37 One centimeter dilated! Prepare lasagna.

Week 38 Two centimeters dilated, 70 percent effaced! Could go tonight … then again, maybe tomorrow. Clean spice rack.

Week 40 Four centimeters dilated, 100 percent effaced. Clean windows.

One day past due date Now entering fourth trimester. Feel 11 months pregnant.

Three days later Answer 14 phone calls that begin, "You're still there?!" Scrub top of fridge.

Six days later OB wants to induce. Walk around like penguin in heat. Girlfriend Della says shepherd's pie brought on her labor. Eat shepherd's pie.

Eight days later Water breaks. Five hours later, Benjamin Stephen is born. Three-year-old Nicholas meets his new brother. "Shhhh!" he whispers. "Baby brother is sleeping! Let's go to Ben & Jerry's!"

Growing Pains Your growing uterus may leave you short of breath. Your skin may be tight and itchy, your face might break out, and your feet could swell. (On the upside, you may have thicker hair and a rosier complexion.) Here's how to prevent and treat other common third-trimester problems.

Bladder Pressure Prevention: Urinate frequently; avoid drinking coffee and tea; don't cut back on fluids, but do drink more during the day and less in the evening. Treatment: None.

Hemorrhoids Prevention: Exercise and avoid constipation by eating lots of fiber and drinking plenty of water. Treatment: Use over-the-counter topical drugs like Preparation H or Anusol; sit in warm baths.

Swollen Legs Prevention: Keep your legs elevated when possible. Avoid salty foods, stay cool, and wear support pantyhose or stockings. Treatment: Massage may help.

Varicose Veins Prevention: Avoid prolonged standing, move your legs and feet frequently to stimulate circulation; keep your legs elevated and wear support stockings. Treatment: If varicose veins don't disappear after delivery, surgical treatments are an option.

More Serious Symptoms Call your doctor if you experience vaginal bleeding; severe headaches; a marked increase in swelling; decreased fetal movement; leakage of watery fluid from the vagina; constant, severe abdominal pain; or, if you're less than 37 weeks pregnant, more than five contractions per hour.

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