Weeks 23 -28
Vivid, bizarre dreams may be starting to disturb your sleep. Many experts speculate it’s your mind’s way of processing the enormity of what it means to become a parent. Don’t worry: Dreaming that you’ve left your newborn in his car seat on the roof of your car indicates you’re going to be a conscientious mom.
You may be afflicted with heartburn and leg cramps, both of which are most common at night. Avoid eating late in the evening, and make friends with Maalox or Mylanta. They won’t harm your baby, and they can work wonders on the burning in your throat and chest. (Just to be safe, talk to your doctor or midwife first.) To help prevent sleep-disturbing leg cramps, stretch your legs, especially your calves, before going to bed. Also avoid standing or sitting in one position for too long and be sure to load up on fluids, particularly water, throughout the day. If you do get a cramp, straighten your leg, heel first, and wiggle your toes. Better yet, have your partner do it—and ask him to throw in a foot rub while he’s at it! (Our trimester-by-trimester sleep guide will help you get the rest you need now fitpregnancy.com/sleepguide.)
Hemorrhoids and constipation may also be setting in. Lucky you! Keep downing the fluids and load up on fiber-rich foods. Talk to your doc about using Preparation H or other products if hemorrhoids are really bothering you. Ditto for stool softeners. Between 2 percent and 10 percent of women develop gestational diabetes, a condition that causes high levels of glucose (sugar) in the blood. Gaining too much weight may be a contributing factor. Your doctor will screen you for it via a simple blood test in weeks 24 to 28 weeks of pregnancy.
[ ] Believe it or not, it’s not too early to start looking into child care if you plan to return to work after your baby is born: Day-care centers fill up fast, and nannies can be hard to find.
How much weight should you gain?
The American College of Obstetricians and Gynecologists advises most women of normal prepregnancy weight (a body mass index, or BMI, of 18.5-24.9) to gain 25 to 35 pounds; underweight women (BMI below 18.5), 28 to 40 pounds; and overweight women (BMI 25-29.9), 15 to 25 pounds. If your BMI is 30+, talk to your doctor. (Use our tool to calculate your pre-pregnancy BMI. This will give you a starting point for recommended weight gain fitpregnancy.com/bmi.)
Welcome to the third trimester
Start being on the lookout for signs of preeclampsia, a common complication that can lead to serious, even deadly, complications for you and your baby. It can develop any time after the 20th week, though it’s most common after week 28, which is why your OB or midwife might want to start seeing you every two weeks around that time. Call immediately if you notice any of the following possible symptoms: changes in vision, including temporary loss of vision, blurred vision or sensitivity to light; decreased urination; dizziness; nausea or vomiting; pain in the upper right abdomen; severe headaches; or sudden weight gain of more than 4 pounds a week.
Braxton Hicks (“practice”) contractions often start about now. Unlike true contractions, these do not indicate that labor has started; they usually happen sporadically and do not get closer together. (The lowdown on different types and what they mean fitpregnancy.com/contractions.)
[ ] Ask your doctor about doing fetal kick counts, which help assess your baby’s well-being. (Learn how to do them at fitpregnancy.com/kickcounts.)
[ ] Interview labor and/or postpartum doulas, if you’ll be using one.
[ ] Call your health insurance provider and find out any requirements it may have about adding a baby to your policy.
] Get a life insurance policy and write a will, if you haven’t already.
Be alert for signs of depression: Contrary to popular belief, pregnancy doesn’t protect against it. In fact, the rate is the same among pregnant and nonpregnant women: approximately 12 percent. If you suspect you might be depressed (symptoms include fatigue, difficulty sleeping, change in appetite, feelings of despair or hopelessness or crying that won’t stop), get help; untreated depression during pregnancy almost always leads to full-fledged postpartum depression. For resources, go to postpartum.net.