What to Expect, and Why It’s Important
You’re finally entering your third trimester. That means that baby’s arrival is getting close, and you’re about to begin what may be the most physically challenging time of your pregnancy as your baby reaches its full pre-birth size. You can expect just as much support from your OBGYN as you’ve received in your first and second trimester. He or she will work closely with you to help you prepare for the birth of your baby in these critical final weeks. Here’s what you should expect from weeks 28 through 40.
More Frequent OBGYN Visits
During your last trimester, you’ll be meeting with your OBGYN more frequently. You will have a prenatal visit every two weeks up until week 36, and then you’ll be meeting with your OBGYN weekly. Consider bringing your partner or labor coach with you during your third trimester doctor visits. You can expect regular weight checks, blood pressure checks, and urine checks that will test for protein in the urine. He or she will also continue to monitor baby’s heartbeat and activity, and may also perform pelvic exams to determine if your cervix is beginning to dilate.
Baby’s Movement
Pay attention to how much movement you feel from your baby, and keep your doctor informed if you observe anything concerning or any significant changes. In your third trimester, you should be noticing that baby will have very active periods, and times when he or she is not active at all — both of which are normal and expected. If baby suddenly seems to be less active, eat a snack and then lie down for a few minutes. If you still don’t detect much movement, call your OBGYN to describe what you’ve observed.
Screening Tests, Lab Tests, and Ultrasounds
You will likely receive a screening test during your third trimester for group B streptococcus (GBS), a common bacterium often carried in the intestines or lower genital tract that can cause complications to a newborn if the baby is infected during a vaginal delivery.
Your OBGYN may order additional testing during your last trimester if you:
Pelvic Exam
As you progress through your third trimester, your doctor may complete a pelvic exam to identify any cervical changes. Before baby arrives, your cervix will begin to soften, dilate, and thin (efface), changes that are typically measured in centimeters and percentages. Once you reach 10 centimeters dilated and 100 percent effaced, you’re ready to start pushing, which makes monitoring changes to your cervix important.
Fatigue
Expect to feel tired during your last trimester. Much of your energy is being diverted to help support baby’s final growth spirt. Don’t fight the feelings of fatigue. Make sure you are getting enough rest each day. You may want to think about starting to reduce your number of daily activities, and toward the end of your third trimester, you may want to talk to your doctor about cutting back your work hours if applicable.
Nutrition and Exercise
Even though you’re approaching the end of the finish line, you need to stay the course with the diet and exercise plan you’ve created with your doctor. Be sure to eat foods high in protein, and eat small amounts of vegetables regularly. Also, be sure to get some exercise, such as a short walk, each day.
Baby’s Positioning
Toward the end of your last trimester, your OBGYN will begin estimating your baby’s weight and will work to determine his or her position. Your baby should be positioned head first in the uterus. An ultrasound may be ordered to confirm the baby’s position and to determine the level of amniotic fluid around the baby.
When to Call Your OBGYN
If you experience any of the following, call your OBGYN:
- You have any bleeding.
- You are experiencing headaches.
- You notice increased vaginal discharge with odor.
- You have a fever, chills, or pain with urination.
- You experience changes to your eyesight or have blind spots in your vision.
It’s also time to call your OBGYN when your water breaks, or if you begin experiencing regular, painful contractions. When this happens, don’t be alarmed. Baby is just preparing for his or her grand entrance.
Did you miss part 1 and 2 of our prenatal care series? If so, please check out the links below…
Prenatal Care in Your First Trimester
Prenatal Care in Your Second Trimester
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What to Bring to the Hospital When You’re Ready to Deliver, and What to Leave at Home
You’ve been planning for months to welcome your new baby into your family, and the big day is steadily approaching. To make sure you are prepared with everything you need to bring with you to the hospital, spend some time at the start of your third trimester packing the bag you’ll be taking with you to the hospital. Remember that you’ll be coming back home with a big bundle of joy, so pack lightly, and only bring those things with you that you will truly need, and leave the rest at home. We’ve got your hospital checklist of what to bring, and what to leave behind.
Pack it for Mom
- Photo identification, such as your driver’s license.
- Health insurance information.
- Hospital forms.
- Birth plan (if you have one).
- Cell phone and charger (everyone will be looking for the first Facebook post of your new little one!).
- A few pairs of disposable, but comfortable, socks or slippers that you can wear walking the halls before and after labor.
- A warm, comfortable robe or cardigan that you don’t mind getting dirty. Bring one that opens in the front if you’re planning on breast feeding.
- Your own pillow, if you find it comforting, but bring a pillowcase you don’t mind disposing of after you leave.
- Maternity bras and nursing pads.
- Sanitary pads to wear post-delivery.
- Ear plugs, to help you sleep.
- Sugar-free lozenges to keep your mouth moist during labor.
- Glasses, contacts, and solution, if needed.
- Personal toiletries and bath products (pack travel sized items to make your bag lighter).
- Hairbrush and ponytail holders.
- Lip balm.
- Pen and paper.
- Change for the vending machine, and cafe, and cash for the parking lot.
- Non-perishable (healthy) snacks.
- A book, e-reader, laptop, magazines, or anything else you may want to use to stay busy while waiting for baby, or while recovering.
Pack it – For Baby
- A pacifier.
- A receiving blanket.
- A few clothing options for baby to wear on the way home to accommodate your baby’s size, and what the weather will be like on the day he/she goes home.
- A car seat, but make sure you have it installed, and checked, before you arrive at the hospital. You don’t want the stress of trying to install it when you are ready to go home, and you certainly don’t want to risk an unsafe travel experience for your newborn.
Forget It
- Any clothes you don’t want to get ruined.
- Valuable jewelry.
- Prescription medications, including vitamins, but let your doctor know in advance what you may need so that the hospital can provide it for you.
- Diapers. Keep the stacks you have at home (you’re going to need them!), because the hospital will provide diapers while you’re there.
- A breast pump. The hospital will provide that too if needed.
With an expertly packed hospital bag you will be prepared with all of the items you and your baby will need to make your time at the hospital comfortable, and comforting.
If you need more advice, feel free to ask your OB-GYN. He or she has the experience to help you feel at ease before, during and after your delivery.
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During pregnancy women experience a wide range of physical changes and sensations. The signs of preeclampsia, a disorder that occurs only during pregnancy and the postpartum period, are too often misinterpreted as the symptoms of a normal pregnancy. Preeclampsia generally occurs late in the second or third trimesters, and up to six weeks postpartum. In rare cases it can occur before the second trimester begins. It is estimated that approximately three to five percent of pregnant women suffer from preeclampsia. Globally, preeclampsia and other hypertensive disorders of pregnancy are responsible for 76,000 maternal and 500,000 infant deaths every year. The symptoms can progress rapidly, and in the most severe cases, the results can be fatal. Understanding the signs of this dangerous condition will help keep you and your baby safe.
Symptoms
Preeclampsia can be particularly dangerous because many of the signs are unidentifiable or misunderstood to be normal effects of pregnancy. Speak with your OBGYN if you experience any of the following:
- High blood pressure (Hypertension). High blood pressure is one of the most important indicators of preeclampsia, however it can easily go unrealized since women cannot feel their blood pressure rising. High blood pressure is generally defined by a reading of 140/90 or greater, measured on two separate occasions six hours apart. During pregnancy, a rise in the lower number of 15 degrees or more, or a rise in the upper number of 30 degrees or more, can be a cause for concern. Your OBGYN will help you keep a record of your blood pressure before and during your pregnancy to help identify an unsafe rise.
- Protein in your urine (Proteinuria). Protein in your urine can occur when proteins that are normally confined to your blood spill into your urine. Preeclampsia temporarily damages the filtering of blood by your kidneys, which causes the leakage of proteins into your urine. To identify this symptom, your OBGYN will test your urine at each prenatal check-up. In between visits if your urine appears to look dark, reddish, or the color of cola, contact your OBGYN immediately.
- Changes in vision. Vision changes are one of the most serious symptoms of preeclampsia. It may be an indication of irritation of the central nervous system or swelling of the brain (cerebral edema). If you experience sensations of flashing lights, auras, light sensitivity, or blurry vision or spots, contact your OBGYN or go directly to the hospital.
- Swelling (Edema). Some swelling is normal and common for pregnant women, however edema is the accumulation of excess fluid that occurs in the face, hands, or around the eyes. Contact your OBGYN if you notice excessive puffiness in your face, hands, or feet. Also, watch for signs of “pitting edema.” When you press your thumb into your skin, if an indentation remains for a few seconds, or you notice discoloration of your legs, you may be experiencing pitting edema and should contact your OBGYN right away.
- Headaches. Severe or dull throbbing headaches that won’t go away could be a sign of preeclampsia. If over-the-counter medicine does not relieve your symptoms, you have light sensitivity, you experiences changes in your vision, or the pain becomes severe, contact your OBGYN.
- Nausea or vomiting. Many women experience morning sickness, however nausea or vomiting that is sudden, and that occurs after mid-pregnancy could be a sign of preeclampsia.
- Abdominal (epigastric) pain and or shoulder pain. Both abdominal pain and shoulder pain, often called “referred pain” because it radiates from the liver under the right ribs, can be confused with heartburn, gallbladder issues, the flu, indigestion or the baby kicking. If the pain is associated with preeclampsia it will be more severe than the pain experienced with muscle strain. Shoulder pain may feel like you are being deeply pinched along the bra strap, on your neck, or your right side. Such pain could be related to an issue with your liver, so contact your OBGYN immediately if your pain seems abnormal or severe.
- Lower back pain. Again not to be confused with general muscle fatigue, lower back pain that is severe may be an indication of an issue with the liver, especially when accompanied by other signs of preeclampsia.
- Sudden weight gain. Many women are hyper-aware of changes in their weight during pregnancy, especially as they watch their baby bump grow and expand with each month. Rapid weight gain, however, could be a cause for concern. Weight gain of more than two pounds in a week could be an indicator of preeclampsia. The rapid increase could be caused by damaged blood vessels allowing more water to leak into body tissues instead of passing through to the kidneys.
- Hyperreflexia. Hyperreflexia is characterized by reflexes that are so strong that when your knee is tapped by a rubber hammer, your leg bounces back hard. It is typically caused by an overreaction of the involuntary nervous system to stimulation. Your OBGYN will test you for hyperreflexia; otherwise it may be difficult to identify on your own.
- Shortness of breath and anxiety. Having moments of nervousness during pregnancy is common, however women should pay attention to more severe signs of anxiety, such as shortness of breath, a racing pulse, mental confusion, and a heightened sense of anxiety. Contact your OBGYN if these symptoms come on immediately or severely.
Preeclampsia Treatment and Prevention
Proper prenatal care is essential to manage the risk of preeclampsia. Attend all scheduled OBGYN visits to make sure you are getting regular weight checks, blood pressure readings, and urine tests. Maintain a healthy diet full of vitamins, and natural, rather than processed, foods. Most importantly, pay attention to your body. While every feeling you experience may seem sudden and strange, trust your instincts. Any rapid or severe changes or symptoms should be taken seriously.
Never hesitate to contact your OBGYN with questions or concerns. And if you are looking for at top OBGYN group in Western New York, please give our practice of Chouchani, Sayegh and Bagnarello a call today.
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