Symptoms

Unfortunately, the third trimester can be the most painful and uncomfortable phase of your pregnancy. As Baby grows and you continue to gain weight, you’ll feel some strain here and there. Here are some symptoms that might be coming your way:

• Fatigue: Most women gain 20-30 pounds (9-13.6 kg) by the end of their third trimester, so you’re bound to get tired if you feel like you’re lugging around a watermelon in your womb. Try combatting the exhaustion with light exercise and small meals throughout the day, and never hesitate to get some well-deserved rest.
• Back pain: A growing baby, along with hormones to loosen your joints in preparation for childbirth, puts stress on your pelvis and lower back. There are lots of stretches or exercises you can do to improve your posture, or you can try supportive garments to lift your stomach.
• Heartburn: When your uterus grows, it can shift around your organs a bit, and a change in stomach position can lead to heartburn. You can control this by monitoring what and how much you eat in one sitting, so you might want to stay away from fried or spicy foods and try to eat small meals throughout the day.
• Swelling: As Baby takes up more real estate in your body, the uterus presses against vessels that take blood to and from the heart, which can cause swelling in your limbs or extremities. Try going for a swim or just lying down on your side to improve circulation.
• Breast growth and discharge: Most women put on about 2 pounds (900 g) of extra breast tissue by the third trimester, so your breasts could become tender. They might also start secreting a yellow liquid called colostrum, which is important for delivering nutrients to Baby in the first few days after delivery.

Health care provider appointments

Third trimester healthcare provider visits will occur more often than those in the first six months, and you’ll probably have appointments every two weeks until week 36 when they become weekly until labor. You’ll talk about delivery in detail and continue to receive standard physical exams to check for potential problems.

At some point during the third trimester, your healthcare provider will probably suggest getting a Tdap vaccine. The Tdap is given during pregnancy to help protect the baby, who is protected through maternal antibodies passed on before birth, from whooping cough. The vaccine lasts until around 2 months old, and is important because babies are at the highest risk for whooping cough, and, with their as-yet-unformed immune systems, have the least ability to fight it off.

As always, these appointments give you time to talk about worrisome symptoms and discuss results from previous tests. Baby’s size and heartbeat will continue to be monitored, in addition to their position. An ultrasound is the best way to determine if they is oriented bottom-down and, if this is the case, you can schedule a procedure to internally or externally turn them.

You probably won’t be having regular pelvic exams unless your healthcare provider suspects an issue, but if you’re more than a few days past your due date it is important to check the condition or dilation of the cervix.

Take advantage of these appointments to talk about your concerns regarding childbirth or postpartum issues, such as breastfeeding or contraception after Baby is born. The best preparation for going into labor is expanding your knowledge and having clear expectations for what you will experience.

Tests

Your healthcare provider can perform more tests in the third trimester since Baby is more developed. These will include vaginal exams to check their position and evaluate the condition of your cervix.

• Group B strep test: Group B strep bacteria lives in about 1 in 3 women, and is not dangerous for moms-to-be, but could affect Baby when they passes through the birth canal, where the bacteria resides. The test is performed with a simple vaginal and rectal swab, and if you get a positive result, it can be treated with antibiotics so that they doesn’t have it at birth.
• Non-stress test: This is usually reserved for high-risk pregnancies or women past their due date. It monitors Baby’s heart rate with a strap across your abdomen to make sure they is developing well.
• Biophysical profile (BPP): A BPP is a combination of tests to evaluate Baby’s heart rate, muscle tone, and movement. It also assesses the amount of amniotic fluid around them, which is a factor that can contribute unsafe conditions. This is also performed mainly for high-risk pregnancies or for women susceptible to certain diseases.
• Oxytocin challenge test: Frequent or intense contractions limit the amount of oxygen Baby receives during labor, so your healthcare provider might perform this test to see how they responds to simulated contractions. This is usually done only when your healthcare provider anticipates that the baby will struggle under stress.

All in all, these tests give you a good idea of any foreseeable issues in labor. Seeing that your baby is in a good position with a steady heartbeat should put you at ease for a safe and healthy delivery.

Reviewed by the Ovia Health Clinical Team

Read more

• Third trimester doctor appointments
• Second and third trimester weight gain

Sources

• Mayo Clinic Staff. “Biophysical Profile.” Mayo Clinic. Mayo Clinic, 3/5/2015. Web.
• Mayo Clinic Staff. “Third trimester pregnancy: What to expect.” Mayo Clinic. Mayo Clinic, 5/5/2014. Web.
• “Body changes and discomforts.” Womenshealth.gov. U.S. Department of Health & Human Services, 9/27/2010. Web.

Symptoms

Second trimester symptoms are generally tame, and most of the bothersome ones are overshadowed by exciting signs of new life. A few pesky symptoms include:

• Shortness of breath: The uterus continues to grow and might put some pressure on your lungs that you notice while taking the stairs or going for a run. This feeling is totally normal, but talk to your healthcare provider if you feel like even basic activities leave you breathless or if the difficulty breathing has a very quick onset.
• Stretch marks: Your ever-changing shape might cause you to develop some purple or white lines on your skin. They’ll fade and become less noticeable or most folks after the postpartum phase. Stretch marks can feel itchy or dry, and a soothing lotion or balm can help!
• Vivid dreams: Blame it on pregnancy hormones or interrupted sleep, but vivid dreams can be very common during pregnancy. 
• Dizziness: The second trimester can make your blood pressure drop as your blood volume increases and blood vessels relax. This can leave you lightheaded or dizzy, so make sure you stay hydrated and feel free to sit or lie on your side to feel better and stay safe.
• Round ligament pain: A brief and sharp pain, often felt in the groin or hips, round ligament pain is a pregnancy staple for most folks. Although you may be unable to avoid it completely, moving slowly (don’t jump up out of your seat!) and wearing supportive belts or clothing can help. 

Healthcare provider appointments

Second trimester OB provider visits, which should take place about every four weeks, are important for tracking your blood pressure, baby’s growth and discussing symptoms.

Your provider will take measurements of your stomach from the top of the uterus to the base of your pelvis, which gives a good idea of Baby’s changing size. Perhaps the most exciting part of second trimester visits is the opportunity to hear their heartbeat.

Even though birth is still a few months away, your healthcare provider will also take this time to talk to you about childbirth classes and give you information about signs of premature labor. Don’t hesitate to tell your healthcare provider about any physical or emotional concerns, as they can guide you to further sources of support when necessary.

Tests

Between weeks 15 and 24, most people have several milestone pregnancy exams! These may include:

• Anatomy Ultrasound and Cervical Length: A favorite of most parents, the anatomy ultrasound takes a thorough look at every inch of your growing baby. From head to toe, and your baby’s sex if you want to know it, will be shown to you in detail. A cervical length is often done at the same time. This precise ultrasound measurement of the opening of your uterus can identify those at risk for preterm labor and birth.
• Multiple marker screening: Alpha-fetoprotein, which is secreted by the fetus, can be a sign of Down syndrome or spina bifida if present at very high levels. This can be detected with a simple blood draw, and most women undergo the screening. An abnormal result, which occurs in about 4% of women, could be a false positive, so your healthcare provider will perform an ultrasound to confirm a genetic defect.
• Amniocentesis: This is an invasive diagnostic test to confirm chromosomal differences, usually after a screening blood test or ultrasound has been flagged as high risk. It is an optional test for parents who want more certainty than screening tests can provide. A needle is inserted into the amniotic sac to withdraw a small amount of fluid for testing. It is a brief in-office procedure guided by ultrasound. It carries a small risk of miscarriage.
• Glucose challenge test: After drinking a prepared beverage, parents-to-be have their blood drawn to see how their body responds to a specific amount of glucose. High results require additional testing and may lead to a diagnosis of gestational diabetes. High-risk people will have this test even earlier in pregnancy.

Reviewed by the Ovia Health Clinical Team

Read more

• Second trimester doctor appontments
• Shortness of breath when pregnant

Sources

• Mayo Clinic Staff. “Second trimester pregnancy: What to expect.” Mayo Clinic. Mayo Clinic, 5/15/2014. Web.
• “Body changes and discomforts.” Womenshealth.gov. U.S. Department of Health & Human Services, 9/27/2010. Web.
• Mayo Clinic Staff. “Prenatal testing: Is it right for you?.” Mayo Clinic. Mayo Clinic, 8/22/2015. Web.
• Mayo Clinic Staff. “Prenatal testing: Quick guide to common tests.” Mayo Clinic. Mayo Clinic, 8/8/2015. Web.
• “Preterm labor.” March of Dimes. March of Dimes, n.d. Web.

Symptoms

First trimester symptoms are perhaps the most well known and include:

• Morning sickness: Though the exact cause is unclear, an increase in pregnancy hormone chorionic gonadotropin has been known to make you queasy. Try eating smaller meals throughout the day or taking in ginger or vitamin B6 to combat bouts of nausea.
• Food cravings or aversions: Strong likes or dislikes for various foods are often connected to morning sickness and are similarly unpredictable. Try not to give in to too many unhealthy cravings and substitute healthy alternatives for the foods that you can’t stand.
• Frequent urination: Attributed mainly to the increasing size of your uterus and pressure on your bladder. Empty your bladder often to prevent a urinary tract infection.
• A heightened sense of smell: This one is very closely intertwined with morning sickness.
• Fatigue: One of the most common symptoms of pregnancy, overall tiredness is a result of all the new processes your body goes through to nourish Baby and help them grow. The increase in progesterone is also associated with a sedative effect.

Additionally, the beginning stages of pregnancy can leave you feeling overly emotional due to the whirlwind of new concerns and pressures on your body. There are many solutions to make this time more comfortable for you, and you can ask your healthcare provider to suggest the best one for you. The majority of your experiences are common to millions of women around the world, and it’s best to take one day at a time and treat your symptoms as they come.

However, certain symptoms should never be ignored, such as heavy vaginal bleeding, persistent vomiting, or severe cramps. These should be addressed immediately as they could be associated with a miscarriage.

Health care provider appointments

Your healthcare provider is the best resource you have throughout the course of your pregnancy, and he or she can easily resolve your concerns and give you the best personalized advice to ensure as healthy a pregnancy as possible.

The first visit should be scheduled as soon as you think you’re pregnant, and it would be a good idea to bring your partner along since you will receive a lot of important information regarding your future lifestyle. At this appointment, your provoder will ask about your medical history, including your typical menstrual cycle and medication use. Additionally, they can establish an estimated due date, which is important to monitor Baby’s growth and schedule certain tests or procedures accordingly.

Your provider will also perform a physical exam that encompasses weight, height and blood pressure to assess your overall health and a vaginal exam to check for infections. This appointment also includes the blood tests, urine tests and screening procedures mentioned above relating to fetal abnormalities.

Subsequent prenatal visits are usually scheduled every four weeks in the first trimester and won’t be quite as thorough as the first appointment. Rather, you’ll meet with your healthcare provider, who will check your weight and blood pressure and use it as a time to discuss any signs and symptoms.

At an appointment toward the end of the first trimester, around 9-12 weeks, you may be able to hear Baby’s heartbeat, one of the most exciting developments for any new mom.

Tests

The first trimester is a critical time to test for various diseases or conditions that could affect Baby, particularly if they are common in your racial, ethnic, or family background. Most issues are detected through:

• Blood tests screen for conditions like anemia, Hepatitis B, and HIV in addition to providing your blood type and Rh-factor. All of these can be assessed with a single blood draw, which is performed on almost every new mom at her first appointment.
• Urine tests look for signs of kidney infection and evaluate glucose and protein levels. You will probably provide a urine sample at every prenatal appointment to track these, since abnormal levels can indicate serious pregnancy-related issues.
• Chorionic Villus Sampling (CVS): tests for chromosomal defects like Down syndrome and muscular dystrophy. This test is optional and very invasive, usually reserved for women over 35. The procedure requires a tissue sample from the placenta obtained by threading a small catheter through the cervix or inserting a needle into your abdomen. It is 98% accurate in ruling out some chromosomal birth defects, but does not detect neural tube disorders, such as spina bifida and anencephaly.
• First Trimester Combined Screen: Performed between weeks 11 and 14, the First Trimester Combined Screen is a testing option that consists of a Maternal Serum Screening Test (MSS) and a Nuchal Translucency ultrasound (NT). The MSS tests for pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (hCG), irregular levels of both of which can indicate a chromosomal disorder. In addition, the nuchal translucency ultrasound is performed to determine the size of clear space (fluid) in the back of the neck, which can also indicate a risk of Trisomy-21 (Down Syndrome). The First Trimester Combined Screen is not diagnostic, it merely screens for an increased likelihood of having certain chromosomal disorders. Although it identifies 85% of the babies with Down Syndrome, 5% of women tested will also register a false positive, and because Down Syndrome is relatively rare, even most babies of most women who are notified that their baby has a heightened risk for the condition will not actually have the condition. The First Trimester Combined Screen is highly effective at screening for chromosomal disorders, but cannot give conclusive results for the genetic disorders, nor can it show any indication of neural tube defects, so an amniocentesis may be recommended during the second trimester if there is a positive indication during this screen.

Genetic diseases like cystic fibrosis and sickle cell anemia will be tested for only if you are likely to develop them based on your family history. Some women have their hCG and progesterone levels checked often as well.

Reviewed by the Ovia Health Clinical Team

Read more

• Heightened sense of smell when pregnant
• Frequent urination when pregnant

Sources

• Mayo Clinic Staff. “Symptoms of pregnancy – What happens right away.” Mayo Clinic. Mayo Clinic, 7/12/2013. Web.
• Healthline Editorial Team. “What Bodily Changes Can You Expect During Pregnancy?” Healthline. Healthline, 3/5/2012. Web.
• Mayo Clinic Staff. “Prenatal care: 1st trimester visits.” Mayo Clinic. Mayo Clinic, 7/31/2015. Web.
• “Prenatal care in your first trimester.” U.S National Library of Medicine. MedlinePlus, 6/11/2014. Web.
• “The Rh Factor: How It Can Affect Your Pregnancy: FAQ027.” ACOG. American College of Obstetricians and Gynecologists, 9/13/2015. Web.
• Mayo Clinic Staff. “Chorionic Villus Sampling.” Mayo Clinic. Mayo Clinic, 10/17/2015. Web.
• “Prenatal Tests.” March of Dimes. March of Dimes, 6/03/2016. Web.
• “Carrier Testing for CF.” CFF. Cystic Fibrosis Foundation, n.d. Web.

Make your workday work for you

Everyone’s work and home responsibilities are different. For some people, it’s entirely reasonable to get work done and be present with their children. Others may need to step away and work in a separate space. For a lot of us, it’s a mix of this, depending on what kind of work we need to do at any given moment. Maybe you can answer email while your little one builds a block tower nearby, but you need to make important clients calls in your office while they nap. These specifics should shape your day. You’ll also want to consider when you need and want to be working and what your needs at home are. Do you prefer to wrap up your last bits of work after hours when your kids are asleep, or do you want that time to be off limits? Does your school age child need help logging into online classes? Does agreeing to a set schedule for your whole family help? As much as possible, use the shape of your workday to help you get what you need done at work and at home — or at least most days, fingers crossed.

If you and your partner are both working from home, take shifts

A fairly simple solution to a rather big challenge: one of you works, while the other takes care of your little one, and then you switch. You can work in large swaths of time, like a morning and evening shift, or switch every couple of hours. It might be best for you to have a set schedule every day or maybe you need to be more flexible, adapting to meetings, calls, and deadlines. If your schedule looks different from day to day, just make sure you review it together each week, or even just in the morning every day, so that you’re both on the same page and no one misses a meeting or deadline. This solution isn’t perfect — it can be hard to step back and set a schedule when you’re drowning in to-dos, but many dual WFH parents have found this to be their best option. 

Take breaks to recharge and reconnect with your family

If your child is very young, they might have a hard time with you working apart from them all day; they might need some quality time with you throughout the day. Meals can be a great time to reconnect, as can nap time. Find some time to play, or get outside together (if it’s safe to do so where you live). These moments also help to break up your workday and give you a way to recharge — everyone needs regular breaks from their work. 

Set clear expectations and boundaries, and ask for what you need to succeed

As much as you’re comfortable doing so, be honest with your employer about your reality at home — maybe you prefer not to take meetings midday so that you can put your baby down for a nap, or you need to ask coworkers to email rather than video call you when possible. Many employers are doing what they can to be flexible and make accommodations for working parents right now, but this is new for everyone, and your employer might not know you’re struggling with something until you tell them. Similarly, you might not know if a change can be made until you ask for it. Be honest with your family about the realities of your job right now too, even with your kids in an age-appropriate way, you might say, “I have to go work in my office during your TV time so that I don’t have to work after dinner.” Ask for help when you need it.

Have a designated work space

An easy way to get into the groove of starting your work day is to actually sit down at a designated work space — maybe this is a desk in the corner of your bedroom, or a home office. If you’re working in a common space, like at your dining room table, it helps to transform that space while you’re working, at least a little bit. Put all of your work things on the table to start your day (laptop, notebook, pen, headset, etc.) so you have everything you need in one place. And at the end of the workday clean it up, to signal to yourself and your family that you’re done for the day. 

Give them a sign

It can be challenging for little ones to understand that, yes, you’re home with them, but you’re also sometimes unavailable because you’re working. Children can benefit from a very clear visual marker that communicates when you’re unavailable — something like a handmade red and green “STOP/GO” sign for little kids or a simple “I’m working” note scrawled on a whiteboard for bigger kids can do the job. 

Use transitions to your benefit

Clear transitions or rituals can help mark the start and end of your work day and are always useful, but particularly so when you’re missing out on your usual routines. Instead of starting your day by stopping at a coffee shop or walking to the bus, start some new at home rituals. Sit down to work with a cup of coffee in your favorite mug, or end the day by walking your dog or playing a favorite game with your little one. 

Dress for success

We’re not necessarily saying that you need to give up your leggings, but clothing is a powerful tool that can shape your mood. And, let’s be honest, it can be so easy right now to just roll out of bed, start caring for your kids, dig into answering emails, and realize it’s lunch time before you even realize you’re still in your pajamas. It can help to get dressed for your work day in a way that helps you feel good, whether that’s cozy sweats or your favorite dress. 

Know when you’re off the clock

When you’re working from home, it’s so easy for work to bleed into all hours of your day. If you can, set clear hours when you’re off the clock. Work is important, but you need and deserve time to step away to care for yourself and to be fully present with your family.

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