Your 3rd Trimester 7-9 Months (week 27-40)

Back ache

• One would recognise sciatica (painful disorder from the hip down the back of the thigh and surrounding areas) by the following symptoms: Dull ache in the buttock, sharp shooting pain down the back of the leg and in the foot of the affected side, a lame or numb feeling down the affected leg, burning or tingling in the toes and certain areas of the leg, the skin may be very sensitive to touch and the foot may not have full range of motion.
• Massage the affected foot, leg and buttock to help relieve pain, inflammation and the burning ache of sciatica.
• Women often don't take enough care when bending and picking up weighty objects and even other children when expecting, and this makes them more prone to stumbling and tripping, which together with the stretched and softened ligaments, means the body cannot compensate as effectively and lower back injury is more likely.
• If you have a previous back injury, discuss exercise and posture in pregnancy with a physiotherapist.
• Ensure a sensible exercise programme throughout pregnancy - walking and swimming are wonderful for overall muscle tone and strength of back muscles.
• Rest frequently during an acute sciatica attack.
• Wear a Carriwell Pregnancy Band to support the entire abdominal and lower back region, contributing to less pressure in the lower back area and better posture.

Swelling

• An expectant woman's blood circulation is often compromised due to the weight of the whole pregnancy (not just baby) on the major blood vessels in the abdominal area, keeping blood flow from being as efficient as normal.
• As pregnancy progresses, many women are often less agile and mobile and that too makes blood circulation less efficient.
• The hands and feet, being relatively bony areas, show water retention fastest as there is so little fleshy area to accommodate the swelling.
• Another fairly common area where swelling can be troublesome is the fluid of the eyes, leading to visual disturbances and sometimes one cannot wear contact lenses and may even need a new lens prescription for spectacles.
• Nasal congestion may well also be a form of swelling experienced in pregnancy, rather than a cold or sinus congestion.
• Swelling can however be a serious symptom if accompanied by other signs like protein in the urine, elevated blood pressure, visual disturbances, headaches, dizziness and nausea.
• Walk briskly for five minutes of each hour especially if in a standing or sedentary occupation.
• Do ankle and calf exercises while seated to stimulate circulation.
• Do not cross legs at ankles or knees while seated.
• Walk briskly each day for at least 20 minutes.
• Rest sufficiently with your feet up to counteract swelling.
• Plunge feet into a tub of cold water to relieve swelling and pain.
• See your doctor urgently to check for toxaemia of pregnancy if you have any of the serious symptoms listed above, you notice swelling in the morning already, if baby's pattern of movement changes significantly or you do not feel well, especially if you are close to or in the third trimester of pregnancy.

Varicose veins

• Varicose veins in pregnancy are quite common, especially in the calves.
• One can develop varicose veins in the labia and groin area too.
• Varicose veins of all forms are generally very uncomfortable with aching in the affected body part.
• There is often an inherent family weakness in the circulatory system, especially the elasticity and strength of the muscular sheath of the blood vessel wall.
• For varicose veins in the legs, genital area and piles, rest often in between activity.
• Put your feet up and do not cross legs at the ankles or knees so that circulation is not further impeded if you have varicose veins.
• Firm supportive stockings are sometimes necessary to support circulation and soothe pain, although these can be very uncomfortable in pregnancy especially in hot weather.
• Occasionally lie with your buttocks up on a pillow or two to relieve the pressure of genital veins and piles.
• Do this exercise for considerable relief from varicose veins in the legs: lie flat on the floor with your buttocks up against the wall and your legs extended up the wall; gradually open your legs against the wall until you feel stretching of the inner thigh muscles; draw them together again; keep your feet against the wall and draw your knees down towards your chest and then gradually return your legs to the starting position; repeat ten times 2-3x/day.
• Genital varicose veins respond well to a firm pressure pad worn inside one's panty.
• Ice packs wrapped in a face flannel and applied to any bulging painful area with varicose veins gives some relief.
• Exercise regularly, eat at least three pieces of fresh fruit a day and drink sufficient fluids if prone to varicose veins.
• See your doctor if the area where varicose veins are located looks bruised, is very painful or if you feel unwell and abnormally short of breath.

Piles

• Piles (or haemorrhoids) are a form of varicose vein.
• Piles or haemorrhoids are varicose veins of the anal region and are more common in pregnancy.
• Piles may protrude externally or remain inside the rectum.
• If you pass fresh blood with bowel movements or notice tags of skin or even grape-like clusters protruding from the anus, these are piles.
• Piles burn, itch and are very uncomfortable and usually become worse during pregnancy and labour if not treated.
• Exercise regularly to tone all body tissues as piles are then less likely.
• Avoid constipation to further decrease the risk of piles.
• Drink water liberally.
• Take care not to pick up excess weight in pregnancy to lessen the chance of piles forming.
• Tell your doctor or midwife if you have piles as this may affect the type of birth you can have.

Palpitations

• One's blood volume increases by about 40-50% during pregnancy.
• The maternal network of blood vessels is greatly extended to supply baby with nutrients, oxygen and a waste disposal system.
• The mom-to-be's heart must work much harder to pump the extra blood she has around the extended blood vessel network.
• An expectant woman carries around 12kg or more extra weight by the end of pregnancy and so the circulatory and respiratory systems are more taxed.
• Palpitations, the feeling of one's heart beating harder and faster, and shortness of breath, are quite common from now on in pregnancy.
• If palpitations soon cease and you in no other way feel unwell, there is in all likelihood no reason for concern.
• Palpitations might occur even when resting in pregnancy but should settle quite soon.
• Walk briskly regularly to keep fit and improve stamina.
• If you are a very anxious person, you will be more prone to palpitations and breathing exercises will improve matters.
• If you feel unwell and palpitations or shortness of breath stay for quite some time when you are not exerting yourself at all or if you feel as if you have a fever, see your doctor.

Pelvic aching

• When lower pelvic aching seems unbearable, cup your hands around the lower part of your 'bump' and 'lift' it up a little as this will instantly soothe the pressure you feel.
• Go down on all fours, with your arms bent at the elbows, so that your buttocks are higher than your head, to relieve lower pelvic pain, as baby then puts less pressure on the nerves in the groin.
• Walking and other forms of exercise like swimming and dancing are excellent for overall strength and posture, but be guided by your body's messages and rather do little bits frequently than overdo it in one session.
• Cross your hands in the small of your back and press up against a wall to provide relief from lower backache.
• Try and correct posture by pulling in tummy muscles and buttocks, keeping shoulders back and down and slightly tilting the chin upwards.
• If low pelvic pain and backache are accompanied by ligament pain elsewhere in the abdominal area, wear a Carriwell maternity support band at night.

Breathing exercises

• Balanced breathing for relaxation in pregnancy is an excellent way of preparing mentally for labour, birth and mothering.
• Find a comfortable chair that allows you to sit upright with your spine straight and feet on the floor - it is best not to lounge backward while doing balanced breathing.
• Close your eyes, let your mind rest, and place the thumb of your right hand beside your right nostril, your two middle fingers beside your left nostril.
• To perform the exercise, gently close one nostril, then the other, as you breathe normally.
• To keep your arm, from getting tired, it helps to tuck your right elbow in close to your ribs, but don't prop it up on your chair or on a table.
• Begin each breath on the exhale and finish on the inhale - this is different from most breathing exercises, which begin by taking in a deep breath.
• The basic rhythm of balanced breathing is as follows:
• Gently close the right nostril with your thumb and slowly exhale through your left nostril.
• Inhale easily through your left nostril.
• Close the left nostril with the two middle fingers and exhale out of the right nostril.
• Inhale easily through the right nostril.
• Alternate nostrils for 5 minutes. Then lower your arm and sit back comfortably with eyes closed for 1 or 2 minutes.
• In balanced breathing, you do not need to take deep breaths - just let your breathing come naturally but a little slower and deeper than usual.
• If at any time you feel like breathing through your mouth, go ahead, then return to the exercise as soon as you feel comfortable again.
• You might find your nose blocking up initially, but this phase will soon pass.

Perennial Preparation

• Lie on your back, knees pulled up, arms relaxed at your sides, tense the muscles around your urethra, vagina and rectum and count to three, then relax totally, repeating six times, for pelvic tone.
• Try this tip to help locate pelvic muscles accurately - when you next go to the loo, interrupt the flow of urine by pinching - the sensation will be exactly the same as one uses the same muscles.
• Lie on your left side, left leg slightly bent at the knee, right leg flexed more and resting on a pillow, left arm behind your back, right arm flexed in front of you and resting on the same pillow as your head, tense your perineal muscles, repeat six times but steadily increase amount as you get the hang of it.
• Practise tensing these very important perineal muscles almost anywhere and at almost any time, for example in the car or bus on the way to work, in the lift, on the loo!
• It is also important to be able to help open perineal muscles voluntarily at birth.
• To help prepare your perineum to stretch easily at birth and to strengthen your thighs and pelvic muscles and ligaments, imitate a butterfly.
• Sit on the floor with your buttocks pressed right up against the wall, your back straight and shoulders relaxed, bend your knees, bring the soles of your feet together, place your hands on your knees, push them downwards with butterfly-like movements for a few minutes at a time, most days of the week.
• Use a pregnancy and birth ball to good effect by sitting securely, then lunging from side to side to stretch the perineal area.
• Roll your pelvis around in big circles on the birth ball.
• Toning and stretch exercises will increase suppleness, tone the pelvic area and strengthen back muscles.
• Practice squatting to strengthen the muscles of your legs, buttocks and pelvis as well as helping stretch pelvic tissue.

Perennial Preparation II

• The perineum is the thick muscle wedge between vagina and anus.
• Massaging one's perineum for 4-6 weeks before birth helps make the area more supple and able to stretch.
• Using the correct oil and massage technique can help avoid perineal tearing or the need for an episiotomy, the cut done to increase the dimensions of the vaginal outlet.
• Massage your perineum at least 5 nights a week before retiring.
• Ensure that you hands are clean and spray or pour a little oil onto your fingertips.
• Place your thumbs into the vaginal outlet and massage the perineum between your index, middle fingers and thumbs for a few minutes until the area feels softer.
• Keeping your thumbs in position, stretch the vaginal outlet sideways a number of times and then down and slightly forwards.
• If you find it difficult to reach the area over your swelling abdomen, lie on one side or stand with one foot up on a chair and use only one hand to do something similar, or one's partner can assist.
• Perineal massage also increases awareness of the area that must stretch to let baby out and it is easier to focus on it in the birth process and visualise it opening.
• If you have thrush or another vaginal infection, make sure this is cleared before starting this massage routine.

Preparing for labour

• Prepare a list of preferences important to you for labour and discuss these with your partner, doctor or midwife and hospital.
• A birth plan is simply a flexible wish list but will help focus you on what you want.
• Learn to visualise how you attain a goal; apply this in labour too, literally 'seeing' how the baby moves down in the birth canal and then is born.
• Use water in labour and during the actual birth too for effective pain relief, if you like the idea.
• Deep baths, relaxing showers or moist sheets wrapped around your belly can all be tried.
• Pace yourself through early labour by either sleeping a little longer, resting and reading or keeping busy with easy activities or gentle walking.
• Explain to your partner that you might well need him to not touch you at all during labour.
• Explain to your partner that anxiety and a tendency to shorter endurance levels might make you impatient, angry and scared in labour and that it would be very valuable for him to reassure you often and not take your comments personally.
• Tell your partner and staff that you will ask if you need your hand to be held or your back massaged.
• Keep your bladder empty in labour so that it does not impede baby's downward movement.
• You might feel a need to have less talking and touching once labour is intense - communicate this to your partner or caregiver so that they understand and respect your wishes.
• During pushing contractions, remember to continue breathing. Take deep breaths and really push down hard in the vaginal area but then come up for a fresh breath! About 4-5 pushes per contraction are possible.
• Most of all, remember that there is more time without than with the pain of contractions in labour!

• Keep up liquid and snack intake throughout labour to ensure your energy does not lag at critical times.
• Comfort objects, music and massage techniques are essential for well-being in labour.

Congratulations!! It's a ...

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