Third Trimester

Gestational diabetes

This is a type of diabetes that some women may get during pregnancy. This is one of the most common health problems during the pregnancy with about 2- 10 % of women getting gestational diabetes. Some of the risk factors include, but not limited to : BMI of over 30, gestational diabetes in a previous pregnancy, sugar in your urine, strong family history of diabetes, previously given birth to a big baby,  had an unexplained stillbirth, high blood pressure, had a baby with a birth defect, or if you are over 35 years of age.

You can find more information about gestational diabetes on the following web sites:

http://www.diabetes.org.nz/about_diabetes/gestational_diabetes

http://www.mamamaternity.co.nz/mama-maternity-abc/planning-your-pregnancy-care/testing-for-gestational-diabetes-gdm/

http://www.diabetes.org.nz/about_diabetes/gestational_diabetes

Pre-eclampsia

Preeclampsia is  a serious condition that affects 3-5% of all pregnancies. The main characteristics of preeclampsia are high blood pressure and protein in the urine. Some risk factors include: first pregnancy, multiple pregnancy, overweight, age over 35 years, history of diabetes, high blood pressure or kidney disease.

http://www.preeclampsia.org/

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001900/

36 week bloods

The blood test at 36 weeks include a full blood count which looks at many components of the blood.  The most important during pregnancy are:

Haemoglobin or Hb- related to iron levels and being anaemic. 

Platelets or thrombocytes- These small blood cells play a vital role in helping the blood to clot and control bleeding. 

Also checked at this stage are the Ferritine levels, which indicate how much iron you have on storage in the body.

Antibody screen detects antibodies that may occur in the baby.

http://www.health.govt.nz/your-health/services-and-support/health-care-services/maternity-services/pregnancy-and-newborn-screening

http://www.bpac.org.nz/resources/bt/2011/07_pregnancy.asp

Sore back/pelvis/hips

Backache, pelvic pain and hips pain are caused by the softened ligaments and altered posture. Those also make you more prone to back strain. Check you posture, stand straight and use cushion behind your lower back when sitting. Lift with straight back and keep the weight close to your body. Sharp pains in your pelvis may be your baby bumping against a full bladder. Watch out your sleeping position, sleep on your side (left side is best) with pillow between your knees and under your tummy so your pelvis is not twisted.

Some pregnant women may also experience a condition called Symphysis Pubis Dysfunction (SPD). It is a condition that causes excessive movement of the pubic symphysis, as well as associated pain, possibly because of a misalignment of the pelvis. It is thought to affect up to one in four pregnant women to varying degrees, with 7% of sufferers continuing to experience serious symptoms postpartum.

Pregnancy massage, acupuncture and osteopathic treatments by professionals are great ways to help you feel better.

http://www.pelvicjointpain.org.nz/downloads/SPD-Information%20doc.pdf

http://pelvicjointpain.org.nz/

Heartburn/reflux

If you experience a burning sensation in your chest and a sour test in your mouth, you have heartburn or reflux. It is caused by a softening of the sphincter that closes your stomach allowing acid to spill out. It is made worst by the pressure of the growing uterus, reducing the stomach space. You can help yourself by eating small meals frequently, and avoiding spicy and fatty foods. You can try to neutralise the acidity with something alkaline- milk or yoghurt. Don’t bend over or lie down after a meal. Don’t drink water or other fluids with your meal.

http://heartburn.about.com/od/preventingheartburn/a/pregnancyhrtbrn.htm

http://www.buzzle.com/articles/acid-reflux-remedies-during-pregnancy.html

Sleep disruption

Insomnia can be caused by mild anxiety, discomforts, and frequent trips to the toilet. You can try walking every day, relaxation exercise and listening to soothing musing before bed. A warm bath and milky drink before bed can also be helpful. Avoid getting overtired during the day.

http://www.naturalsleep.org/effects-and-treatment-of-insomnia-during-pregnancy/

http://www.ncbi.nlm.nih.gov/pubmed/16025784

http://www.steadyhealth.com/articles/Remedies_To_Help_Combat_Insomnia_During_Pregnancy_a1623.html

Birth planning

Take the time to think about your labour and what do you want and don’t want. It also gives you a chance to talk to your midwife and discuss options. You have to keep an open mind and be flexible, its not always that everything goes according to plan, but if your midwife is aware of your wishes she will try to keep things as close as possible to what you have planned for. The following are some ideas about what to consider when writhing a birth plan, but you can include anything thats important for you.

http://www.kiwifamilies.co.nz/articles/making-a-birth-plan/

http://www.tabs.org.nz/birthplans.htm                                                                       

Packing your hospital bag

Packing your hospital bag will make the upcoming events very real. You can start thinking what to put in during your third trimester or in early labour. Think about what would you need for an overnight trip, choose comfortable clothing, tops that open in front, breastfeeding bra, your toilet bag, a pack of  maternity pads, hair ties, lip balm, massage oils, music, energy and comfort food for you and your support people. You also need couple of sets of baby clothing, woollen hat, booties, and singlet.

 

Planning  for breastfeeding

Breastfeeding is best for your baby and it is an important health choice. The World health organisation recommends exclusive breastfeeding for six months and once complementary foods are added, they suggest breastfeeding should continue up to two years or more. There are many benefits to breastfeeding –protection of the baby from disease, develops babies immune system, its free and already available, promotes bonding, provides protection to mothers from some forms of breast and cervical cancer, helps to lose the pregnancy weight.

http://www.lalecheleague.org.nz/ 

http://kellymom.com/

http://www.v25.com/breastfeeding/index.html

Breech presentation

breech means that your baby is lying bottom first or feet first in the uterus instead of most common position- head first. In early pregnancy breech is very common and as the pregnancy progresses a baby usually turns by itself into the head-first position. About 3-4 % of babies will stay in breech position at term. There are a few different types of breech presentation- complete breech, when the legs are bent at the hips and knees so the baby sits cross-legged on his bottom, Incomplete breech, most common breech presentation, where the baby’s legs are flat up against the body, footling breech, where the foot or feet are coming first (very rare), kneeling breech and more complex presentations. If your midwife suspects that your baby is in a breech position she will send you for a scan to confirm this. She will also discuss options for birth for you. Just remember breech presentation is not abnormal, it’s different and it does not necessary means you have to have a Caesarean section.

Great book to read is Breech Birth Woman-Wise by Maggie Banks

http://www.birthways.com/girlnet_docs/Natural_Measures.pdf
http://spinningbabies.com/
http://evidencebasedbirth.com/what-is-the-evidence-for-using-an-external-cephalic-version-to-turn-a-breech-baby/

Placenta praevia

Placenta praevia is a complication of pregnancy in which the placenta grows in the lowest part of the uterus and covers all or part of the opening to the cervix. During pregnancy, the placenta moves as the uterus stretches and grows. It is very common for the placenta to be low in the uterus in early pregnancy, but as the pregnancy continues, the placenta moves to the top of the uterus. By the third trimester in the majority of the pregnancies the placenta will be well away of the cervix.

Placenta praevia happens in about 1 of 200 pregnancies

 http://www.mayoclinic.com/health/placenta-previa/DS00588/

https://www.rcog.org.uk/en/patients/patient-leaflets/a-low-lying-placenta-after-20-weeks-placenta-praevia/

http://www.placentaprevia.org/

Vitamin K

Vit.k is a fat soluble vitamin that we obtain from our diet and our bodies make it from the bacteria in the gut. Vit K is necessary for the blood to clot normally. Babies are born with lower vit. K levels than adults, which is normal for them. Small number of babies may develop Vitamin K Deficiency Bleeding (VKDB), which is more likely to occur early in the first week of life; however it can happen any time. Bleeding can be from the nose, stomach, gut, brain, skin or cord stump. Some babies are more at risk- born before 36 weeks, had an infection, small babies, difficulty to establish breathing at birth, unable to feed, having bruises, babies born by Caesarean Section, forceps or ventouse, mother or baby having liver disease.

http://www.parentscentre.org.nz/myfiles/Kiwi_Parent_Vitamin_K_article.pdf   

http://www.maternity.org.nz/pdfs/VITAMIN%20K%20DEFICIENCY%20BLEEDING.pdf

http://www.midwife.org.nz/index.cfm/3,108,559/vitamin-k-2000.pdf

http://www.sarawickham.com/tag/vitamin-k/