As a Mommy,  As an OT

Surviving the Third Trimester

I’m officially 2 months away from Baby #2’s due date and deep into the third trimester. I feel like the time has flown by in this pregnancy. When I was pregnant with Chase, this was definitely the time I experienced the most discomfort and exhaustion.  I’m now reliving the back pain, itchy belly, and swollen legs, while caring for a rambunctious toddler which elevates the degree of difficulty to a whole other level. I felt like sharing my own tips for surviving the third trimester which will hopefully be of some use whether it’s your first time or second go-around. **Disclaimer Alert: I am not a physician, and every woman’s pregnancy is different. These tips are based on my own limited personal experiences and my clinical knowledge as an occupational therapist.

Swollen extremities

Your once-cute ankles and feet have now ballooned to almost twice their normal size and you’re no longer able to wear your wedding rings. As you may have realized, you retain a lot more fluid while pregnant, especially as your growth ramps up in the third trimester.  This has something to do with the combination of increased overall volume of blood in your circulation, the different hormones of pregnancy that cause you to hold on to more water as well as the pressure your growing fetus places on your internal vascular plumbing (especially the biggest draining veins of the abdomen/pelvis: the vena cava). Bottom line: you want to elevate your feet them as much as you can, but also pump your ankles (like your stepping on the gas pedal) to maintain good circulation down there. I have been working full-time in the hospital during both pregnancies. This entails  being on my feet all day (averaging 7-8,000 steps if you believe my FitBit) and coming home with puffy legs. I started wearing compression stockings to improve my circulation and reduce the amount of fluid pooling at my feet. As effective as these are, there’s a compliance issue at play here. These things are a challenge to put on and not the most fashion forward accessory in one’s wardrobe. Thankfully for this pregnancy my friend and co-worker lent me some cute and colorful ones, made by ProCompression, which I’ve tried out and love!

Heavy Belly

As your cantaloupe belly grows into a watermelon, you begin to compensate for the weight in front by curving more at your spine (increased lumbar lordosis to be technical).  It also puts strain on the top of your stomach and causes additional discomfort in both sitting and standing. Your stretched abdominal wall muscles are also at higher risk for strains, especially when picking up a heavy load (like a 27lb toddler for example). I began wearing a belly-band to support the melon during the day and offload the strain from the top of abdominal wall muscles and lower back. This one was bought on Amazon, and I usually wear it discreetly under my scrubs or loose clothing.

Back pain

As mentioned before, your growing belly increases the pressure put on your low back.  Thanks to the increase in the Relaxin hormone, your connective tissue, ligaments, tendons also become more lax and therefore you are more prone to strained muscles at the joints.  Learn more about the physiology of back pain and pregnancy here. To protect your precious spine:

  1. Use good body mechanics. It’s best practice to avoid any heavy lifting during pregnancy and delegate those tasks to someone else. Your doctor will probably determine your activity and lifting limits and some women are placed on strict no-lift restrictions.  For those without formal restrictions, caution should always be taken and you want to be mindful of not only how much you are lifting, but also how you are lifting. As a rule of thumb, always lift with you legs not your low back, bring items close to your body instead of holding them far away, and never twist at the waist when you are carrying items.  As a mom of a toddler, lifting this 27lb little human is a daily necessity. However, I’m very conscious about how I lift, carry and place him, as the smallest movement can misalign my back or cause debilitating strains as I alluded to earlier. I’ve read some extreme cases of placenta abruption or premature labor caused by lifting heavy objects, but research has not consistently confirmed this as a highly probaly scenario.
  2. Use a reacher to pick up things off the floor. I’m an OT, and everyday I teach my patients how to get dressed and perform daily tasks to overcome their physical limitations caused medical illness or recent surgery. A reacher is something used mainly for retrieving items both high and low, but can also be helpful for dressing oneself (pants/underwear for example). Luckily I haven’t gotten to that stage at all, but using it to pick up toys instead of crawling on my knees has been quite helpful
  3. Sleep with a maternity pillow. During my first pregnancy, my husband bought my a gigantic maternity pillow by Leachco. It has become my best snuggle buddy when I sleep (Hubby doesn’t mind one bit). I’m usually a side-sleeper, and the pillow keeps my spine completely aligned and supported, especially with a gap between the knees.  Now you don’t have to go out and buy these fancy pillows, and you can achieve the same level of comfort from a bunch of regular bed pillows. Just remember, firm is best when trying to provide support.
  4. Sit in a supportive chair. If you are sitting at a desk all day at work, it’s a good idea to check your workstation for potential back-straining hazards. Check my older post about ergonomics in the workplace for ideas about some modifications! The main thing is to support your lower back (where it curves in) and to keep your feet elevated. You can place a small towel roll in this space behind your back to achieve this type of support as well.

Carpal Tunnel Syndrome

I mentioned earlier that throughout pregnancy you retain a lot more fluid. This increase can often result in the nerves in your arms and legs becoming slightly compressed by bigger vascular structures or edematous soft tissue. If you find your feet or arms going to sleep more easily, this is why. It is common for women to experience temporary carpal tunnel syndrome while pregnant because of this. I had it a lot in my first pregnancy. To help with the tingling/numbness, check out my old post about Carpal Tunnel Syndrome with easy remedies.

Stretch Marks

50-70% of women experience stretch marks during pregnancy. I’ve been lucky enough to not get a single stretch mark last pregnancy or this one (knock on wood). Stretch marks are the body’s response to drastic change in skin growth. It’s actually due to hormonal changes from weight gain and not from the actually skin stretching. For some, the susceptibility of stretch marks is mostly hereditary. Current scientific research does support the theory that creams and oils will effectively treat stretch marks. However, keeping skin hydrated can help it stay more elastic to prevent the excess stretching.

There are a few steps you can take to possibly reduce the prevalence of stretch marks. The main approach I took while pregnant was HYDRATION…both inside and out. (Drinking copious amounts of water during pregnancy is great for you and baby for noncosmetic reasons as well). You want to keep your skin moisturized at all times during this period of rapid growth. Avoid any creams or oils with retinols, as these are not safe for you or baby. I swear by Burt’s Bees Mamabee Oil which has vitamin A & E. I didn’t just apply it to the belly, but all over! Not to mention it smells deeeeelicious. I started using from the day I got pregnant and months after I had the baby as I was losing weight more rapidly than I had gained. The key is also to massage your skin with the oil to help stimulate the skin cells. It can also be a fun activity for the daddy-to-be 😉

Here are some more information resources about stretch marks in pregnancy:

Prevention of stretch marks

Treating stretch marks

 

Good luck to all the mamas going through the third trimester! Hope this helps you get through to the homestretch! Don’t forget, after sacrificing your body for 9-10 months, you’ll receive the best reward you’ll ever have in your life. Do you have any tips or products that have worked well for you during your pregnancy? Feel free to share in the comments!

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