Managing Third Trimester Challenges
Most people will experience a few of these issues at some point in their pregnancies. If you’re experiencing something not listed here, it may be in pages for First Trimester and Second Trimester Challenges.
Indigestion/Heartburn/Acid Reflux
Why it happens:
Your digestive system (stomach, intestines) is being squished into a much smaller area as your uterus takes up more and more real estate. This can cause you to feel full and bloated quickly; you may also feel nauseous and queasy.
The changes to your body can also push your stomach - and the acids it releases - closer to your esophagus, and pregnancy hormones relax the sphincter of your esophagus, allowing more acid to move up. This can lead to a burning sensation in your chest and throat, and even a sour taste. (FYI - “heartburn” has nothing to do with your heart!)
How to relieve:
Eat smaller, more frequent meals and don’t drink much water with meals, to avoid overfilling your stomach
As weird as it sounds, it can help to look at your food for a few minutes before eating so that your brain sends signals to your digestive system to prepare
Avoid lying down after a meal; instead, taking a short walk might help. Gentle twisting can also help stimulate digestion
If experiencing heartburn at night, try to have dinner earlier so you feel better by bedtime; and if still feeling it, prop your head up while sleeping so that acid is less likely to come up from your stomach
In terms of OTC medication, two main options:
TUMS can provide occasional relief, but if taking very frequently (i.e. multiple times a day or over the maximum listed dose), it may cause problems, in which case you should switch to Pepcid
Pepcid is recommended for daily use, and is taken preventatively, 30 mins before breakfast and 30 mins before dinner
Back Pain
Why it happens:
The growth of your belly and boobs can shift your center of gravity and change your posture, putting strain on your back and causing shoulders/back to hunch forward. Some women overcompensate for these changes by pushing their bellies forward and leaning back, which can also hurt the back.
How to relieve:
Focus on maintaining a tall, straight posture - pull shoulder blades back and down, keep pelvis in neutral rather than tilted.
When lifting heavy objects, use your leg muscles rather than your back
Stretching/yoga can both alleviate and strengthen (15 min routine here):
On all fours: hip circles, pelvic tilts, cat/cow, thread the needle, child’s pose, single arm row, donkey kicks
On back: rocking happy baby pose, bridge pose, windshield wiper knees. For upper back pain, add in shoulder and neck rolls.
Consider getting a foam roller to massage your back and release some tension, and/or a belly band to relieve some of the weight/pressure (cheaper option here)
Treat yourself to a prenatal massage (SF options here)
Sciatica
Why it happens:
The sciatic nerve ( runs from lower back all the way down the leg) can get pinched by the expansion of the uterus and increased weight. Baby’s head itself may even be resting on the nerve
This can cause sudden, shooting nerve pain in the lower back or butt, or more a tingling “pins and needles” feeling
How to relieve:
Warm compresses
Avoiding sitting for too long
Swimming can take pressure off
Yoga poses that can provide relief include lunges, pigeon (or seated figure 4 if more comfortable), cat pose, downward dog, or forward fold. Full yoga video here.
Symphysis Pubis Dysfunction (aka Lightning Crotch)
Why it happens:
During this phase of pregnancy, the ligaments in the pelvic area become loose (due to relaxin) and the gap in pelvic joint widens. This helps accommodate baby for birth but can cause instability and pain in the meantime. The pain ranges from slight pinch to searing pain. Common triggers are walking, getting in and out of bed or the car, going up and down stairs, getting dressed.
How to relieve:
Pay attention to what kind of movements trigger your pain and avoid those! For instance, instead of standing on one leg to get dressed, try dressing from a seated position. Avoid exercises that exacerbate pain, such as deep squats, single-leg movements like lunges, or high impact movements (e.g. jumping).
Focus on maintaining a neutral alignment as you stand or walk, rather than jutting your hips forward. Avoid the pregnancy waddle (where your legs are out extra wide and you move side to side like a penguin!) because it can exacerbate the pain
Strengthen the pelvic muscles with pelvic tilts, cat pose, bridge pose, Kegels, and “belly breathing” (sometimes called 360 breathing, diaphragmatic breathing, “hugging your baby”).
Hemorrhoids
Why it happens:
Hemorrhoids are swollen veins in the anus that can cause pain or itchiness while pooping (and blood in stool/toilet). Your growing fetus puts increased pressure on the veins of your anus, causing them to swell - plus, veins are dealing with higher blood volume than ever before. Constipation - which is common during pregnancy due to hormonal changes - can also contribute to hemorrhoids
How to relieve:
Avoid constipation by eating more fiber, hydrating, exercising, and/or taking pregnancy safe OTC medicine: Colace (stool softener), Miralax (laxative), Metamucil (fiber-based laxative)
Apply an ice pack or witch hazel to the area to reduce swelling and pain
Soak in a warm bathtub or a sitz bath
Carpal Tunnel Syndrome
Why it happens:
The swelling in the hands due to increased fluid volume can pinch the median nerve in your wrist. Can cause tingling, numbness or pain, and is made worse if you spend most of your workday typing.
How to relieve:
Take breaks and stretch your hands often - this video includes some useful stretches that can help drain the fluid
If stretching doesn’t help, consider using a wrist brace or splint (worn day and night) to immobilize the area and relieve the nerve pain
Diastasis Recti
Why it happens:
This is the separation of the ab muscles caused by the protruding belly. This is very normal - by the end of pregnancy, most women have this to varying degrees, measured by the size of the gap. Unless it’s really extreme, Diastasis Recti isn’t harmful; it’s more of a cosmetic worry for some women since it can look like a bit of a bulge or “pooch” postpartum.
How to relieve:
There a few steps you can take that might help:
Log roll out of bed instead of trying to sit up straight - bend your knees, roll to the side, and use your arms to push yourself up into sitting position
If you have to lift something heavy, do it on the exhale, as this can help engage the pelvic floor and protect the abs
Choose the right core exercises: opt for planks, birddog, glute kickbacks and bridges, rather than situps or crunches. If you notice your stomach “doming” or “coning” while doing a workout, stop the activity.
That said, there’s only so much you can do to avoid it - your genetics, your torso length, size of baby, the length of your labor and other factors outside of your control can impact the severity
Postpartum, it usually resolves itself within 6-8 weeks or so; for some women, it may take longer and require special exercises to heal the muscles (or in extreme cases, surgery)
Increased Fear/Anxiety
Why it happens:
While normal at any stage of pregnancy, you may find yourself experiencing increased fear and anxiety as you approach the end. Of course, there’s worry about impending birth itself, but it’s also common to have a more generalized uptick in emotion, even in areas that feel completely unrelated to pregnancy/birth/motherhood. Personally, for me it manifested in fear of myself or my husband getting in a car accident! The stakes of everything just felt higher and scarier.
How to relieve:
Extremely normal and adaptive to be more anxious as you’re about to bring a child into the world! Talking about it, rather than bottling it inside, can help.
However, if it is affecting your ability to function and enjoy the things that used to bring you joy, it may be worth meeting with a perinatal psychologist or psychiatrist who specializes in this area.
If in the Bay Area, here are a few recs: Anna Glezer, Michele Cilia, Erica Rath, Minton Family Therapy
Meditation is another powerful tool to reconnect in more positive ways with yourself and your pregnancy. Below is an affirmation meditation I created specifically for the third trimester
These affirmations are intended to bring greater joy and self-love to this phase of your pregnancy, especially if you can make time to listen to them on a weekly (or even more regular!) basis.
(also available on Spotify)
