BLOG BY Rhiannon Lambert, BSc MSc RNutr

My Third Trimester & Tips To Help

As I finish this blog we have been hit in the UK by the coronavirus and we have had the announcement that pregnant women should be socially distancing and taking extra precautions. In these uncertain times I just want to send lots of positive energy to anyone else who, like me, is pregnant and going through not only major life changes but also entering the unknown with an added pressure and responsibility.

If we are all kind to one another as a community we can all get through this together!

LISTEN TO YOUR GUT

After a worrying and pretty scary experience at A&E towards the end of my second trimester, I really thought that would be the toughest trial of my pregnancy, but I have been proven wrong. Thankfully my little man and I are fit and healthy but I did have to take antibiotics for the first time in years, something I felt so guilty doing even though I know there is no harm to the baby. Those internal voices speak to you constantly in the pregnancy as you are already technically a mother, you feel extremely anxious. It really demonstrated to me the magic of listening to your gut, as a mum to be you know best and when something doesn't feel right please don't be scared to ask for help. Your midwife will always be happy to help, I felt guilty taking up their time but if I hadn't gone in that situation things could have escalated badly.

SYMPTOMS

Turns out my trip to A&E wasn’t the only trial I would face, from week 27 I started to feel as if my vagina was bruised, walking around felt so strange and suddenly uncomfortable and painful. I now know, writing this blog at 37 weeks that I have what is known as Pelvic Girdle Pain (PGP or SPD), which affects 1 in 5 pregnant women. It can make moving in the bed at night painful, changing your clothes is difficult as you can't stand on one leg, and getting comfortable is tricky as well as day to day tasks being tough.

A positive symptom you may experience on a daily basis is the magical movement. I have to laugh sometimes when my little baby moves and pushes out in my belly in the most awkward positions, his little bottom cresting a mountain shaped dome, I have named it Mount X. It's not always comfortable but when you feel those little feet and annoying hiccups you can't help but be in awe of your body.

This isn't as common but I experienced nausea again from around week 33, it has meant rushing to the loo in some situations to be sick and then delivering a talk or event with my work. The change in hormones and space in your stomach can have varying effects in women, for some of you it may be heartburn or just an uncomfortable feeling. 

Here’s a few other symptoms to be aware of in the third trimester:

1.Back Pain

2.Pelvic Pain

3.Achy Bones

4.Heartburn

5.Indigestion

6.Tiredness

7.Insomnia

8.Constipation

9.Diarrhoea

My advice would be to go and get checked out by your GP or call your midwife if something doesn't feel right. Each pregnancy is unique and some symptoms vary in severity from person to person.

DIGESTION TIPS

Your hormones are causing problems with your digestion now and things can get a little slow, this is particularly true in the third trimester when we have next to no room in our body as the baby is pushing our organs and squashing you. So go easy on yourself and if you are still not eating a balanced diet keep taking your pregnancy multivitamins.

Indigestion:

• Eat little and often, when you're full you are more likely to experience heartburn and indigestion

• Cut down on drinks containing caffeine, and foods that are rich, spicy or fatty, this can also ease symptoms.

• Sit upright when you eat, ask for an extra cushion when eating out, this has really helped me and try using a pillow at home.

• Try not to eat too late, give your digestion time to settle and ensure you're getting enough water.

• Needless to say smoking and consumption of alcohol will not be helpful and should be avoided, especially with these symptoms.

Constipation:

This is very common, but there are so many additional extras you can add to your diet to help improve your bowel movements.

• Keep hydrated, now the UK doesn't have any guidelines for pregnancy but it is thought to increase fluid intake a bit. The European suggestion is 300ml more a day which is around 1-2 glasses on top of your 6-8 usual glasses of water a day. Please check that the drinks don't contain too much caffeine, I have a good YouTube video here on what to eat/drink in pregnancy which should help.

• Keep moving, the more blood flow the better for your digestion.

• Fibre, fibre, fibre, my favourite F word, we don't get enough in the UK and we need to be aiming for 30g a day. Try adding one more portion of fruit or veg or wholegrains.

BACK PAIN TIPS

Perhaps one of the most common side effects is pain in the back, legs and pelvis, being pregnant is tough, the ligaments in your body naturally become softer and stretch to prepare you for labour, which is what causes the strain. I have found exercise, walking and a good pregnancy pillow have helped immensely. Try strengthening your stomach (abdominal) muscles, which can help take the pressure off of your back.

The NHS recommends the following, I am not a physio and unable to offer anything further than what I have personally tried:

• Bend your knees and keep your back straight when you lift or pick something up from the floor

• Avoid lifting heavy objects

• Move your feet when you turn to avoid twisting your spine

• Wear flat shoes to evenly distribute your weight

• Try to balance the weight between 2 bags when carrying shopping

• Keep your back straight and well supported when sitting at work and at home – look for maternity support pillows

• Get enough rest, particularly later in pregnancy

• A massage or warm bath may help

• Use a mattress that supports you properly – you can put a piece of hardboard under a soft mattress to make it firmer, if necessary

• Go to a group or individual back care class

FATIGUE

The tiredness improves a bit in the second trimester but once insomnia and back ache combine the hormones all kick in, this trimester is tough. I have found exercising earlier in the day has helped alongside taking a nap where and when you can (if you’re fortunate enough to have flexible work hours).

The worst bit for me has been the frequent loo visits and the weight of my bump, which makes every day activities more tiring than usual. I would recommend ensuring you are eating that little bit extra in the third trimester, just 200 kcal is all it can take to get a bit of extra energy for you and focus on keeping a healthy diet. I have a section in my book ReNourish with some fabulous tips for sleep so do go and check it out and we have the UK's leading sleep expert on the Food For Thought podcast and can listen to the episode here.

A herbal tea in the evenings is going to work wonders over a cup of English breakfast tea (you should be reducing your caffeine anyway) and try to sleep proof your environment, darker lighting, less technology and even some yoga or meditation before bed helps.

Now sleep positions are important in the third trimester, from week 28 especially, research suggests sleeping on your back can double the risk of a stillbirth (NHS), try and sleep on  your side (left is recommended) and place a pillow between your knees.

EXERCISE

Naturally exercise is going to help your mood, aches and pains and hopefully sleep (perhaps wishful thinking) but it really does depend on which exercise is right for you. By this stage you may find walking is enough but I would encourage you to do some safe stretching and perhaps little bits of weights at home, even carrying the shopping where you can.

I went to have a physio appointment at complete pilates in Fulham and now use a bouncy ball to sit on instead of my chair when working and have a small ball to sit on in the pelvic area everyday. We also went back over pelvic floor activation and relaxation and breathing which was SO useful. I began to find in the third trimester that even in pregnancy classes I was struggling to do some of the core work that was so light, once I had learnt how to engage correctly without abdominal doming (a sign to look out for) it really made life a lot easier. Yoga classes are now more achievable for me with the right activation technique in downward dog and if you are able to try some online videos by qualified trainers this could help. I have saved my workouts to my movement highlights on instagram but here's a fabulous site you can try too.

Bumps and Burpees has been invaluable with my PGP. Now this has been my experience but my level 3 PT does NOT make me an expert in pregnancy training, I would recommend asking a professional always before trying something and seeking professional advice if you are unsure.

HYPNOBIRTHING

I think this hands down has to be one of the best things my husband and I have done, not only has this enabled him to be a bigger part of the journey and have a larger role with the birth to come but it’s completely relaxed my birth anxiety.

We all feel apprehensive about the unknown, what’s to come and the stories surrounding birth but I cannot recommend a hypnobirthing course enough! I used the Positive Birth Company’s online programme and it takes you through breathing techniques, language in birth, your options and rights, massages your partner can do, questions about tearing and the epidural, the science of birth, environment and ultimately, everything you could need to know.

We used the Positive Birth Company and their online programme spaced out over a month so plenty of time, as my husband and I both work very long hours and we could watch a module before bed or at the weekend.

ANTENATAL CLASSES

As I don’t have a permanent home yet or plan for my birth I decided to enrol with Bundle London as they offer classes in my current area but you can all register with your local NCTs. I would highly recommend if you are the type of person who wants to know what to expect and be prepared to attend these classes. They are also a great way of meeting other parents to be in your local area who are due the same time as you, but this is of course a personal preference

I felt that hypnobirthing and antenatal combined has really given me a complete boost in my approach to birth. It is a completely natural process and understanding your hormones, muscles and of course after the labour stage, the parenting techniques have been beyond useful! There are classes on how to care for your baby, breastfeeding and obviously preparing for birth as well as the different options from home births to Cesareans. We were so lucky to have the head midwife at Chelsea and Westminster, Vicki who was extremely inspiring.

Ultimately you need to do what works for you, pregnancy is like a rollercoaster, everyday you are aware of it, the magical kicks, the aches and pains, sleepless nights, lovely changes in appetite and so much more but we really all are unique.

If you are looking for support on your nutrition then look no further, I am fully qualified in pre and postnatal nutrition and am able to help anyone who wants to enquire further in the Rhitrition clinic just email info@rhitrition.com. The Food For Thought Podcast is also a wonderful free learning resource alongside the blogs on the website. I have steered clear of google throughout my pregnancy and highly advise you to too, Tommys charity and the NHS are the most reliable and reputable online sources or ask your health professional.

Wishing you all the very best!

Rhiannon x

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