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During the final three months of your pregnancy, the uterus continues to grow until it reaches the level of the breastbone. The growing baby also causes the uterus to expand in all directions, increasing the sensation of pressure in your lower abdomen and pelvis. If the baby’s head is sitting on top of your bladder, you may notice a return of the frequency of urination you experienced in the first trimester.

By the end of your pregnancy, the baby has grown to approximately 20 inches long and weighs anaverage of seven pounds.

The hormone called relaxin causes a softening of the ligaments that hold the joints of the pelvic bones together. This may cause a feeling of instability while walking. Other hormones cause a proliferation of small blood vessels in the skin, which lead to small red blotches known as vascular spiders.

The breasts continue to grow as they get ready to produce milk for the baby. It is common to notice clear fluid leaking from your nipples during the third trimester. Vaginal secretions also tend to gradually increase as you get closer to term.

It is common to experience a slight increase in body temperature, and many women find that they perspire more during this stage of pregnancy. This is why pregnant women find the summer heat more uncomfortable than their friends who are not pregnant.

Fluid retention, a common problem in the last trimester, causes swollen ankles, numbness of the hands (also called carpal tunnel syndrome), and varicose veins.

As you approach the time of delivery, you may become apprehensive about how you will handle the labor and delivery process, and if your baby will be normal. Many women tend to become quieter and more introspective. You may experience a nesting instinct and begin to prepare a place in your home for the new baby. During the third trimester, time often seems endless.

By the third trimester, the enlargement of the uterus may make you feel awkward and unattractive, thus decreasing your sexual drive. Some women, however, actually experience aroused sexual desires, apparently due to the congestion of the pelvic blood vessels.

You may need to experiment with a variety of positions in order to have comfortable intercourse. Some couples find that the close physical contact of massaging, touching, or caressing provides a satisfactory alternative to sexual intercourse. Many women find that orgasms cause the uterus to contract. It is very rare, however, for an orgasm to initiate labor.

Shortness of breath is a common sensation, caused by the uterus pushing up on the diaphragm. This is a normal symptom and usually improves when the baby’s head begins to settle in the pelvis. You should avoid lying flat on your back. When sitting, be conscious of sitting up straight and try not to slouch forward. While sleeping, it may be helpful to use pillows to elevate your head to an angle that is approximately 30 degrees.

Due to the increasing weight of the uterus and baby pressing down on the pelvic blood vessels and nerves, you may experience pelvic pressure and pain. You can relieve this pressure by lying down on your side and resting for a brief period of time.

Backaches during pregnancy are an almost universal symptom. Back pain results when the weight of the enlarging uterus causes an exaggerated inward curve in the lower spine. You must make a concerted effort to maintain good posture at all times and avoid wearing high-heeled shoes. When backaches occur, do exercises such as pelvic rocks or apply heat to the lower back. You could also ask your partner to massage your back or consider a professional massage or massage therapy.

Swollen ankles often occur as the pregnancy progresses. This is caused by increased fluid retention. Because the fluid gradually accumulates as the day goes on, you may find it helpful to rest frequently on your side during the day and to sleep in this position at night. Avoid excess salt, increase your fluid consumption, and make sure you are getting enough protein in your diet. Since fluid retention can be a symptom of toxemia, you should notify the clinic if the swelling is extreme or if it involves your face or hands.

Varicose veins are caused when vein walls stretch and thin out. For some people, this is hereditary. The pressure of the uterus on the abdominal blood vessels may prevent the return of blood from your legs. You should avoid constrictive clothing, particularly knee-high nylons. You should also avoid standing or sitting for long periods of time without movement. Take frequent rest periods to lie on your side with your legs level with your heart. This should be done for several minutes every few hours throughout the day. Put on good supportive stockings first thing each morning. If you have excessive varicose veins, you can order special compression stockings.
If red streaks or extreme calf tenderness occur, please notify us immediately since this could mean that a blood clot has formed in the distended vein.

Hemorrhoids occur when the veins in the rectal area become dilated and thinned out, similar to varicose veins. Relief measures include those suggested in the above section on varicose veins. Try to avoid constipation, since it aggravates symptoms. When hemorrhoids occur, avoid cleansing with a dry tissue, using Tucks or moistened cotton balls instead. If these measures fail to relieve your symptoms, you may need a prescription hemorrhoid cream with hydrocortisone.

Insomnia becomes very common in late pregnancy, but the cause is not clear. We suggest that you develop a relaxation ritual before going to bed such as having a warm glass of milk or reading for half an hour. One of the best remedies seems to be the use of relaxation techniques, which you can read about in the “Relaxation and Massage” chapter.