© 2016 MIDWIVES@BOTANY

Working hours

Mon - Fri: 8am - 6pm for non- urgent calls

No texting please!!!

Botany Downs Birthing Unit

292 Botany road

Golflands

 

Our Team:

Margie Ireland

Laetitia Pelser

Megan Switzer

Jaimee McLindon

Get in touch:

021 978 667       (Margie)

021 13 111 54      (Laetitia)

0210 202 6006  (Megan) 

021 900 915        (Jaimee)

Third Trimester (28-40+ weeks)

You've only got a few more weeks to go, but this part of your pregnancy can be the most challenging. You and your belly may be two-thirds of the way there, but your baby still has plenty of growing to do. Here's more on what to expect in the third trimester of pregnancy.

Baby’s Growth During the Third Trimester

 

Your little one will get a whole lot larger in the third trimester. Don't be surprised if his increase in size along with a decrease in living space leads to some serious kicks and pokes in your gut.

Here are a few of the highlights happening in your third trimester of pregnancy:

Around week 34 of pregnancy, baby’s body turns southward, settling into a heads-down, bottom-up position — unless, of course, your baby remains stubbornly in the breech position (in which case your doctor will likely attempt to manually turn baby around week 37).

Monitor your baby’s movements daily!

 

Usually, an active baby is a healthy baby. Some women may not feel their baby move as much as others, even though their baby is doing well. Women who are of larger body size, or whose placenta is located at the front of the uterus may not feel their baby's movements as strongly.

 

  • Being aware of your baby's movements each day is a very good habit to have during pregnancy. There is no need to keep a written record of your baby's movements, although some women may want to. 

  • We suggest that from 28 weeks (third trimester), you spend some time each day focussing on your baby's movements. Most babies move around more in the morning and in the evening. 

  • When your baby is awake you can practise feeling for movements. You will feel movements best when you relax while lying or sitting down. You will feel your baby's movements least while standing, walking or if you are busy with other things

  • Babies do not move all the time, even when they are perfectly healthy. All healthy babies will be quiet or asleep for short periods of time. Before birth, babies have similar sleep and wake cycles to those of a newborn baby.

 

If you have any concerns during your pregnancy about your baby's movements, you should first sit in a quiet place and focus on feeling your baby's movements!

 

Optimal Fetal Positioning

 

The position of your baby in the pelvis at the end of your pregnancy can influence the kind of labour you have and even the way the baby may be born. Babies can be encouraged into a more favourable position for labour, thus decreasing the chance of medical intervention.

From 32 weeks do these exercises to help get baby in a good position for labour:

 

  • Avoid all reclining positions!

  • Keep knees below your pelvis at all times.

  • Keep active, walk as much as possible.

  • Practice pelvic rocks on your hands and knees every day.

  • Take up the knee-to-chest position (sometimes called the playful puppy pose - chest to the floor, bottom up in the air) for an hour or so every day.

  • Sleep on your left side with your left leg straight and your right leg at a 90-degree angle supported by a pillow or two. This creates a ‘hammock’ for your belly and will encourage the baby to rotate. You can change sides when you get uncomfortable.

  • Avoid squatting unless you are sure baby is now anterior. Squatting can force a posterior baby into the pelvis before s/he rotates.

* Have a look at: http://spinningbabies.com/

36 week bloods

 

The blood test at 36 weeks include:

  • Full blood count and screen for antibodies

  • Ferritin (iron stores)

  • Midstream urine test (MSU) will screen for urinary tract infections

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

     

  • This is due to pregnancy hormones that soften the ligaments.

  • Correct your posture: Keep your head up, your chest up, pelvis tilted up and relax your shoulders.

  • Wear sensible shoes with a moderate heel.

  • Sleep on a good firm mattress; sleep on your side with a pillow between your knees or three-quarters on your stomach with a pillow under one drawn up leg.

  • Avoid heavy lifting.

  • Massage your back or points with lavender oil diluted with base oil eg. Grapeseed/ Olive/ Almond/ Coconut oil

  • Use a heat pad and/or warm bath

  • Try and avoid painkillers when possible. If you are really battling, use Salmon Oil and Panadol combination.

  • When standing, rest one foot on another slightly higher surface.

  • Sit on a firm stool.

  • See a craniosacral therapist, osteopath, physiotherapist or chiropractor.

Exercises to ease back pain:

 

  • Lie on your back with your knees bent and your head on a pillow. Put one hand under the small of your back. Pull in your tummy muscles until your back flattens against your hand. Don’t hold your breath. Count to four and relax.

  • Kneel on all fours and hump your back like a camel, firmly pulling in your tummy muscles and then relax. Don’t hollow your back.

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

Heartburn (also called acid indigestion or acid reflux) is a burning sensation that often extends from the bottom of the breastbone to the lower throat. It's caused by some of the hormonal and physical changes in your body. During pregnancy, the placenta produces the hormone progesterone, which relaxes the smooth muscles of the uterus. This hormone also relaxes the valve that separates the oesophagus from the stomach, allowing gastric acids to seep back up, which causes that unpleasant burning sensation. Progesterone also slows down the wavelike contractions of your oesophagus and intestines, making digestion sluggish. Later in pregnancy, your growing baby crowds your abdominal cavity, pushing the stomach acids back

 up into the oesophagus.

Many women start experiencing heartburn and other gastrointestinal discomforts in the second half of pregnancy. Unfortunately, it usually comes and goes until your baby is born. Though you may not be able to eliminate heartburn entirely, you can take steps to minimize your discomfort:

  • Avoid food and beverages that cause you gastrointestinal distress. The usual suspects are carbonated drinks; alcohol (which you should avoid anyway during pregnancy); caffeine; chocolate; acidic foods like citrus fruits and juices, tomatoes, mustard, and vinegar; processed meats; mint products; and spicy, highly seasoned, fried, or fatty foods.

  • Don't eat big meals. Instead, eat several small meals throughout the day. Take your time eating and chew thoroughly.

  • Avoid drinking large quantities of fluids during meals — you don't want to distend your stomach. (It's important to drink eight to ten glasses of water daily during pregnancy, but sip it between meals.)

  • Try chewing gum after eating. Chewing gum stimulates your salivary glands, and saliva can help neutralize acid.

  • Don't eat close to bedtime. Give yourself two to three hours to digest before you lie down.

  • Sleep propped up with several pillows or a wedge. Elevating your upper body will help keep your stomach acids where they belong and will aid your digestion.

  • Gain a sensible amount of weight, and stay within the guidelines your healthcare provider suggests.

  • Wear loose, comfortable clothing. Avoid any tightness around your waist and tummy.

  • Bend at the knees instead of at the waist.

  • Don't smoke — in addition to contributing to a host of serious health problems, smoking boosts stomach acidity. (Ideally, smoking is a habit you should break before getting pregnant. If you're still smoking and are having trouble quitting, ask your caregiver for a referral to a smoking-cessation program.)

  • An over-the-counter antacid  like Quickies, Mylanta or Gaviscon is fine to take. Magnesium or calcium may ease discomfort. Try a squeeze of lemon in a glass of water to ease the discomfort.

http://www.buzzle.com/articles/acid-reflux-remedies-during-pregnancy.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 that's important for you. Your Midwife will discuss the Birth plan with you around 36/ 37 weeks.

                                                               

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

 

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/

The Pelvic Floor

 

The pelvic floor is made up of muscles, ligaments and tissue that form a broad sling, stretching from the pubic bone at the front of the body, to the base of the spine at the back. They support the bladder, bowel and lower uterus, and give you control when you empty your bladder and bowel.

Being pregnant can place large amounts of stress on your pelvic floor and its muscles. Your pelvic floor can become weak and stretched from as early as 12 weeks into your pregnancy. Pregnancy symptoms such as constipation can stretch and weaken your pelvic floor further. This can lead to stress incontinence, (you leak a little urine when you cough or laugh, sneeze, jump or run), and decreased satisfaction during sex.

 

 

Pelvic Floor Exercises:

Research has shown that antenatal pelvic floor exercises reduce the risk of incontinence during and after pregnancy. It is a good idea to start pelvic floor exercises now.

  • Imagine that you are trying to stop yourself passing wind and at the same time trying to stop the flow of urine.

  • The feeling should be of squeeze and lift.

  • Hold for as long as possible, up to 10 seconds, breathing normally, and then relax.

  • During these exercises try not to tighten the buttocks, squeeze the legs together or hold your breath.

  • Repeat up to 10 times at least 3 times per day.

  • You can do these while washing up, driving your car, watching TV, etc. No one will know you are doing them.

 

Relaxing Your Pelvic floor:

It is just as important to learn how to relax your pelvic floor as it is to tighten it. When your baby's head "crowns" or emerges from your vagina, during the second stage of labour, your muscles need to relax. A relaxed pelvic floor during the second stage of labour can help prevent tearing or episiotomy. Also, if your muscles cannot relax properly, your pelvic floor exercises won't be working as effectively and strongly as they should, and your muscles will tire quickly. After you have tightened your pelvic floor muscles, make sure you relax them fully before tightening them again. For some women, a gentle push out at the end of each pelvic floor contraction will help. Getting your breathing right will help with this.

FINAL COUNTDOWN: the last few weeks- almost there!

 

  • Weight gain should slow down and you may even lose weight in the last few weeks.

  • Keep your bowels “moving”! Have lots of water, fresh fruit and vegetables, exercise and drink prune juice. Let us know if you are constipated. Phloe Health capsules are an excellent option.

  • If you are having your first baby his/her head usually engages in the pelvis at 36-37 weeks. With subsequent babies this may happen later, possibly even only when you go into labour. This reduces pressure on the ribcage and makes breathing easier. Braxton-Hicks contractions get stronger in preparation for labour and you may notice an increased need to urinate as your baby pushes down on the bladder

  • Ensure your car has fuel in; keys are close by; and you have enough credit on your phone to call your midwife (NO TEXTING PLEASE!)

  • From 35 weeks you can start looking at natural remedies to prepare your body for labour, these are optional and up to you to research and decide if you want to do them. You can start drinking Raspberry Leaf Tea from 35 weeks which helps tone the uterus. Some people take 5W too. Craniosacral therapy and/or acupuncture work well too. Evening primrose oil from 36/37 weeks can help soften the cervix.

  • Perineal massage: Use a small amount of almond oil and massage the outside area of your perineum to encourage stretching during labour