Monday, October 7, 2013

The Last Few Weeks of Pregnancy: What to Expect

Pregnancy is a crazy time. It'll throw you for a loop over and over again. (May as well get used to the idea; babies and kids will surprise you at every turn, too!) But now you've finally made it to the third trimester, the last three months, the almost-end. You think you've experienced it all. You've gotten through morning sickness, back aches, frequent peeing, and lots of tests. You've dealt with constipation and heartburn and insomnia.

And then you hit about 36 or 37 weeks.

Just when you thought pregnancy couldn't get more uncomfortable; just when you thought you couldn't get more impatient for your baby to be born, you hit the home stretch.

I firmly believe that the last bit of pregnancy is so unpleasant so that you'll wish for labor just to get pregnancy over with. Otherwise, labor is pretty scary to contemplate, but if it means being done with this gigantic midsection, clothes that don't fit, sweating in weird places, aches and pains you couldn't imagine, heartburn and reflux and shortness of breath, loose tendons and nausea and insomnia and weird dreams, peeing constantly, hemorrhoids, constipation, and food cravings, well, maybe labor won't be so bad after all! At least it will end, and take with it a lot of these other discomforts and inconveniences.

So, what can you expect in those last few weeks?

Well, having just entered week 38, myself, let me tell you what's changed in the past week or so!
  • Stronger and more frequent Braxton Hicks contractions. I've been having noticeable (but not painful) contractions for many weeks. These are totally normal and to be expected. You only have to worry if they become increasingly painful and more regular (more than 4 in one hour) and don't stop when you hydrate and rest. The contractions I've been having the last couple days are more powerful, occasionally borderline painful, more frequent, and certainly more noticeable!
  • More pain in lower abdomen. The stretching of the ligaments that support the uterus (round ligaments) continues right up to the end. In the last few weeks, the baby is putting on half a pound to a full pound per week, which means you're still having to make room for him, and you're toting around all that extra weight. This stretching causes "round ligament pain," which you've likely been experiencing throughout the pregnancy. I'm finding it just continues to increase, and at times the pain is quite intense. It passes after just a few minutes, fortunately, but it's certainly unpleasant while it lasts. (If you have any reason to suspect that the pain you're feeling is not normal, or if any pain is accompanied by vaginal bleeding, contact your provider right away!)
  • Increased pressure in the hips and pelvis. As the baby starts his downward journey to the eventual exit, his head will start putting pressure in new places. I feel like I constantly have to use the toilet, but most of the time I can't produce or don't actually have to go. (Too much information? Get used to it. Pregnancy robs you of all modesty. May as well be honest!) 
  • Reduced heartburn and shortness of breath. One perk of the baby "dropping" is less pressure on the stomach and diaphragm, which means I can breathe better and am having less acid reflux. So there's that!
  • Increased low back and hip pain. I find it increasingly difficult to get comfortable in bed, and I wake up with achy hips and lower back which often persist at a mild level throughout the day.
  • Harder to get off the floor, reach my feet. Putting on socks and shoes is a whole new adventure. And if I get down on the floor to play with the kids, sweep, or pick up toys, getting up involves a lot of grunting and groaning.
  • Less stamina. I run out of steam in the afternoon and absolutely must lie down. I often fall asleep when I do. Any extra physical activity takes more out of me than it normally would, so even going food shopping or taking the kids to the park feels like a much bigger energy investment than it did a few weeks ago or will after I recover from the birth.
Of all of these changes, I think the increased pressure as the baby drops is the most irritating. It's this feeling of "almost there" that is such a tease. And I know my life won't get easier once he's born, but I won't miss being pregnant, either.



It's also these big changes near the end that make women very impatient to give birth. Three weeks of this might seem interminable, and if you're one of the many women who goes "post-dates" (beyond the estimated due date), those "extra" days can be even more torturous. 

However!

Remember that every day makes a difference in your baby's development. Every day that your baby stays inside you is one more day for his lungs and brain and gut to develop properly, for him to put on fat stores that will see him through the first few days of life. Every day that you can wait is contributing in a positive way to your baby's overall lifetime health. Unless there is a medical reason for yourself or your baby that might require giving birth before you go into labor spontaneously, you are doing your baby good by being as patient as you can be. Continue your routine, pretend you've still got a month to go, make plans with friends, go for walks, see movies, go out to dinner with your partner, watch TV, read books, surf the Web, and go shopping. Pass the time. 

And if you are at or past your due date, here are some ways you might be able to help labor start, if your body and your baby are ready. At the very least, it might make you feel like you're doing something to move things along.
  • Get that oxytocin flowing! Oxytocin is the hormone that promotes uterine contractions, and there are two ways outside of labor to get oxytocin going. One is orgasm. Another is nipple stimulation. As long as your provider has deemed it safe for you, and as long as your amniotic sac isn't broken, go ahead and have sex. As a bonus, semen has prostoglandins in it, which are hormones that help the cervix ripen (efface and dilate), so if you have intercourse, you might be helping yourself in two ways. Nipple stimulation can be done in a fun way (use your imagination) or by using a breast pump. If you've got a double electric breast pump, hook yourself up for 20 minutes or so. You might even mine some precious golden colostrum, which you can save in your freezer just in case your newborn needs a little extra or has any trouble breastfeeding at first.
  • Walk! Walk up and down stairs, up and down hills. Alternatively, do some cleaning or gardening. Anything that gets your body moving in a way that will encourage your baby to move down, get his head bumping against the cervix, and open up your pelvis (squatting to clean the floor, for example) can help settle the baby into the most ideal position for giving birth. At the very least, this will help your labor be more efficient and the birth easier. At most, the physical activity might help labor get started.
  • Look up some folk remedies. Some people swear by eating certain meals, drinking certain teas, or using certain herbs. I can't recommend anything specific, and I would definitely do some research before you ingest anything that you don't know is safe.
There's no real way to know if any of these methods actually induce labor, but it might help you psychologically to feel that you are making an effort to move things along. I want to reiterate that once your water breaks, nothing should go into your vagina! The amniotic sac protects your baby and uterus from infection. Once that membrane is broken, it's very easy to introduce bacteria in places you do not want it to be. Nothing nothing nothing, not fingers, not bath water, should go up there. If your water has broken and labor doesn't start within about 24 hours, contact your provider.

How were your last few weeks of pregnancy? How did you psych yourself up for the big day? Did you try any of these "natural" induction methods? Do you think they worked? What other methods have you heard of?

Check out my Ask-Me Monday video on this same topic, also published today!

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