Third Trimester Issues

Mother in Nursery

Issue

Cause

Recommendations

Shortness of breath and dyspnea occur in 60% of pregnant women

Expansion of diaphragm limited by enlarging uterus; diaphragm is elevated about 4 cm (1 1/2 in); some relief after lightening

Good posture; sleep with extra pillows; avoid overloading stomach, stop smoking; refer to physician if symptoms worsen.


Insomnia (trouble sleeping) in later weeks of pregnancy

Fetal movements, muscular cramping, urinary frequency, shortness of breath, or other discomforts

Reassurance; conscious relaxation; back massage or effleurage; support of body parts with pillows; warm milk or warm shower before retiring.


Mood swings, mixed feelings, increased anxiety

Hormonal and metabolic adaptations; feelings about impending labor, delivery, and parenthood

Reassurance and support from significant other; improved communication with partner, family and others


Return of urinary frequency and urgency

Vascular engorgement and altered bladder function caused by hormones; bladder capacity reduced by enlarging uterus and fetal presenting part; lightening

Kegel’s exercises; limit fluid intake before bedtime; reassurance; wear perineal pad; refer to doctor for pain and burning sensation.


Perineal discomfort and pressure

Pressure from enlarging uterus, especially when standing or walking; multi-fetal gestation

Rest, conscious relaxation and good posture; maternity girdle; refer to physician for assessment and treatment if pain is present.


Braxton Hicks contractions

Intensification of uterine contractions in preparation for work of labor

Reassurance; rest; change of position; practice breathing techniques when contractions are bothersome; effleurage; rule out labor!


Leg cramps — especially when reclining

Compression of nerves supplying lower extremities because of enlarging uterus; aggravating factors: fatigue, poor peripheral circulation, pointing toes when stretching legs or when walking, drinking more than 1 qt of milk per day

Use massage and heat over affected muscle; stretch affected muscle until spasm relaxes; stand on cold surface. Do not point toes straight out if in pain — point toes towards your head.


Expansion of diaphragm limited by enlarging uterus; diaphragm is elevated about 4 cm (1 1/2 in); some relief after lightening

Edema aggravated by prolonged standing, sitting, poor posture, lack of exercise, constrictive clothing (e.g., garters), or hot weather

Ample fluid intake for “natural” diuretic effect; put on support stockings before arising; rest periodically with legs and hips elevated; exercise moderately; refer to physician if generalized edema develops; No diuretics!


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