Trimester 3 of Pregnancy Weeks 26 – 40

As an expecting Dad you will want to know what is happening to your partner – the expecting mother. The information below will keep you updated!

Pregnancy 28 Weeks

An isolated shot of a father listening to his unborn child
An isolated shot of a father listening to his unborn child

Expecting Moms can face various health challenges during the pregnancy, and the third trimester is when her body starts to show how she is coping.    The frequency of checks by your Doctor/Obstetrician/Midwife increases  particularly in this trimester – checking on Mum’s well-being and the health of the baby.
Your Doctor/Obstetrician/Midwife will be monitoring the expecting Mom for:
•    Gestational Diabetes
•    Group B Strep
•    Anaemia
•    Pre-eclampsia – also called pregnancy induced hypertension (PIH)
Deep Vein thrombosis

The expecting mother has regular physical examinations of her weight gain, urine samples are tested, blood is tested, her fundal height is recorded – which would be increasing as the baby grows, her hands and feet are checked for swelling, and her overall feeling of well-being.

1.    Testing for Gestational Diabetes

About 1 – 3% of expecting mothers develop gestational diabetes and obese women are more at risk.   During pregnancy the placenta produces hormones that inhibit the insulin, leading to raised blood sugar levels (hyperglycaemia).   The test to see how the expecting Mom is coping with sugar is done in different ways depending on the laboratory.   You will be advised what to do, some tests involve a period of fasting, a blood sample is taken and then a set amount of sugar has to be taken, and at certain periods further blood tests are done.   This shows how well the expecting Mom is dealing with sugar loads.    The gestational diabetes may be controlled by diet alone, or the mom may need to use insulin.   The expecting Mom would be educated on her diet and any treatment she needs.    Mums with gestational diabetes may develop a lot of amniotic fluid (called polyhydramnios) which can result in the baby being born prematurely.   Because of the high levels of sugar in Mum’s blood, the other effect is that the baby may be quite large.   This may effect the choice of delivering the baby.   Once baby is born, baby’s blood sugar levels are closely monitored until baby is stable.   There is a 50% chance of the mother becoming a diabetic later in life.

2.    Testing for Group B Streptococcus (GBS)

There are various bacteria that live in/on our bodies that do not cause disease.   Group B strep is fairly common and may live in the vagina.   This bacteria can be very harmful to a newborn baby causing breathing difficulties, so most hospitals will do a vaginal swab at about 36 weeks of pregnancy – to check to see if the expecting mother is Postive to Group B Strep.   If she is, she will be given intravenous antibiotics when she is in labour.   Her baby is closely monitored in a newborn intensive care unit and receives intravenous antibiotics as well.

3.    Testing for Anaemia

Blood tests to estimate your Red Blood Cell (RBC) count are done throughout your pregnancy.   This is because the RBC carry oxygen in the blood, and your growing baby gets their oxygen from you, so it’s important to maintain your iron levels – which are needed to build RBC’s.   All pregnant women are prone to anaemia (low RBC count) and an iron supplement is recommended.   Iron is best absorbed with something like oranges.   Occasionally iron injections may be required.   The iron supplements may be constipating (occasionally they can cause diarrhoea) so make sure you drink lots of water, eat fruit and vegetables with fibre, and exercise regularly – discuss this with your Doctor.

Some expecting Mothers will accept the offer for a further Ultrasound.

4.    Pre-eclampsia  or Pregnancy induced Hypertension (PIH)

This disease only happens in pregnancy.   85% of first time pregnancies are affected, and overall 8% of pregnant moms develop this condition.

Modern day obstetric care is very advanced with treating expecting mothers with this condition.   Even so – it can develop into a serious condition and the only way to stop the disease is to terminate the pregnancy.  If the unborn baby still has a long way to go before your due date – the Obstetrician will start treatment to minimize the effects of PIH.

The reason you need to go for regular visits is that the expecting mother herself doesn’t realise she is developing this disease.   PIH is diagnosed by high blood pressure, swelling of hands/and or feet, and protein in your urine.

Pregnant Moms who are at increased risk are teenage Moms, Moms over 40 and those with existing kidney disease.

What signs should an expecting Mother look out for?

Report any swelling of hands or feet to your Health Care Professional.   These are early signs.   If the disease isn’t picked up early, you experience headache and your vision is affected.   By this stage you need emergency medical treatment.

Regular prenatal visits would show that you have:
•    Swelling of hands and/or feet (oedema – which is estimated at each visit)
•    Increasing blood pressure
•    Your urine test will show protein

Asprin may be given to try to prevent PIH from happening.

If the PIH continues it can develop into Eclampsia which causes seizures (fitting) and possibly coma.   Another rare condition known as HELLP syndrome can happen.   This is similar to Eclampsia, but blood tests show changes in the liver and blood

The only way to stop these conditions getting worse is to terminate the pregnancy.   In order to prevent furthe stress to Mom and baby – the expecting mother will be delivered by Caesarian Section.   The Mom will be closely monitored for a period AFTER the baby is born.   (If you’re a Downton Abbey fan – you’ll remember that Sybil developed Eclampsia before her baby was born and Dr Clarkson’s attempts to get her to a public hospital were ignored)

These baby are born smaller than expected


Carpal tunnel syndrome Pregnancy

Many expecting mothers experience this.   The area where the nerves and tendons to the finger pass through is called the carpal tunnel.   As the fingers and hands swell in pregnancy this area also becomes swollen.  This causes pins and needles.   This is usually worse at night when there is little movement in the hand causing excess fluid in the wrist causes swelling.

Some expecting mothers find sleeping with your hand on a pillow helps.   A wrist spint can also help.   Carpal tunnel stops after baby is born.

Possible effects on You :
•    Your breasts have enlarged and need a good supportive bra!
•    Pregnancy heartburn caused by pressure on your stomach from the very high and large uterus.
•    Shortness of breath.   It is possible to develop blood clots during pregnancy – particularly when you are not exercising as normal – so if you are short of breath and you have chest pain, or pain in your legs see your Health Care Professional asap.
•    Varicose veins and constipation are common because of the effect of Progesterone on smooth muscle.
•    Make sure you relax every day – even if only for 10 minutes
•    As the delivery day gets closer discuss your birthing options with your Doctor/Midwife.   Write out a birth plan being aware that at the time, you may need to change your plan.
•  get ready for baby’s delivery – prepare where baby will sleep and all the necessities for a newborn.

Your Baby

Baby is “viable” from 28 weeks of pregnancy – though many babies born even before this time do incredibly well due to huge advances in Neonatal Intensive care treatment.   This is also due to the fact that we now know that all the love and care the Mom and Dad bring has an even greater effect on the baby’s chances of survival.   All modern day Neonatal Intensive Care units include the parents completely – ask the Doctors and nurses how you can be involved, but even sitting next to your baby, maybe just touching a little hand, and sending loving thoughts to your baby affects your baby’s chances.
Baby weighs approx 2 ½lbs or 1.1kg, and is about 10 inches from top of head to rump (25cm).
Your baby can hear sounds, and will be moving about regularly every day.