Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0043/00437.txt

Text File | 1993-06-14 | 21KB | 365 lines

$Unique_ID{PAR00437}
$Pretitle{}
$Title{Pregnancy:  The Third Trimester:  Coping With the Changes}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{Third Trimester Coping Changes physical emotional stress
conscientious diet childbirth preparation classes employment child care infant
feeding health care Discomfort Discomforts Breath Shortness enlarged uterus
lungs Varicose Veins blood vessels Dizzy Dizziness Light-headed
Light-headedness Stand sit rise hypoglycemia Hemorrhoids constipation Swelling
Legs Feet Ankles Aches Vagina Groin Hips loosening joints ligaments pelvis
hormone Vision Psychological anticipation attention anxiety fatherhood Sexual
Relations large abdomen swollen breasts increased vaginal secretions skin
pigmentation unattractive embarrassed sexuality sex intercourse Orgasm Orgasms
amniotic sac Health drugs toxic chemicals radiation infection infections
nutritional deficiency deficiencies diet fall falling Comfort Sleep Exercise
exercising Travel traveling}
$Log{
When Resting or Sleeping*0043701.tif
To Prevent Dizziness (Caption)*0043702.tif
To Prevent Dizziness (Image)*0043702a.tif
Getting Up from Floor*0043703.tif
Comfortable Night's Sleep*0043704.tif}

Miracle of Birth


The Third Trimester:  Coping With the Changes


Keeping up the Good Work


     Throughout pregnancy, you are confronted with many physical and emotional
changes.  You may also experience stress caused by your feelings about your
changing body and your future role as a parent.  During these last three
months of your pregnancy, when you're probably just plain tired of being
pregnant, it may be encouraging to remember that most of these physical and
emotional changes are quite normal and that they'll be quickly overshadowed by
the joy you feel when you give birth.

Practical Matters in the Third Trimester

     As you get ready for the birth of your baby, you will need to continue to
be conscientious about your diet and be sure to get plenty of rest.  At the
same time, however, you'll probably also need to take childbirth preparation
classes; make decisions about employment, child care, infant feeding, and
health care for your baby; and prepare the baby's space and equipment.
     If they have not already done so, this is when most couples take a good
look at their financial situation and figure out the impact that the birth of
the baby will have.  There may be a loss of income for a while, extra bills
associated with the birth, other expenses for the baby's needs, and more.  It
is best to try to prepare yourself for these financial changes as much as
possible so that you are not caught in a financial bind when your baby is
born.

Common Discomforts of the Third Trimester

     Shortness of Breath

     As the uterus continues to enlarge during the last three months of
pregnancy, it will push up on your lungs, and you may experience shortness of
breath.  The best way to relieve this sensation is to maintain an upright
position as often as possible and avoid lying flat on your back.  The flatter
your position, the greater the pressure of the uterus on your lungs.
     It may be easy to remain upright during the day, but at bedtime, it will
take some preparation.  Before you go to sleep, place two pillows under your
head and one under your back so that your body is at a slight angle, thus
helping to relieve the pressure on your lungs.
     If you ever suddenly experience shortness of breath, especially if it is
not relieved by standing up or resting, call your doctor, since this could be
a sign of a more serious condition such as pneumonia.

     Varicose Veins

     These are common side effects of pregnancy, and they tend to become more
severe with each subsequent pregnancy.
     Varicose veins are caused by the pressure that the enlarging uterus
places on blood vessels in the abdomen that carry blood from the legs back up
to the heart.  The walls of the veins in the legs weaken as a result of being
overfilled with blood.  This eventually causes the veins directly below the
skin of the legs to bulge and ache.
     The following suggestions may help you relieve some of the discomfort of
varicose veins and may prevent them from getting worse.

  -  Elevate your legs on a stool, if possible, while you are sitting.
  -  Avoid prolonged standing.
  -  Avoid sitting with your knees crossed or sitting in one position for a
     long period of time.
  -  If it is possible during the day, take frequent rest periods and lie
     down with your head and shoulders raised slightly and your feet propped
     up on a low stool or several pillows.
  -  Avoid wearing clothing that may constrict the blood vessels in your legs,
     such as tight slacks, knee-high stockings, or girdles.
  -  Nonconstricting support stockings may be worn during the day.  Be certain
     to put them on in the morning before you get out of bed.  If you stand up
     first, which allows the varicose veins to bulge, the support stockings
     will be less effective.
  -  Elevate the foot of your bed with six- to eight-inch blocks.  This will
     raise your legs at night and reduce the pressure on the walls of the leg
     veins.
  -  When you are sleeping, lie on your left side.  This will help to move the
     uterus off of the veins in the abdomen and thereby reduce the pressure in
     the leg veins.

     If you ever experience severe pain or tenderness in your legs or notice
redness over a leg vein, call your doctor immediately.  This may be a sign of
a blood clot.

     Dizziness and Light-headedness

     Other problems caused by the pressure of the growing uterus on blood
vessels in the abdomen include dizziness and light-headedness.  Since this
pressure tends to make the blood pool in your legs, less blood is available
for your heart to pump up to the brain.  These discomforts usually occur if
you rise suddenly from a sitting or reclining position, because the heart
cannot compensate quickly enough for your new position.  Until the heart can
compensate by pumping harder, you may experience dizziness and a sensation of
light-headedness.
     To prevent this from happening, make certain that you avoid sudden
changes in your position.  Stand or sit up slowly.  For example, when you rise
from bed in the morning, use your arms to push yourself up slowly to a sitting
position.  Remain seated for a minute or two, and then slowly stand up.
     A low blood sugar level--called hypoglycemia--may also cause dizziness.
Since the baby is constantly taking sugar from your blood, your blood sugar
level may drop at certain times of the day, usually between meals.  To relieve
this, always carry a high-carbohydrate snack, such as crackers or an apple.
At the first sign of light-headedness, eat the snack.  This will usually
relieve symptoms within a few minutes.  You may also want to eat several
smaller meals throughout the day instead of three large meals, since this will
also help to keep your blood sugar level from dropping too low.

     Hemorrhoids

     This problem is also caused by the pressure that the enlarging uterus
puts on the veins in the abdomen.  The following suggestions may help you
relieve hemorrhoids.

  -  First, try to relieve any constipation (see The First Trimester:  Coping
     with the Changes), since straining to have a bowel movement may cause
     hemorrhoids to develop and will make existing ones larger.
  -  Avoid prolonged standing and sitting.  Lie down whenever you can.
  -  For relief, place witch-hazel pads, which you can purchase at a
     drugstore, directly on the hemorrhoids.  You may do this three or four
     times a day as needed.
  -  Soak in a warm bath whenever possible.

     If these simple measures fail to bring relief, your doctor can prescribe
safe medications, such as stool softeners and pain-relieving hemorrhoid creams
and suppositories, for you to use.
     If extreme pain develops in the rectal area or if you experience any
rectal bleeding, notify your doctor.

     Swelling of the Legs, Feet, and Ankles

     This common problem is also caused by the heavy weight of the uterus
pressing on blood vessels in the abdomen.  It is usually most apparent after
you have been standing or sitting for a long period of time.
     The following suggestions may help you relieve this swelling.

  -  Try to lie down or sit with your feet elevated as often as possible.
  -  Do not wear constricting stockings, panties, or girdles.
  -  Sleep on your left side with your feet slightly elevated on pillows.
     This will help to move the uterus off the blood vessels in the abdomen
     and will aid circulation in the legs.
  -  Salt in your diet may cause you to retain fluid, which will contribute to
     swelling.  While you should not severely restrict your salt intake, you
     may want to avoid heavily salted foods.  You might also try cutting back
     on the use of salt at the table if you add salt while cooking.  Consult
     your doctor if you have any questions about salt in your diet.

     While swelling of the legs is common during pregnancy, swelling of the
hands or face may be a sign of preeclampsia.  If you ever experience swelling
of the hands or face, or if your feet, ankles, or legs swell suddenly, notify
your doctor immediately.

     Aches in the Vagina, Groin, and Hips

     These discomforts are caused by the pressure of the enlarging uterus and
the loosening of the joints and ligaments in the pelvis caused by your
changing hormone levels.
     The best remedy is to avoid activities that may strain these joints and
ligaments.  Move carefully and avoid sudden twisting or bending.  Also, turn
over slowly when you are in bed or getting up.  Practicing the pelvic tilt
exercise (see The Second Trimester, For You and Your Baby) may also help to
relieve these discomforts.

     Vision Problems

     Women who wear glasses or contact lenses may find that their vision
during pregnancy is not as good as it was prior to pregnancy.  Vision changes
may occur if the shape of the eyeball changes slightly due to increased fluid
in the tissues.  (Some women experience similar vision changes five to seven
days before their menstrual period when they are not pregnant.)  If you do
have this problem, it may be necessary to have your lens prescription changed
during pregnancy.  Talk to your eye doctor about this.
     Be sure to notify your doctor immediately if you experience blurred or
double vision, since these may be signs of preeclampsia.

Psychological Changes

     The third trimester is a time of anticipation.  Soon, your baby will be
born.  During these final months of pregnancy, the baby will begin to take on
an identity of her own.  This is usually when parents-to-be set up the nursery
and discuss names for their child.
     Usually, by the time the third trimester has arrived, any ambivalent
feelings about the pregnancy have been resolved.  During this time, you may
feel very special.  If you had difficulty becoming pregnant in the first
place, the last weeks of pregnancy may take on even more significance.
     During this time, you may find that you need extra attention from your
husband, your family, and your friends.  You may need reassurance regarding
your appearance and your ability to be a good parent.
     First-time mothers often experience a great deal of anxiety at this time
about whether they will know when labor has begun.  In women who have had
children before, Braxton Hicks contractions may be so strong that they may not
know when real labor has started.  Childbirth classes, which are usually
attended in the seventh or eighth month of pregnancy, are very helpful in
educating parents-to-be about what they can expect and in relieving many
common fears about childbirth.
     For your husband, impending fatherhood may trigger memories and emotions
concerning his childhood relationship with his own father.  For some men,
becoming a father means giving up the idea of being a son.  It also means
reconciling childhood experiences with the reality of becoming a father.  In
some men, it seems that these feelings are stronger during the latter weeks of
pregnancy than they are after birth.
     Even if a man has fathered children before, his wife's pregnancy may
elicit a variety of emotions and thoughts.  He may think about the kind of
father he has been to the children that he has, and he may worry about the
additional responsibilities he will be facing.  If the father-to-be is proud
of his fathering experience, he will probably be excited about the upcoming
birth.
     Just as it was assumed in the 1950s that no father could adequately
participate in the labor and delivery experience, it is now assumed that most
fathers will.  If your husband plans to attend the birth, he may be concerned
about his ability to act as your coach during labor, especially if this is
your first baby.  Talking to other men who have gone through the experience
may be helpful.  Often, childbirth preparation classes provide the perfect
opportunity for this type of discussion.
     If your husband feels that he will not be able to participate in labor
and delivery, this should be discussed and resolved prior to the event.  You
and your husband should not feel that this decision is in any way wrong or
abnormal.
     It is very important during the third trimester for you and your husband
to communicate your needs, fears, and concerns openly and to provide each
other with support and reassurance.  Childbirth preparation classes can also
be a great source of reassurance and will increase your knowledge and
decrease your fears about the events ahead.  You may find it comforting to be
able to talk to other couples and may find that they share many of the same
emotions and concerns.

Sexual Relations

     How couples feel about sexual relations during the last few months of
pregnancy varies greatly.  Some couples may experience a renewal of the
romantic bond that may have been missing during the previous few months.
However, other couples may have a decline in sexual interest and may limit
their sexual activity.
     Some women feel quite self-conscious about their bodies during the last
months of pregnancy.  A large abdomen, swollen breasts, increased vaginal
secretions, and increased skin pigmentation may cause a woman to feel
unattractive and even embarrassed.  This can affect her relationship with
her husband.  On the other hand, some women may feel that these changes
enhance their sexuality, and they may have an increased desire for sex.
     Men, too, will have feelings about their partner's changing body.  Some
men will take great delight in feeling the baby's movements and massaging the
abdomen.  Others, however, maybe uncomfortable with their partner's physical
appearance or may fear that they will hurt the baby during sexual intercourse.
     During the last few months of a normal pregnancy, sexual intercourse
poses little threat of infection to the baby as long as the amniotic sac has
not ruptured.  Orgasm can initiate labor contractions only if the woman is
near her due date.  The erect penis will not hurt the baby and is unlikely to
rupture the amniotic sac.
     If you have developed any complications during your current pregnancy or
if you experienced complications in a previous pregnancy, however, be sure to
discuss with your doctor any limits that might be placed on sexual activity.
Likewise, if you have any concerns about safe sexual activity during
pregnancy, consult your doctor.
     It is important that you communicate with your partner and discuss how
you feel about sexual relations.  Your increasing size may necessitate some
experimentation with positions for intercourse.  You may, for example, want
to try intercourse lying side by side or with you on top.  The important point
is to find a position that is comfortable for both of you and that does not
place too much stress on your body.
     If having intercourse during these last months of pregnancy makes either
of you uncomfortable or if your doctor has advised that you abstain for
medical reasons, keep in mind that there are other ways of expressing your
love for one another, such as touching, kissing, and cuddling.
     For many couples expecting their first child, the impending birth may
make them acutely aware that they will never be simply a couple again--they
will also be parents.  This may lead to fears that they will be unable to
experience the intimacy that they enjoyed before the baby.  Other
parents-to-be try to convince themselves that life will be unchanged after
their child is born.  Neither view is realistic.
     The birth of a child will bring with it multiple changes, both in the
couple's relationship and in their daily activities and plans.  It is critical
that expectant parents discuss these issues before the birth of their child.
Expectant parents who have convinced themselves that nothing will change will
be in for a great many disappointments and frustrations.  The idea that they
are in control of so profound an experience will be a disappointing fantasy
once the baby is brought home from the hospital.
     On the other hand, those who have realistic expectations about the
pregnancy and about life with a newborn will be more likely to cope well and
perhaps even enjoy many of the changes.

Safeguarding Your Baby's Health

     During the third trimester, your baby remains vulnerable to the effects
of drugs, toxic chemicals, radiation, and infection.  Since this is also a
time of rapid growth, your baby may be severely affected by any nutritional
deficiencies in your diet.
     Even though she is protected by the amniotic fluid and your abdominal
wall, your baby can still be injured if you have an accident in which you
suffer trauma to the abdomen.  Rupture of the membranes, separation of the
placenta from the wall of the uterus, and even physical injury to the baby can
occur if you have a serious accident.
     For these reasons, you need to be especially careful during the third
trimester to avoid situations in which there is potential for injury.  For
example, you may wish to stop driving a car if your enlarged abdomen has made
it difficult for you to maneuver the steering wheel or reach the pedals.  You
should avoid standing on ladders or chairs, since you may easily lose your
balance and fall.  You should also avoid any sporting activity in which you
may either lose your balance or get hit by a ball or a teammate.
     It is also important that you keep in mind the signs and symptoms that
may indicate that a problem is developing in your pregnancy (see The Fifth
Month:  Ask the Doctor).  If you ever feel that you are developing any of
these signs, call your doctor immediately.

For Your Comfort

     Sleep

     During the last few months of your pregnancy, you may find it difficult
to find a comfortable position for sleeping.  Many factors contribute to this,
including shortness of breath, leg cramps, backache, movement of the baby, and
the large size of your abdomen.
     You may sleep in any position that you find comfortable, since it is not
possible for you to harm the baby by compressing or rolling onto your uterus.
The use of several pillows positioned beneath your head and back and between
your legs may help you to get comfortable.  If you are experiencing
shortness of breath, you may wish to use more pillows under your head and back
so that you are in a semireclining position.  A heating pad or hot-water
bottle under your back or legs may also be helpful.
     Never use sleeping pills during pregnancy, since their effects on the
baby are not entirely known.  A short walk in the open air, a glass of warm
milk, or a warm shower or bath will often help to relieve insomnia.

     Exercise

     During the last few weeks of pregnancy, it is best to avoid most forms of
strenuous exercise, including jogging and tennis, since you will become out of
breath easily and your balance may be affected by the size and weight of your
uterus.
     Walking and swimming remain excellent forms of exercise during the latter
months of pregnancy, since they are safe activities, and they will help
maintain good circulation in your legs and good muscle tone in your legs and
abdomen.

     Travel

     During the last month of pregnancy, it is best to travel no farther than
one hour's distance from the hospital in which you intend to deliver.